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  1. Opinion

Why doctors still need to supervise nurse anesthetists

Here’s what readers are saying in Wednesday’s letters to the editor
A nurse helps a patient. [Shutterstock]
A nurse helps a patient. [Shutterstock]
Published Feb. 11

Keep doctors in loop for safety

Let nurses use all their skills | Column, Feb. 8

In his column supporting HB 607, Florida Association of Nurse Anesthetists President Jose Delfin D. Castillo III repeats many talking points that have been used to justify this dangerous proposal since the legislative session began. Allowing advanced practice registered nurses (APRNs) and physician assistants to practice beyond the scope of their training and with no physician supervision would expose Florida’s patients to unnecessary risk, while compromising the standard of care. The numbers speak for themselves: After completing four years of medical school, physicians receive at least 15,000 clinical training hours in post-graduate residency programs lasting three to seven years. By comparison, APRNs spend 1.5 to three years in nursing programs, are not required to undergo any post-graduate training and obtain only 500 to 1,500 clinical training hours.

Despite the writer’s assertion that physician supervision rules are “antiquated,” they are the norm. As Census data shows, states that do not allow APRNs to practice autonomously represent about 70 percent of the country’s population. Studies also cast serious doubt on the argument that HB 607 would help control health-care costs. For example, a Mayo Clinic study revealed that inappropriate patient referrals by APRNs and physician assistants could offset any potential savings from expanding their use. A JAMA Internal Medicine study found that, compared to primary care doctors, APRNs and PAs were associated with increased ordering of diagnostic imaging.

HB 607 poses a threat to vulnerable patients, which is why the Florida Medical Association and more than 50 other medical professional societies formed the Florida Patient Protection Coalition, aiming to educate the public about the benefits of physician-led, team-based care, while combating the narrative being spun by HB 607’s supporters. We urge lawmakers to put Floridians’ well-being above rhetoric.

Ronald F. Giffler, Tallahassee

The writer is president of the Florida Medical Association.

Impeachment is too easy

Scott says impeachment should be harder | Feb. 9

In this image from video, the vote total, 53-47 for not guilty, on the second article of impeachment, obstruction of congress, is displayed on screen during the impeachment trial against President Donald Trump in the Senate. [AP]

Sen. Rick Scott’s proposal is dead on. Three years ago, no one would have questioned the procedures set forth in the Constitution for impeaching a president. However, watching the recent fiasco that has come out of the House, it is obvious that something has to change. Requiring at least a 60 percent vote to impeach is a good start. And while we’re at it, there needs to be a better definition for grounds for impeachment other than “high crimes and misdemeanors,” very ambiguous terms. What do they mean? It should be spelled out in the Constitution. I’ve never been an advocate of changing the Constitution unless it were absolutely necessary. These changes are necessary.

Lester E. Scates, Lithia

With numbers like these ...

Scott says impeachment should be harder | Feb. 9

Sen. Rick Scott, R-Fla., departs after the impeachment acquittal of President Donald Trump. [ALEX BRANDON | AP]

Given the fact that Rick Scott won the 2010 governor’s race with 48.9 percent of the vote, the 2014 race with 48.1 percent of the vote and his 2018 Senate race with 50.1 percent of the vote, perhaps he should rethink his position on a constitutional amendment requiring a 60 percent vote in the House to impeach an elected official. On the other hand, if Scott would propose an amendment to abolish the Electoral College and allow for the direct election of the president, as he himself has been elected, I would gladly support duly-elected Sen. Scott in that proposal.

John Avery, Gulfport

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