FOR COST-EFFETIVE HEALTH CARE, DON'T NEGLECT NURSING
I agree that "Public health is in a bad way" (Science & Technology, Aug. 17) but you ignored a major sector of health care that is cost-effective and provides primary, low-tech, and inner-city care to those most in need: nurses.
Medical journals have published studies demonstrating the diagnostic certainty, quality enhancement, and effective, efficient primary care that advanced-practice nurses provide. All states currently reimburse advanced-practice nursing services, and 41 states authorize prescriptive privileges for these nurses.
Why should a medical student, who incurs three times the cost of a nursing student, confine a career to primary care, which is not very lucrative? And why should the public pay three times the bill (both in educational subsidies and in salaries) to physicians for services provided equally well by nurses?
Mary O. Mundinger
Dean & Professor
Columbia University School of Nursing