House Bill 495, now in our Legislature, would give nurse practitioners full practice authority without physician supervision. In a recent letter from Dr. Katherine Williams, president of the Louisiana State Medical Society, she proposed that physicians need to be "at the helm" of medical care. A more recent letter by Claire Daniel and Maeve Wallace was highly misleading. During my 36 years of private practice, I witnessed numerous cases of patients seeing me after being grossly misdiagnosed by nurse practitioners having failed to get their supervising physicians involved. Often numerous medications were used inappropriately; try one, if it does not work, blindly try another. Maybe they will get it right.

On a more personal note, my elderly father with a history of heart disease had his obvious congestive heart failure misdiagnosed by a nurse practitioner. I diagnosed it in two minutes in his living room. Mistakes such as this contributed to his death.

I believe we must keep medical care in the primary hands of our physicians. Eight to 10 years of intense training cannot be matched by the meager education received by nurse practitioners. I hope our legislators are listening.

HERBERT W. MARKS, M.D.

clinical professor, LSU Health Sciences Center

Mandeville