AAFP Responds to New York Times Editorial, “When the Doctor is Not Needed.”
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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.
Reid Blackwelder, MD
President-Elect
American Academy of Family Physicians
