Here's a sample letter to be used to contact your STATE legislators to ask for laws to preserve the practice of medicine. Feel free to offer modifications, suggestions, and to use it freely...
1. Google the website for your state senate and your state house of representatives ===>
http://www.google.com . Find your representative, either by zip code, county etc. Get their contact information and either send them your letter [below] from your email or from the state legislation website.
2). Give your message a title:
Defining the scope of medical practice and healthcare truth and transparency
3. Your message body:
Dear (State Senator or State Representative):
Through this correspondence, I would like to kindly request your action in formulating legislation to ensure the clear definition of the practice of medicine, that when a patient sees a doctor in a clinical setting she/he sees a medical doctor (MD/DO), and that the practice of independent medical practitioners be brought under the regulation of our state board of medicine.
I am concerned about the growing efforts of Doctors of Nurse Practitioning (DNP) and other nurse practitioners (NP) to expand their scope of practice to include the same practice rights and reimbursement rates as physicians while demonstrating lower levels of education, training, and medical liability. Currently, they are petitioning in 28 states for the right to practice medicine independently, without physician (MD/DO) oversight.
Unfortunately, this is not the role NPs are designed to fill, and this is reflected in their significantly less clinical training and the nature of their training. NPs are physician extenders, their role is to assess patients and present the pertinent findings to a licensed physician so he/she can more efficiently treat the patient, thus optimizing the number of patients they can care for each day. They are not trained to practice as independent physicians.
I oppose expanding the rights of NPs because the length depth and nature of their training is not equivalent to physicians. To qualify as a board-certified physician, one must, in general, complete 4 years of undergraduate training, 4 years of medical school (MD or DO), and 3-7 years of residency. To sub-specialize, physicians must train an additional 1-3 years. In comparison to the 11-18 years of higher education that physicians must complete, DNPs require only 8-10 years while many of these years are comprised of training to function under supervision only. DNPs must spend 2-4 years to receive a nursing degree , 2 years to receive a Masters of Science in Nursing, and a variable number of years, usually 2-4, to receive a DPN, a degree which, in many cases, can be completed entirely online without ever attending a class in person (i.e. Ball State University). However, where the difference in training is most obvious is in the huge discrepancy between number of clinical hours required for certification as a DNP compared to a board-certified physician and the discrepancy in the training for independent practice of physicians compared to most of the training to practice under supervision of DNPs.
In the instance of family medicine, certification for an NP to practice family medicine requires a minimum of 500 hours with a nationwide mean requirement of 686 clinical hours (Bray, CO, Olson KK. Family Nurse Practitioner Clinical Requirements: Is the Best Recommendation 500 Hours? J. Amer. Acad. Nurse Prac. 2009;21: 135-139). An MD/DO family medicine residency requires 9,555 clinical hours* If an NP student were to work 65 hours a week, like the average MD/DO resident does, it would take only 8-11 weeks to complete their training, while it takes a physician 3 years.
There is no logical rationale why anyone with demonstrably substandard education, training, and skills and non-independent nature of training, should be allowed to circumvent this time-tested path to practice medicine unsupervised.
I understand that while NPs and other physician extenders play an important role in healthcare delivery, they are not equivalent to physicians, and as such should not be allowed to practice without supervision or be reimbursed at the same rate as physicians. If this is allowed to happen, the quality of medical care available to the public will noticeably suffer as the likelihood that a serious condition that would be noticed by a physician will be missed by DNPs, who only have 7% of the clinical hours possessed by the physicians that they wish to emulate. As a result, grave conditions that would be caught by physicians at an earlier, more treatable stage will go unnoticed by the less trained DNP and will be allowed to progress. DNPs are seeking false credentials that will confuse the public into thinking that they are physicians.
The path to becoming a physician is already established and I, therefore, kindly ask, that you , do not support the establishment of a short-cut path so that less qualified and less knowledgeable individuals can reap the financial and social benefits of being a physician at the expense of the publics wellbeing. Furthermore, I kindly ask you propose legislation to prevent the establishment of such shortcut in our state. Thank you.
Sincerely,
[Your Name]
* assuming an average of 65hr/wk x 49wk/yr x 3yr. 65 hr average was calculated by myself but looking at the avg number of hours worked by FM residents in FL, CT, and CA.
) as : "Dr Debra Shelby, director of the Dermatology residency at USF." This is a no no.
