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Letter to the Baltimore Sun that we submitted January 6, 2003

Dear Editor:

Reginald Fields' January 4, 2003 article on the front page of the Sun's Maryland section ("A doctor's office rolls out") commendably highlights a St. Joseph's Hospital mobile health program that provides care to the homeless. Unfortunately, some parts of the article reflect a misunderstanding and undervaluation of the role nurses play in health care.

The story revolves around Bill Gough, the nurse practitioner (NP) who manages the mobile health program. Mr. Gough is evidently the primary care provider of the patient he is shown examining in photos accompanying the article. Nevertheless, the article describes the clinic as a "doctor's office" and claims the homeless patient "could use a physician's touch." More accurate terms might be "health care clinic" and "health care provider." Moreover, use of the term "doctor" to refer to physicians inaccurately suggests that only physicians can earn a doctoral level education. Few people know that nurses can earn PhD's or DNSc's in nursing, in part because the media fails to consult nurse experts for its stories.

The article also implies that nurse practitioners lack expertise because they consult with physicians. Yet the author does not similarly suggest that the clinic physician lacks expertise when he consults with other providers, as any competent professional would do for patients with illnesses outside his scope of practice. Nursing and medicine are overlapping professions, but nursing is not a subspecialty or junior version of medicine. Nurse practitioners typically have master's degrees requiring two or more years of graduate training--in nursing.

In these respects, the otherwise praiseworthy article appears to reflect the tendency to glorify physicians as superhumans who possess all health care knowledge and deliver all health care. While physicians deserve respect and support for their work, they do not deserve to be credited for the work of nurses or other health care professionals.

Until the media increases its awareness of the important role nurses play in health care and acts accordingly, the public will continue to undervalue nursing as a career choice, and the current critical nursing shortage will worsen. For many reasons, including disrespect for nurses by many in the media, medicine and the health care industry, nurses are leaving the profession in droves and young people are not entering in numbers sufficient to handle the increasing demand. The health of the nation can still be preserved--if everyone starts to take responsibility for how his or her behavior affects the nursing shortage.

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