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Re: IUD and PID From: Geffrey H. Klein, MD (gklein@icsi.net) Sat May 29 12:53:07 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steven Crawford: "Re: IUD and PID" Previous message: Robert J. Woolley: "Re: IUD and PID" In reply to: Robert J. Woolley: "Re: IUD and PID" Next in thread: Steven Crawford: "Re: IUD and PID" At 11:56 AM -0500 on 5/29/99, Robert J. Woolley wrote: > > I think everyone would agree that a NP can easily perform a pap smear and > > counsel on contraception. I think we are all equally convinced that the NP > > should not be performing a vaginal hysterectomy. > > Ahem. Count me out of the latter consensus. This is a technical skill >that could > be learned by anybody willing to invest the time--NP, PA, chiropractor, Army > medic, etc. Naturally, it will take more time to adequately learn the >necessary > skills for one who has not had the broader and deeper general background >of med > school. But nothing conceptually stands in the way of their gaining the > necessary knowledge and skill outside of a formal medical >school/residency. I, > for one, have worked with surgical assistants who have been doing their >job for > so long and with so many surgeons that they could easily perform >singlehandedly > most of the routine cases on which they now merely assist. No doubt, I have met surgical assistants, who by virtue of their daily lives, COULD perform the surgery as well or better than the doctor they assist. Licensure does not guarantee competence. Lack of licensure does not indicate that a person is incompentent. I would compare licensure to a lab test in so much as it has a sensitivity and specificity for competence. It is most certainly better than letting anyone who felt they were competent to hang out a shingle. There SHOULD be some objective measure that has the appropriate sensitivity and specificity for competence. Are you really in favor of no certification whatsoever? > It seems inevitable that your reason for this is that you think you know >what is > better for your neighbor than he does. I find this attitude condescending >and > demeaning, no matter how well-intentioned. If you genuinely trusted your >fellow > citizens to be capable of figuring out who is best qualified to care for >them, > and genuinely thought that you have superior training and skills, such that > rational people would voluntarily choose to see you and your peers rather >than > non-MDs, then you wouldn't feel the need to *force* that choice on them >by law. > Your insecurity is showing. In a perfect world, perhaps. To expect that level of public knowledge is unrealistic. As smart as everyone knows I am, and I know this might come as a shock to some of you, I don't know EVERYTHING! I am glad that there are building codes and licensure for home builders. I would be an easy target for a con who would build substandard housing. I relied on and am grateful for the protection afforded by the government when I bought my home. I feel the same about the goverment's protection regarding food, banking, securities, and manufacturing. While I do realize that no system is perfect, I feel that the anarchy of the alternative would make me far more likely to fall victim to well-intentioned incompetence or outright fraud. > Then you are naive. *Everybody* who seeks to force people to choose *their* > services (1) claims only to be working in the public interest, and (2) is > actually working in self-interest. Self interest and public interest are not mutually exclusive. Your view is very cynical and extreme. > I do not believe that an insurer, which has to worry about liability for > contracting with incompetents, would knowingly allow that. Really? Why not. Where would they draw the line? -- Geffrey H. Klein, MD geffrey.klein@obgyn.net 17448 State Hwy 3 Suite 200 Webster, Texas 77598 (713) 741 2273 ext 2628 Next message: Steven Crawford: "Re: IUD and PID" Previous message: Robert J. Woolley: "Re: IUD and PID" In reply to: Robert J. Woolley: "Re: IUD and PID" Next in thread: Steven Crawford: "Re: IUD and PID"

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