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Readers respond to a story on the shortage of primary care physicians.

SOLVING THE DOCTOR SHORTAGE

In his piece “Why Is It So Hard to Find a Doctor?” (October 13), Michael Fitzgerald neglected to discuss the critical role of nurse practitioners as primary care providers. Nurse practitioners are board certified, fulfill mandatory clinical hours in their specialties, and are recognized by both Centers for Medicare and Medicaid Services and MassHealth as primary care providers. Yet many of our medical colleagues do not support nurse practitioners assuming the role of primary care provider, despite evidence that nurse practitioners are cost effective and deliver safe, quality primary care. The practice I work in, Commonwealth Community Care, was established more than 30 years ago by a nurse practitioner and a physician to provide home-based care to people with severe physical disabilities. Nurse practitioners provide primary care for patients and function as the leader of this interdisciplinary team. Data collected under a global payment pilot demonstrated $1,400 in cost savings per member per month for those patients managed by nurse practitioners rather than primary care doctors. Failure to discuss nurse practitioners perpetuates the shortage of primary care providers and denies people access to safe, affordable care.

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