Open letter to the American Medical Association
Dear Dr. Rebecca Patchin and the AMA Board of Trustees:
I am writing to urge you to rectify the damaging distortions about nurse practitioners (NPs) propounded recently by Dr. Rebecca Patchin in high-profile media pieces about retail store "quick clinics." Dr. Patchin has exploited her status as a "former nurse" to buttress unfounded attacks on the training and care of NPs. In particular, Dr. Patchin has claimed that physicians receive five more years of education than NPs, which is misleading at best, and suggested that NPs do not know enough to effectively diagnose or treat patients, which is plainly false.
The 140,000 NPs in the U.S. are highly trained health professionals. They typically have at least six years of college-level training, including a bachelor's degree in nursing and a two-year master's degree in nursing. Physicians in the U.S. take science and liberal arts courses in college, then get four years of health training in medical school. At most, this is a two-year difference in total formal education, and it's not clear that physicians receive more formal health care education. No doubt Dr. Patchin is counting physician residencies as education, but not the early years of NP practice, which ignores the intense challenges of those years and the fact that the vast majority of NPs have years of prior experience as registered nurses. Dr. Patchin has repeatedly claimed that she herself knew less as a nurse--but to our knowledge she was not an NP.
Extensive research has shown that NP care is at least as good as that provided by physicians. Dr. Patchin cites no research whatsoever to support her claims. In addition to rigorous formal education, key factors in the high quality of NP diagnosis and treatment include the ability to see the big health picture, to maintain a sense of one's scope of practice, to emphasize prevention and health maintenance, and to listen to colleagues and patients.
Dr. Patchin has suggested in these press pieces that patients must know when to use a "doctor's office" for comprehensive primary care, but in fact NPs themselves play a vital role in such primary care, especially in underserved communities where few physicians practice. Moreover, as skilled professionals, quick clinic NPs are well qualified to refer patients to other primary care providers when that is indicated. Because physicians compete with NPs, it is difficult to avoid the impression that comments like those of Dr. Patchin reflect economic self-interest or bias.
Public health benefits flow from the preventative care at which NPs excel. Of course, quick clinics are not meant to provide all primary care. But quick clinic NPs do provide affordable, convenient health screenings and vaccinations, health measures that have saved millions of lives. And if more people had access to such care--such as the one in six Americans who now lack health insurance--many more lives could be saved. These clinics may help many patients get care they would not otherwise get at all, and so they may be a promising new basic care model in an often hostile and inaccessible health care system.
As you know, the AMA's unfounded attacks on NPs are nothing new. In a 2005 segment about NP-staffed "quick clinics" on NBC's "Today" Show, former AMA President Dr. Edward Hill expressed "concern" that we not confuse "convenience" and "affordability" with "quality," and made clear that his concern focused on "supervision of these non-physician providers." More than 3,500 nurses and supporters--including physicians--wrote to the "Today" show and to Dr. Hill in protest, and the Center for Nursing Advocacy called Dr. Hill's office 30-40 times in an unsuccessful effort to establish a dialogue.
We urge Dr. Patchin and the AMA to apologize to nurse practitioners, to provide the public with accurate information about nurse practitioner care, and to base policy positions on scientific research and the interests of the public at large. Please refrain from conduct that works against increased access to vital primary care, and that--by erroneously disparaging nursing care--exacerbates the nursing shortage that is taking lives worldwide.
Thank you for considering my views.
Sandy Summers, RN, MSN, MPH
The Truth About Nursing, founded in 2001, is a Baltimore-based non-profit organization that seeks to increase public understanding of the central, front-line role nurses play in modern health care. The focus of the Truth is to promote more accurate, balanced and frequent media portrayals of nurses and increase the media's use of nurses as expert sources.
For more information, please contact:
Sandy Summers, MSN, MPH, RN
The URL for this page is www.truthaboutnursing.org/press/releases/2006/ama.html