Letters: Readers comment on Medical Economics stories

November 19, 2010

Letters discuss remembering patients as human beings, recalling positive past experiences, and the misuse of midlevels.

Touching article evokes memories

Thank you for the touching article that Dr. Hien Nguyen wrote ("Care goes beyond sophisticated tests," [The Way I See It], October 8 issue). My father died almost 2 years ago at the age of 93, requiring 24-hour care. We had to move him to a skilled care facility, i.e., a nursing home. He first hated it because of the food, and just providing some Japanese food helped in the transition. Toward the end, I would sometimes sit with him to feed him as we watched old home movies in the common room. Some of the other residents would join us and seemed to enjoy the home movies also. Thank you for letting me shed a tear in remembrance of my own loved ones. We can, as healthcare providers, remember our patients as human beings and remind those who work with us that we may all be in this needy place and require some tender loving care.

JANE KANO, MD
Denver, Colorado

I rarely write letters to the editor, but after reading your article, I feel compelled to write ("A good job," [by Jennifer Frank, MD], October 8 issue).

My first response to you is: "Been there, done that." In the early 1960s, we opened a new community hospital, and as a family physician, I was elected as chairman of the Department of Obstetrics. I had a superb surgeon and certified anesthesiologist available 24/7. We were near a community where there were many inter-relative marriages, with a large number of infants with genetic abnormalities.

As I read your description of your delivery, tears were flowing down my cheeks. Many times in the 17 years as chair of the department, I spent countless sleepless nights.

I am proud to say that we never lost a mother in childbirth and had a fetal salvage rate that was above the national rate. I had the greatest privilege a physician can have in delivering babies.

Your experience has branded you to a life of a caring and compassionate physician. By all means, include your experience in your mentoring to the next generation of physicians. Thank you for sharing your experience.

I am 85 years old, which gives you an idea as to how long you will remember.

LYNN F. BRUMM, DO
East Lansing, Michigan

Midlevels are misused

I have read with interest the controversy about midlevels. I have never been in favor of midlevel care-physician assistants (PAs) or nurse practitioners (NPs). They have never shown me their superiority over a well-trained registered nurse (RN) or licensed practical nurse (LPN). An LPN or RN with the proper training can do as much or more than an NP for your particular practice.

I also agree with the readers who commented that midlevels are misused. I find that often the doctors do not care for routine things in the office, which allows an NP to overstep his or her training and abilities.

I have been in practice for a little over 50 years. My patient volumes range from 35 to 100 or more patients per day. I have seen every patient myself with a well-trained office nurse.

I also agree with the reader who stated that if midlevels want to practice medicine, they should go to medical school and become doctors.

JAMES P. TEMPLE, MD, FAAFP, RPH
Alexander City, Alabama