How is it possible that in an article about the lack of primary care in western Massachusetts [“Primary care in crisis: Doctor shortage continues,” July 26], there is not a word concerning the active role of nurse practitioners as providers of primary care in our area?

I am an NP and I provided primary care for many years at community health centers in Springfield as well as in practices in Hampshire County. If you conducted a survey, you would likely discover that many people in our communities have an NP (or physician assistant) as their primary care provider and are quite happy with their care.

Massachusetts practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances. We also manage complex chronic diseases, make referrals as needed and collaborate and coordinate care with other providers.

We sometimes work as part of an NP/MD team. We support, counsel, provide resources, teach and help people achieve health and well-being. We listen with compassion to patients and we connect. We manage the same heavy burdens as physicians, wrestling with insurance companies on behalf of patients, dealing with the challenges of electronic medical records, responding to messages, reviewing lab results and returning phone calls, often well into the evening.

Nurse practitioners accept these responsibilities and are committed to providing the best possible care in spite of this broken health care system that adversely affects everyone.

Ellen Miller-Mack

Hadley