Notes on the news:
- Andis Robeznieks' story on the American Medical Association criticizing a “doctor of nursing practice” program in California (ModernPhysician.com, Oct. 14) drew much reaction. Some came from physicians who fear other professionals might appropriate the title “doctor” and some from nurses who think the doctors are overwrought.
First of all, you'll find few fields in which people are so jealous of their degrees, certificates and titles. Some clinicians and executives have so many initials after their signatures that it looks as if someone spilled the contents of a Scrabble set.
But the underlying concern is that other practitioners might encroach on physicians' lucrative turf. As noted repeatedly, U.S. healthcare is the most expensive among developed nations. A large part of the cost—21%—is attributable to physician/clinical services, according to government figures. American physician fees and incomes are the highest in the world.
Of course, physicians, even though they make treatment decisions that affect a range of care, hardly deserve all the blame. Hospital care accounts for 31% of spending, 10% from pharmaceuticals and everything from administrative costs to other care makes up the balance. So as the political establishment looks for ways to slash spending, especially after the ill-conceived deficit-reduction deal, all healthcare professionals, no matter what their titles, have something in common—a target on their backs.