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"Physician-extenders" lack "know-how" to diagnose complex stuff, but are really good at taking out splinters

August 3, 2008 -- In today's Washington Post, physician Ben Natelson (right) puts forward condescending comments on "physician-extenders" in a "Hard Cases" piece called "Lost in a System Where Doctors Don't Want to Listen." In it, he discusses the growing shortage of primary care physicians and the "economics of modern medicine [that] have converted the doctor from Ben Casey to a factory worker on a conveyor belt." Natelson also laments his paltry $86/hour take home salary and discusses solutions to the primary care physician shortage in which he says:

Society has come up with a partial solution to the growing gap in primary care providers: "physician extenders." These master's level health-care professionals are trained to deal with commonly occurring, easy-to-diagnose problems: a flu, hay fever, a splinter, even severe chest pain. Usually, however, they haven't had enough training to give them the know-how to sort through a complex medical history to arrive at a diagnosis that isn't immediately evident. When they're stuck, they have to call the physician, and by then, the 30-minute visit is very often over. The patient is left hanging and disappointed -- on his or her own to figure out what to do next. The inevitable result: patients falling between the cracks of classical medicine.

Somehow he forgot to mention that advanced practice registered nurses deliver care that is equal to or better than that delivered by physicians.

We will have more on this soon. In the meantime, please contact Ben Natelson with your comments at and please copy us on your message at Thank you!