12 Comments
User's avatar
steve schutzer, MD's avatar

Hey Bill. Is anyone surprised that the AMA would protect their turf and the status quo? This from the organization that still supports the RVS Update Committee (RUC) and "Relative Value Units" - an instrument of the devil. In my joint replacement practice, I had the pleasure of working with an APRN one-on-one for 23 years. In terms of patient care and decision-making, she could do 85% of what I could do as well if not better. I have not been a member of the AMA since medical school and given this entrenched stance on Nurse Practitioners, likely never will. Nice post...

Expand full comment
William H Bestermann Jr MD's avatar

Thanks so much. You made my week

Expand full comment
RBG in SWFl's avatar

Thank you for your perspective. I have been a a Family Nurse Practitioner working with an endocrinologist in private practice for 22 years. My education taught me to be a caring scholar and clinician, then my career choice gave me a long apprenticeship. A year ago we made the difficult decision to become a total concierge practice due to the diminishing reimbursement and increase in business costs. Nearly 200 people signed up for my practice, and another 200 for the MD practice. It is such a relief to be able to relax while spending time with my patients. They appreciate that I know them personally and everything I do for them. When I am asked why I didn’t “go on to be a medical doctor”, I respond that I preferred to be a nurse. We have a collaborative relationship, not a competitive one.

Expand full comment
William H Bestermann Jr MD's avatar

Understand your point completely and I share it. Nurse practitioners and physicians should collaborate on teams like yours. We have been working for four years to standardize and automate best practice care to the extent possible. If you hire more nurse practitioners and support them properly you could dramatically increase the impact of your practice. You provide the high touch and we can provide support in the form of high tech. I would love to be in touch with you. Please provide your contact information on a Subsack message.

Expand full comment
Mary O'Connor, MD's avatar

Thank you Bill for this excellent column. Happy New Year to you and yours!

Expand full comment
William H Bestermann Jr MD's avatar

It is great to hear from you and Happy New Year!

Expand full comment
William Bestermann's avatar

Good article Dad!!!

Expand full comment
William H Bestermann Jr MD's avatar

Thanks Bill

Expand full comment
Marg KJ's avatar

I’ve also dealt, VERY POSITIVELY, with nurse practitioners! I find they seem to care and they listen! Two reasons why I don’t go to a doctors offices!

Expand full comment
William H Bestermann Jr MD's avatar

They are a great resource and could help solve many of our healthcare problems

Expand full comment
Marg KJ's avatar

Not all of them. Just like ppl, politicians. Some are good and some just don’t give a damn!

Expand full comment
The Real Dr. Steven Horvitz's avatar

The AMA only represents themselves. A very small minority of physicians are members. They say things like this to try and make believe they are relevant. It’s almost like click bait to get in the news. Just ignore them whether u agree or disagree with them.

Expand full comment