The American Academy of Family Physicians responded to a recent
editorial posted in the New York Times (see blog post on December 17th).
The LTE can be found below.
Letters to the Editor
The New York Times
Dear Editor,
In discussing the primary care shortage, let’s not lose sight of what
is actually needed versus what is proposed in various solutions. The solutions
in “When the Doctor is Not Needed” (NYT Editorial Dec. 15) are short-term
answers to a long-term, systemic problem. We must differentiate between
providing a service and utilizing expertise.
If we are to improve patients’ health and help restrain costs, we
need to ensure patients get the right care from the right professional at the
right time. Sometimes that means the expertise of the nurse practitioner is the
best. Other times, a pharmacists’ patient education expertise is most
appropriate. At all times, the expertise and deep clinical training of a
primary care physician is the foundation.
Nurse practitioners, physician assistants, even patients
themselves can implement health services —checking pulse and blood pressure,
monitoring blood sugar levels, giving insulin injections, and managing chronic
conditions. But they don’t necessarily have the expertise to know why the
service is needed or how to respond to complications or lack of response.
Limiting patients’ access to services provided only by a retail clinic, a nurse
practitioner, pharmacist or other health professional restricts the patient’s
access to the full panoply of available knowledge. Such solutions don’t ensure
that the patient receives the most appropriate care, nor do they prevent
unnecessary repetition of tests and procedures.
That’s why the American Academy of Family Physicians has called
for patient-centered medical homes with team-based care from all health care
professionals: physicians, nurse practitioners, pharmacists, or any necessary
subspecialty physicians. Each professional has a crucial role to play, but they
are not interchangeable. Only with such a team will patients have access to care
that is comprehensive, accessible, preventive, efficient and, most importantly,
effective.
President-Elect
American Academy of Family Physicians
