Clothing, titles and even the word “Doctor” are no longer clear enough for people to understand which member of the health care team is caring for them. However, her suggestion that ultimate responsibility for the patient is the only distinguishing feature is incorrect. The deeper differences must be recognized as state legislators consider granting independent practice to nurses, as 18 states have done already. We have to think carefully about the implications of such changes for patients and the American health care system.
Saving money should not be the main factor for decisions that impact patient care and safety. Cutting costs by substituting nurses for physicians would lead the United States to two classes of care — one run by physicians and a second by differently qualified health care professionals. Some of our most needy citizens, such as those with little or no health care coverage, are most likely to lose their physician and be given a nurse. Every American deserves to have a personal physician and a nurse!