First Opinion is STAT’s platform for interesting, illuminating, and maybe even provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others.
To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT publishes selected Letters to the Editor received in response to them. You can submit a Letter to the Editor here, or find the submission form at the end of any First Opinion essay.
“Why aren’t philanthropists stepping up to make nursing education free?” by Tracy R. Vitale and Caroline Dorsen
The shortage of nursing faculty at both the associate degree in nursing and the bachelor of science in nursing levels, primarily due to salary structures, has been well documented for at least a couple decades within nursing and health care access advocate circles. Where it’s not known — at least not with a powerful and energized message — is within the circles of college and university development offices and community foundation fundraisers. People of wealth have both personal and professional connections to nursing, whether as practitioners, patients, family members, or community leaders. The full-bore messaging and cultivation of these donors and funders just isn’t out there. Without an active change in strategies, the current pleas aren’t going to get us where we need to go. Time to regroup!
— Allen Smart, PhilanthropywoRx
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It’s a shame that more philanthropists don’t support nursing education. But nursing schools are also to blame due in part to the arrogance of the requirement that a prospective nurse repeat anatomy and physiology 1 and 2 and microbiology if it’s been more than 5 years since she or he has taken those courses. I have repeated those courses once and earned “A” grades in them. I was in my nursing clinicals when Covid-19 shut everything down. Now I can’t afford the tuition and I refuse to repeat those classes. There is no such requirement for medical school. It’s the nursing school and society’s loss: I would have been a great nurse!
— Thomas Martin
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A major issue has to do with the lack of nurse educators. I obtained my MSN-Ed with the idea of becoming a nursing school educator, but was unable to financially make this transition. Nursing school educators make significantly less than patient care nurses. Lack of instructors is why many who are interested in becoming nurses are turned away.
— Kim Blanton, retired
“Functional neurological disorder is not an appropriate diagnosis for people with long Covid,” by David Tuller, Mady Hornig, and David Putrino
I have struggled with a neurological disability for 21 years. It came to a head following an adverse reaction to the Covid-19 vaccine and development of long Covid (though I am grateful that the vaccine protected me from earlier strains of the virus). Since that fateful day in February 2021, I have been rushed to an emergency department 29 times. And while I have been shown true humane and compassionate care by professionals working during the Covid pandemic, I was also repeatedly gaslit, mislabeled, and prevented from receiving the care I should have.
I’m not alone: An April 15, 2024, research letter in JAMA reported that nearly 1 in 4 patients in more than 29 hospitals had misdiagnoses or delays in diagnostic work-ups because of stigmatizing language in their medical records.
As a social worker who believes in social justice, I wonder how many people with long Covid symptoms — like those with chronic fatigue syndrome and Lyme disease and post-viral illness — have been dismissed, and their symptoms overlooked, and their care options missed. In hope for change, I rest my heart on the wisdom from a moving self-reflective medical narrative by Dr. Wes Ely in his book, “Every Deep Drawn Breath.” He wrote, “Many people believe medicine is grounded in benevolence, which is wishing good. It is more than that. The target principle of medicine must be a higher standard: beneficence. Doing good.” As he shares this, it is the covenant of all health care professionals to practice with self-reflection, humane connection, and compassion, make diagnostic queries with curiosity and care, and avoid labeling and words that harm, pathologize and damage.
— Kate Nicoll, LCSW
“Medicare drug pricing rules will delay access to promising therapies,” by Peter Rheinstein
Yes. We already have a problem with the lack of incentives to improve the use of drugs approved decades ago before we had the current tools of modern pharmacology. We fail at personalized medicine for such drugs which can improve both safety and efficacy. Research costs money and price controls will discourage more of the real-world evidence that requires better measurement for better dosing decisions in individuals.
— Peter T. Kissinger, Purdue University + Inotiv + Phlebotics
“Doctors ‘overprescribing’ opioids isn’t the cause of the overdose epidemic — and it never was,” by Richard A. “Red” Lawhern
Casey Heely of Brandeis University has protested what she believes is “over-simplification” on my part of the causes of the U.S. opioid crisis. In response to her concern, I would observe that major pharma companies clearly overpromoted the safety of prescription opioids. But data published by the U.S. Centers for Disease Control and Prevention establish beyond any rational contradiction that any contribution of prescriptions opioids was strictly at the margins of a much larger crisis driven by street drugs. Restrictions on the availability of prescription opioids have actually made the crisis worse, by driving desperate patients into street markets.
Over-prescribing was never the major factor in the rising rates of opioid overdose deaths. That distinction belongs to illegally manufactured fentanyl and heroin. Prescription opioids get lost in the noise.
— Richard A. Lawhern, Ph.D.
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