Author Affiliations: University of Cincinnati Hospital, Cincinnati, Ohio (Dr Coldiron); and Perelman School of Medicine, University of Pennsylvania, Philadelphia (Dr Brod).
Gillum and Dellavalle1 point out deeply troubling, contradictory state regulations on the use of medical lasers. The existence of multiple boards with differing regulations and definitions of qualifications of those using a medical laser creates problems. The most disturbing aspect of the article by Gillum and Dellavalle1 is the confirmation of the unsupervised provision of invasive medical procedures by nurse practitioners (NPs). When NPs or physician assistants (PAs) assist a physician, they are correctly termed medical paraprofessionals. Physician extenders and medical paraprofessionals improve patient access to care and enhance patient care. Having an NP or PA working in teams with physicians is commonplace and accepted by most physicians. Independent practice by paraprofessionals is a wholly different situation from the perspective of patient safety and quality of care.
Coldiron BM, Brod BA. Who Needs Medical School to Practice Medicine? Ask an Electrician. JAMA Dermatol. 2013;149(2):140–142. doi:10.1001/jamadermatol.2013.2370
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