Change structure of care

I would like to propose a slightly different view about the future of medical care. First, we need to recognize that health care has changed, not only in technology, but in complexity and understanding of how disease processes work. There are large differences in how young people, adults and elderly should be treated. Medications and dosage are different. Seniors have more chronic diseases, and respond to therapies with wide variations.

It is my belief that primary care physicians should choose which age group they would like to treat; pediatricians for the young, internists for adults and gerontologists for seniors.

A July 13 article, “Spokane physician proposes changes,” alludes to basic health providers like physician assistants, nurse practitioners and medical aides. These health providers should be the front line as far as health care is concerned. Their backup is one of the primary care specialists. They provide care 24/7 at a much lower cost. They could act as a coordinator by guiding patients through the maze of medical specialists and procedures when a patient needs more medical attention.

Many practices today use basic health care providers for a wide range of duties. I believe most physicians will be on salary soon.

George H. Rice

Spokane