Re: your March 11 editorial concerning passage of H.B. 784 -- giving nurses or physician's assistants the right to write prescription medications for patients:
I take note of the fact that you are against this practice. As you say, "Given the choice, we all want the best doctors we can find to diagnose and treat us. We also want the best health care we can afford. ... House Bill 784 would grant prescription writing rights to registered nurses if they have a signed collaborative agreement with a sponsoring doctor."
I'm a retired military man, 100 percent disabled and getting my care from the Veteran's Administration Hospital. The Clinton administration has been hell-bent on reducing its armed forces, bases, training facilities, equipment, personnel and medical expenses. There are cases where the Base Realignment and Closure Commission has closed nearby base facilities and retirees living in those areas have had to drive long distances for care in VA facilities.
The staff, equipment and funding for our VA sites have been reduced to the point where it is a national disgrace. For many years now, I and other veterans have been placed in "primary care teams," and many of them have physicians assistants or nurses who see the patient in lieu of the doctor. They do the runup or background history of the complaint, consult with the supervising doctor and then write a prescription for the veteran, based upon the decision of the doctor.
On more than one occasion, the doctor himself examines the patient to confirm the diagnosis. As a double check, the patient goes to a pharmacist who reviews the prescriptions and advises of any contra-indications before adding the prescription to the computer database on that patient.
I have no qualms about this type of service, as it is one method for the VA to deal with the caseload of patients despite the shortage of doctors, and it reduces the workload of the doctors.
"A nursing degree, requiring four or five years of schooling, is not in the same league as a medical degree, which calls for four years of undergraduate, four years of medical school, one year of clinical internship and three to five years of clinical residency," added the editorial. "Prescribing medications is a complicated process, fundamentally based on accurate diagnoses, and is one of the critical aspects of a doctor's job."
You'll get no argument from me on those words. But I say that if a doctor is overseeing the diagnosis and proposed prescription -- nay, even double checking the patient himself -- where is the harm? The VA is doing an admirable job, considering the circumstances they have to work under.
I say H.B. 784 is a godsend to the overworked staff. Another plus: It shortens patients' stay at the clinic. I hope the General Assembly understands this from the veterans' viewpoint. I've written them in support of its passage.
John E. Hunt, SFC, USA (Ret.), Augusta
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