Editor's Note: which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Rebekah Bernard, MD, a family physician at Gulf Coast Direct Primary Care in Fort Myers, Florida. The views expressed in these blogs are those of their respective contributors and do not represent the views of or UBM Medica.
Editor’s Note: The author spoke with all physicians involved in this blog. All four physicians reviewed the text and approved the details.
The last thing Steven Maron, MD, expected when he was called into his administrator’s office was to be fired. The Arizona pediatrician said he had never faced any disciplinary actions throughout his 10 ½ years with the organization, and although he had written an opinion piece about nurse practitioners (NPs), he had expressed nothing but admiration, calling them “well-trained, dedicated, popular with patients, and intelligent.”
Which is why the veteran physician of 31 years was stunned when he was abruptly terminated from a Federally Qualified Health Center (FQHC) just days after the article was published in the Green Valley News.
Maron told me he was specifically told he was being terminated because “my article stood in opposition to the principals of the organization, specifically the principle of mutual respect.” He added that his official termination letter stated, “the company exercises its right to the 90-day out clause…”
Maron wrote the op-ed in response to a pro-nurse practitioner article published the prior week that began with the following sentence: “Going to see your family doctor for basic needs may soon be a thing of the past.” In “In My View: Are NPs same as MDs?,” Maron presented an opposing point of view: that a physician’s training of medical school, residency, and subspecialty fellowship, as well as inpatient management exposure, adds an additional dimension of care that separates physicians from nurse practitioners.
While he referred to nurse practitioners as “a great asset” and even asserted that some could “teach some of us physicians a thing or two about bedside manner,” Maron had the audacity to make the following statement: “I am quite concerned about the implications that NPs completely replace physicians. It was never the intent when NP programs were begun to replace physicians, but to function as supervised physician ‘extenders.’” Uh oh. Apparently, those are fighting words. Or more accurately, firing words.
Unfortunately, the biggest losers in this situation are the patients of Maron’s former employer—patients who utilize FQHCs are some of the neediest and most underserved in the country - who have now lost a dedicated and experienced pediatrician.
Other physicians have reported job loss for speaking about patient safety issues and non-physician provider care.