To the editor: Here we go again with the calls to allow nurse practitioners to practice without a physician’s direct supervision.

Nurse practitioners and doctors do not receive the same training. Doctors go to medical school for four years and then have specialty training after that. That is not to say nurse practitioners don’t have skills (they do), but they are not interchangeable with physicians.

Primary care doctors are leaving medicine because of burnout, electronic health records, having to get permission to admit patients to the hospital by talking to people who have no idea of medical diagnoses and more. Fix these things and you might retain more primary care doctors.

Until then, nurse practitioners should provide the care they are trained to deliver. They should not try to be physicians.


Deborah R. Ishida, M.D., Beverly Hills

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To the editor: I moved from L.A. to Palm Springs in 2014 and now regret my decision. I drive to L.A. every three months to see specialists. The ones in the desert area are not accepting new patients.

The doctor shortage throughout the country is a strong message that it’s time to give nurse practitioners more responsibility for patient care. Patients without financial resources or insurance are out of luck.


It’s disgraceful and unsafe in our rich country.

Donna Myrow, Palm Springs

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To the editor: Nurse practitioners would no doubt agree with your editorial, but I must point something out: Insurance reimbursement is identical for nurse practitioners under the supervision of a doctor as it is for just the doctor, so there is no cost saving there.


The editorial suggests the nurse practitioner as a replacement for a general medicine practitioner. But general medicine, like pediatrics, requires a broad knowledge base that would be difficult to assimilate in the reduced training required for nurse practitioners.

Primary care should be made financially more attractive for medical practitioners so as to encourage that path. A well-trained primary care doctor will save resources by requiring fewer specialist referrals and by offering more targeted and therefore more cost-effective management.

Adrian H. Shandling, M.D., Newport Beach