Primary-care physicians provide valuable service

charles a. ball

To the Editor:Two recent articles (“Nurse practitioners fill key role,� March 28, and “Advanced nursing fills gap in doctor shortage,� March 9) in The Tennessean with opinions by Colleen Conway-Welch, Dean of Vanderbilt School of Nursing, have suggested that the issues in health-care access and primary-care management of patients can be solved by increased autonomy of advanced nurse practitioners.

As a family physician for 30 years in rural Tennessee, I have observed the rising role of nurse practitioners and physician assistants and have supervised and provided educational clinical experience for these mid-level providers.

In my opinion, advanced nurse practitioners and physician assistants working under the direct supervision of physicians provide the best outcomes for patient care. The reasoning for the current medical oversight rules is based upon postgraduate medical educational training; two years for mid-level providers vs. seven-plus years for medical doctors.

The shortage of health-care providers in America is a real crisis. The solution is not to legislate the independent practice of nurses, but create systems that expand the work force of primary-care physicians.

Charles A. Ball, M.D., Columbia 38401

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