Tuesday, September 10, 2013

Nurse Practitioners Good - Physicians Bad

An internal investigation by the Department of Veterans Affairs has found that one of its hospitals in Jackson, Miss., did not have enough doctors in its primary care unit, resulting in nurse practitioners’ handling far too many patients, numerous complaints about delayed care and repeated violations of federal rules on prescribing narcotics.
The investigation found no evidence that care had been compromised in the primary care unit, the vital first stop for many patients. But it concluded that there were enough problems “to suggest there may be quality of care issues that require further review,” a copy of the investigators’ report says.
These were the leading paragraphs from an article in the Sep 9 NY Times about major problems affecting a VA hospital in Mississippi.  Further along the article goes on to describe other concerns, particularly those regarding a radiologist (a physician, by the way - not a nurse practitioner!) who misread multiple X-rays and CT scans.  A large number of patients will now have to be recalled for re-evaluation.  
With this real issue of medial malpractice, not to mention, complete physician incompetence displayed by the radiologist, I was astonished to see that the opening paragraphs deal not with this horror, but with the fact that many patients, in the absence of an adequate number of physicians in the primary care area, actually had to see nurse practitioners!!  God, how bad is that!!  But then the reporter informs us that there was "no evidence of that care had been compromised....."  Is that supposed to be a surprise??  
This Blog has always been a strong supporter of nurse practitioners.  They are well trained and extremely capable.  It is wrong for the NY Times to highlight primary care by nurse practitioners as a "failure" of care in its initial description of the problems of this hospital.  Care by nurse practitioners can easily be equal to (and sometimes even exceed) that of a primary care physician!!  The major issue of poor quality of care at this VA center wasn't in the area of primary care, but the physician-radiologist - the MD, not the NP!

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