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Northwest Voices

Seattle Times letters to the editor

April 6, 2009 at 5:00 PM

Putting “care” back in health care

Doctors who listen help the most

Thank you to Ellen Goodman for reminding us of the importance of a patient’s collective health, not just “subdivided body parts” [“Put the ‘care’ back in health care,” Opinion, April 3].

She writes that people want “a known doctor who can diagnose, manage, coordinate and comfort.”

I would like to add a significant component: We want a doctor who can listen.

While our doctors hold the expertise to diagnose and treat, patients hold the expertise on how they will (or will not) manage behavior change and chronic health conditions.

I’ve spend my career teaching health-care providers the not-so-simple skill of listening to their patients and including their input into a treatment plan.

Oddly enough, when patients are asked for their input, health improves. This supports President Obama’s call for reimbursement based on improved quality, not just “quantity of procedures.”

Both providers and patients have everything to gain by being equal partners and sharing responsibility in health care.

— Jonnae Tillman, Edmonds

Problems lie in payment systems

We need both generalists and specialists.

I am an ear, nose and throat doctor. Although I do procedures, I use my cognitive skills as much as any physician. I have seen patients whose problems were tinkered with by an unknowing family physician only to get the problem resolved when they came to me. I regret to say I have tinkered unknowingly. We need both generalists and specialists.

The real problem is how the system (reimbursement and administrative) does not incentivize doctors of all types to listen and think. It has nothing to do with being a specialist or generalist.

Don’t go making war between the specialists and generalists. Good doctors are good doctors. Bad doctors are bad. Goodman was right; this is an old political battle and she took sides.

A smart-thinking doctor is worth a lot, even if they are a specialist.

— Steven Short, Mercer Island

Don’t forget nurse practitioners

I read with interest Ellen Goodman’s column. While I agree with the premise of the column, I am very dismayed that the 140,000 nurse practitioners nationwide were not recognized as part of the potential solution in reforming health care.

We are not physicians, we are nursing professionals. As such, when health-care reform is discussed, nursing frequently gets ignored.

In 1965, partially in response to the shortage of primary-care providers, the first nurse-practitioner program was established. Now, 44 years later, we continue to be one of the best-kept secrets in health care.

My nurse-practitioner partner and I opened a practice in 1985 in Kent to provide primary-care services to the community and to demonstrate that in a suburban community, where access to physicians was not a problem, consumers would choose to see a nurse practitioner. They did and they still do.

In every study done — and there are thousands of them –nurse practitioners in all settings have been shown to provide care that equals or exceeds the care provided by physicians.

Why? It’s the nursing we do. Nurses put the care in caring.

— Bob Smithing, Kent

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