Readers React: When it comes to healthcare, doctors really do know best

To the editor: Christopher Glazek gets it wrong about doctors and nurse practitioners, or NPs. (“What’s best for doctors is best for patients? Maybe not,” op-ed, May 11)

Healthcare delivery is shifting toward team-based, comprehensive care led by physicians in collaboration with professionals from a variety of fields. These reforms, brought on by the Affordable Care Act, are meant to drive down costs while maintaining quality care.

SB 323 would allow NPs in California to perform a wide range of medical procedures with less physician oversight. Glazek says that this would not result in independent practices of NPs; in reality, under SB 323 many NPs would “doctor shop” and set up clinics with only a figurehead physician providing oversight.

Proper physician oversight is crucial to maintaining quality care. Unfortunately, the bill undermines the team-based, physician-supervised care envisioned by the healthcare law. I encourage Glazek to consider the full range of consequences that would occur if this bill becomes law.

Pedram Salimpour, MD, Los Angeles

The writer is president of the Los Angeles County Medical Assn.

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To the editor: I have been a certified nurse midwife for 34 years. In that time I have worked with many NPs, midwives and physician assistants.

These people are dedicated providers who deliver safe, competent and compassionate care. When I was a midwife at Kaiser Permanente for 28 years, I worked with more than 20 others who delivered thousands of babies in a safe, collaborative practice.

I always considered our group as experts in low-risk management of women in the field obstetrics and gynecology. Our caesarean section rate was very low, and we provided epidurals and fetal monitoring when needed.

I find it offensive when I hear someone say that NPs, physician assistants or midwives deliver substandard care. In fact, as highly trained professionals we need to be seen as integral members of our healthcare system, not as a minor addition. We can definitely make a difference.

Holly Hurwitz, San Diego

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