Readers Respond

August 11, 2009

Team approach best for primary care

The article "Nurse practitioners pick up the slack in providing primary care" (Aug. 9) makes an important point about building our primary care workforce. However, it should be expanded to mention the importance of team care in providing high quality primary care.

Nurse practitioners and physicians ideally function in a close professional relationship, communicating frequently such that each can bring his or her own insights to a clinical issue. Nurses, physician assistants, administrative staff and other health professionals are often members individually or in various combinations of a primary care team. The more complicated the patient's ailments, the more important it is to have a highly effective team. This requires frequent communication of changes in a patient's condition.

While team care may seem duplicative, it actually can be more efficient and bring to patient care the wisdom and judgment of several health professionals. There are models of such team care that demonstrate their effectiveness and popularity among patients.

Current health care reform provides an opportunity for innovation in primary care, including team care.

Dr. John R. Burton, Baltimore The writer is a professor of medicine and director of the Johns Hopkins Geriatric Education Center and Consortium.

Vendors fund MACO, not just taxpayers

After reading Mike Gimbel's comments regarding stopping the Maryland Association of Counties Conference this year (Readers respond, July 28), I have only one question. Why didn't you suggest this in January, 2009?

We are a vendor at MACO and could have saved $1,200 for a booth, union fees for booth assembly, hauling in boxes including "...pens, pencils and other useless gifts," hotel rooms, food, etc. When you make an assertion that the taxpayers pay for all of this, you are wrong.

We are a commercial venture and not the only business there that supports this convention through our fees. Government agencies display there as well (at a reduced booth rental rate). Prior to the conference, the agencies that I came in contact with were either using giveaways they already had in inventory or not at all.

Jerry Chiat

Save crab picking jobs for citizens

Your article, "Seafood processor scrambles for visas" (Aug. 8) prompted me to reply. I am an immigrant who used to prepare amnesty and other immigration applications. The United States still has millions of able-bodied welfare recipients, non-violent prison inmates and millions of other unemployed workers. Why shouldn't the federal government seriously enforce our immigration laws across the board and enact some sort of immigration moratorium so that we can put the above American citizens and legal immigrants to work?

Those steps not only will increase employment opportunities for jobless American citizens and increase income tax revenues, they will save tens of billions of dollars a year in unemployment and welfare benefits. President Obama and Congress should be reminded that the U.S. is broke and we are no longer the prosperous nation we once were!

Yeh Ling-Ling, Oakland, Calif. The writer is executive director of Alliance for a Sustainable USA.

Abortion op-ed is off base

I'm writing in response to Penny Young Nance's op-ed "He's just not that into you," (August 6). First, the United Nations Population Fund does not promote or coerce abortions. Several groups sent to China, the state most often accused of these practices, reported no evidence at all for U.S. claims of UNPF collaboration.

Second, for many people who suffer from diseases such as cancer, Parkinson's, multiple sclerosis and others - or who need organ replacements or spinal regeneration - stem cell research using already created embryos that that would otherwise be discarded is absolutely pro-life and a sensible course of action.

Three, were permission granted to all people who do not wish to support government actions with which they are in religious or philosophical disagreement, the government would fall. I, for example, might choose to de-fund wars because, as the hippies of yore used to say, wars are not healthy for children or anyone else!

Fourth, the majority of Americans over the decades since Roe v. Wade has accepted abortion. Not happily, and not without thinking about its implications, but nonetheless, most feel that individual decisions should remain with the individuals who must live with them. Fetuses, after viability in the third trimester, have protection, though not in 100 percent of cases. Would anyone wish to bear a child with irreparable damages? Would anyone wish to bear a child at the cost of her own life? Though you might say yes to each question, would you mandate your answer for other women?

Finally, it is a relentless and reckless lie that "almost all the health care plans" under the current reform proposals would be forced to include "unlimited numbers of abortions for any reason." No one knows the wording of the final statutes, but lawmakers who have responded to the abortion issue have said that the government - which presently does not pay for abortion - would continue this policy.

Mary S. Dagold, Baltimore

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