Washington Post – Don’t be spin doctors for MDs
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Every week, The Post runs a collection of letters of readers’ grievances — pointing out grammatical mistakes, missing coverage and inconsistencies. These letters tell us what we did wrong and, occasionally, offer praise. Here, we present this week’s Free for All letters.
When framing the debate regarding full practice authority for nurse practitioners, the Aug. 21 Politics & the Nation article “Are we entering an era of medicine without doctors?” left out two critical elements.
First, the phrasing of “supervision” is misleading. It is not a requirement in any state for a nurse practitioner to be directly watched over by a physician. Instead, in 23 states, nurse practitioners are required to enter into contracts with physicians. This often amounts to little more than pieces of paper. Physicians in all 50 states often provide very little oversight of nurse practitioners.
The second missing element was the financial incentive doctors have to maintain the status quo. In the 23 states that lack full practice authority, nurse practitioners have to pay to enter into contracts with physicians — and the fees are not nominal. Although they average $750 per month, they can cost as much as $2,000. This fee reduces the incentive for nurse practitioners to want to practice independently from physicians — thus limiting their potential and restricting access to care.
This is not a debate about health and safety; it is a debate about economics and how much financial control physicians should have in the marketplace for health care.
Edward J. Timmons, Morgantown, W.Va.
