Don’t Underestimate Differences Between Doctors and Assistants

Regarding “Healing Powers” (Dec. 25): Nowhere in the article did you ask the nurse praticioners or nurse assistants whether they take their own family members to nurse practitioners or nurse assistants for their medical care.

I have been amazed at how medical paraprofessionals will seek the best medical doctors for the care of their own family. The same people will, with a straight face, emphatically state that their care is as good as a medical doctor for the poor.

Nobody likes going to have a tooth pulled at the dentist. Would you advocate using nondentists to provide dental care? You will find that almost all the medical clinics in poor areas are staffed only with physician assistants, with medical doctors playing a very peripheral role in care of the patients. There is no reason why all people cannot be seen by licensed and trained medical doctors.

After reading your article, I am convinced the only solution to fair and equal medical care for all is [universal] coverage such as Medicare. I am afraid that the only people who benefit from providing this kind of care to individuals are the owners of clinics who save money from not providing medical doctors to see the patients.

--ADRIANA BURGER

Los Angeles

*

Physician assistants may be a boon to medical economics, but the patient should be very aware there is a very big difference between the training of a doctor and that of a physician assistant.

I raise this cautionary note because several years ago, we had an experience in which a physician assistant diagnosed classical brain aneurysm symptoms as flu symptoms and sent my wife home to take aspirin. The supervising doctor rubber-stamped the diagnosis. Fortunately, persistence got us to a doctor who performed the appropriate CT scan diagnostic and scheduled immediate surgery.

Doctors can also err in diagnosis, but it’s all a matter of probabilities.

JOEL SCHRIER

Los Angeles