Team-based care needs physician leaders, not nurses, and other letters

In regards to the article “AMA to Joint Commission: We're the head of the medical household,” it's important to note that this topic is much more far-reaching than just its impact on the medical home.

Many specialties work closely with allied health professionals and view them as integral members of their care teams. In anesthesia, we highly value the work done by anesthesiologist assistants and nurse anesthetists. Working under the supervision and direction of physicians means allied health professionals do more than just provide necessary medical services. They help increase access to and quality of care across the continuum.

The Joint Commission, in its establishment of the Primary Care Medical Home, seemed to have forgotten the importance of that key element—physician leadership of the team. The medical home, the surgical home and every version containing a care team must have physician leadership if we are to provide top-quality, state-of-the-art care.

While the Patient Protection and Affordable Care Act has changed much of how we deliver healthcare, our challenge still remains to provide more, while maintaining the high standards the medical profession demands and our patients expect and deserve.

Dr. Michael B. Simon

Regarding the online story “VA audit finds long waits, employees coerced to alter records,” don't VA employees have to go through annual ethics training?

I would think that just because they are coerced, that is not something that precludes them from being held responsible for their actions. Such training would have taught them that it is not always about following what the boss tells them to do. They should consider if what they are being asked (to do) is against the law or unethical and if so, they not only have a duty to do the right thing, but can be fired if they do the unethical thing.

Pat daCosta