Putting doctor oversight at risk

I take exception to The Times’ characterization of “gentrification” in downtown Los Angeles as a cause of homelessness. The numbers just don’t support it.

Virtually all of the 22,000 units of housing built in the 15 years of the downtown renaissance were converted from old office, commercial and industrial buildings or built new on sites that had not contained any housing. Adaptive reuse accounted for about 5,700 units.

The Residential Hotel Unit Conversion and Demolition Ordinance was adopted in 2008, protecting single-room occupancy hotels downtown. Furthermore, about 2,200 new units of affordable and permanent supportive housing units have been built here since 2001, the greatest concentration in the county.

Downtown has become a vibrant community in the last 15 years. But it did not come at the expense of affordable housing and is not a cause of homelessness. Rather, it has been one of the county’s greatest generators of jobs and economic opportunity.

Carol E. Schatz Los Angeles The writer is president and chief executive of the Central City Assn. of Los Angeles.

One thing the increase in Los Angeles County’s homeless population shows is that the for-profit market cannot provide all our people with housing when values are so high.

People need government support either indirectly with housing regulations or directly by building and maintaining appropriate housing that meets the needs of a diverse population.

Doris Isolini Nelson Los Angeles

Re “Doctors aren’t special,” Opinion, May 12

Christopher Glazek gets it wrong about doctors and nurse practitioners, or NPs.

Healthcare delivery is shifting toward team-based, comprehensive care led by physicians in collaboration with professionals from a variety of fields. These reforms, brought on by the Affordable Care Act, are meant to drive down costs while maintaining quality care.

SB 323 would allow NPs in California to perform a wide range of medical procedures with less physician oversight. Glazek says that this would not result in independent practices of NPs; in reality, under SB 323 many NPs would “doctor shop” and set up clinics with only a figurehead physician providing oversight.

Proper physician oversight is crucial to maintaining quality care. Unfortunately, the bill undermines the team-based, physiciansupervised care envisioned by the healthcare law. I encourage Glazek to consider the full range of consequences that would occur if this bill becomes law.

Pedram Salimpour, MD Los Angeles The writer is president of the Los Angeles County Medical Assn.

I have been a certified nurse midwife for 34 years. In that time I have worked with many NPs, midwives and physician assistants.

These people are dedicated providers who deliver safe, competent and compassionate care. When I was a midwife at Kaiser Permanente for 28 years, I worked with more than 20 others who delivered thousands of babies in a safe, collaborative practice.

I always considered our group as experts in low-risk management of women in the field of obstetrics and gynecology. Our caesarean section rate was very low, and we provided epidurals and fetal monitoring when needed.

I find it offensive when I hear someone say that NPs, physician assistants or midwives deliver substandard care. In fact, as highly trained professionals we need to be seen as integral members of our healthcare system, not as a minor addition. We can definitely make a difference.

Holly Hurwitz San Diego