Nurse practitioner training not equivalent to physician education and experience

Thank you to the Southeast Missourian for publishing the informative piece March 28, 2011, concerning the collaborative practice of Bootheel Counseling Services in Sikeston, Mo.

It is well known among those of us who study the delivery of health care in our country that providing a solid base of primary care to our population will result in decreased cost and increased quality outcomes. A very important component of this primary care base is the time proven team approach that occurs when a nurse practitioner or physician assistant is working in collaboration with a primary care physician. The skills and training of each team member are very important to successful care.

Though your recent article was well done and informative, it did not seem to clearly describe the differences in training and capabilities of the team members and may have provided incomplete and misleading information to your readers.

Most nurse practitioners complete a four-year college education followed by a master's degree which could last one-and-a-half to three years, for a total of five-and-a-half to seven years of training after high school. According to the Texas Primary Care Coalition, this training takes between 2,800 and 5,350 hours.

Family physicians complete a four-year college education followed by a four-year medical school education, and then spend at least three years in a residency caring for many complex and sophisticated medical conditions. The total educational time to become a family physician is 11 years and between 20,700 and 21,700 hours of study.

There are many other differences in training and expertise between these professionals, but it is certainly most important for readers to understand these basic fundamental differences. Both types of professionals are important to our overall health care system, but they are in no way equivalent. Your recent article seems to suggest that these differences are minor in nature, and this could be unintentionally misleading to your readers.

Missouri is fortunate to be among those states that require collaboration in practice between nurse practitioners and physicians. This tried and tested team approach to delivering primary care to our citizens is very effective and efficient. Unfortunately, there are times when articles do not clearly describe the different training of the professionals involved in the primary care team. Hopefully, future articles will more clearly explain this distinction so that readers are not unintentionally misinformed.

Thank you so much for providing this additional information to your readers.

Dr. Keith Ratcliff is a board-certified family physician in Washington, Mo., and serves as the current president of the Missouri Academy of Family Physicians (MAFP).