Patients at Risk - podcast cover

Patients at Risk

Rebekah Bernard MD and Niran Al-Agba MDwww.buzzsprout.com
Patients at Risk exposes the political maneuvering and corporate greed that has led to the replacement of physicians by lesser trained practitioners, including nurse practitioners and physician assistants. As corporations seek to save money and government agencies aim to increase constituent access, minimum qualifications for our nation’s healthcare guardians continue to decline—with deadly consequences. This is a story that has not yet been told, and one that has dangerous repercussions for all Americans.
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Episodes

NP advocates testify in Florida for unsupervised practice rights in psychiatry

When we think of potentially vulnerable patients, it just doesn't get riskier than those with mental health conditions, especially children. Yet, psychiatric mental health nurse practitioners are seeking the right to care for patients 'across the lifespan'--including those with schizophrenia, bipolar disorder, and addiction--without physician oversight. Listen in on testimony in Florida with commentary on why their argument of promoting 'access' without ensuring patient safety may be dangerous t...

Feb 17, 202636 minSeason 1Ep. 121

South Carolina Medical Association fights to ensure patient access to physician-led care

South Carolina Medical Association (SCMA) immediate past president Mayes DuBose, MD and Vice President of Advocacy and Policy Counsel Holly Pisarik discuss efforts that the association has led in fighting bills that would allow unsupervised practice rights to NPs and PAs after just 2,000 hours of clinical hour experience - and let PAs switch specialties after just 1,000 hours. https://www.scmedical.org/ Get the books: Patients at Risk https://www.amazon.com/dp/B08M9YJQR3/ Imposter Doctors: https...

Jan 18, 202635 minSeason 1Ep. 120

The 'P-word': Taking the No Provider Pledge

Dr. Robert McLean, former President of the American College of Physicians discusses the negative impact of the word provider, and encourages all physicians to take the 'No Provider Pledge.' PhysiciansForPatientProtection.org

Dec 26, 202536 minSeason 1Ep. 119

Rural Health Transformation Funding being used to justify NP/PA scope expansion - and PPP response to FTC letter of support

Dr. Phil Shaffer and I are back in SC to testify yet again against a bill that would permit unsupervised NP and PA practice after 2,000 hours of experience. In this episode, I share subcommittee chair Senator Tom Davis's perspectives that SC will lose funding from the Rural Health Transformation project without scope expansion. You'll also hear a letter of support from the FTC Office of Policy Planning supporting scope expansion, and PPP's response explaining why the FTC should reconsider it's p...

Nov 12, 202524 minSeason 1Ep. 118

Powerful patient testimony to Senate committee about importance of physician-led care

7 year old Betty Wattenbarger died hours after being evaluated by a pediatric nurse practitioner at a pediatric urgent care in Texas. Her father testifies to the Texas Legislature about his experience seeking accountability from the Board of Nursing and why he believes physician-led care matters for patient safety. Patients at risk video interview with Jeremy Wattenbarger Part 1 - https://youtu.be/Su43DKxNZoY Part 2- https://youtu.be/pNSWr1GSBnU PhysiciansForPatientProtection.org...

Oct 18, 202515 minSeason 1Ep. 117

Drs. Bernard and Shaffer testify before the South Carolina Legislature on scope of practice

The South Carolina Legislature has introduced bills that would allow unsupervised practice to nurse practitioners and physician assistants after 2000 hours of experience, as well as a bill that would expand pharmacist privileges. On the flip side, there's also a bill that would enhance team-based care, ensuring that physicians remain in the lead of medical care and strengthening requirements and enforcement of physician oversight. Today, you'll hear just a small part of the very, very long two d...

Sep 13, 202534 minSeason 1Ep. 116

25 patients harmed and one dies after nurse permitted to perform ERCPs

One patient died and 25 others were found to have been harmed when a nurse was permitted to perform complex medical procedures in the UK. Gastroenterologist Dr. Kaveh Hoda joins me to discuss the necessary training to perform an endoscopic retrograde cholangiopancreatography (ERCP), a procedure most commonly used to remove gallstones. From the BBC article: 68 patients underwent ERCPs with a 'single consultant nurse', and a review found that 58 received "substandard" care from the service between...

Aug 18, 202526 minSeason 1Ep. 115

A daughter's heartbreak: "My father died when an NP missed his pulmonary embolus"

In this episode of 'Patients at Risk,' Angie Pereira shares the heartbreaking story of losing her father due to a misdiagnosed pulmonary embolism by a nurse practitioner in an after-hours clinic. Despite her father's presenting symptoms of shortness of breath and leg pain, strong family history of blood clots, and normal lung exam, the nurse practitioner diagnosed him with pneumonia, leading to his untimely death the next day. Angie emphasizes the need for proper physician oversight and question...

Jul 14, 202533 minSeason 1Ep. 114

BONUS EPISODE: Webinar on NP/ PA Unsupervised Practice of Medicine (UPM) Legislative Trends

Rebekah Bernard discusses the legislative trends and impacts of allowing non-physician practitioners (NPs and PAs) to practice medicine unsupervised. She highlights the extensive training and hours required for physicians compared to the significantly less training for NPs and PAs. Bernard explains how legislative changes have allowed NPs and PAs to practice independently in many states, often with less experience and training compared to physicians. She delves into the history of physician shor...

Jun 27, 202538 minSeason 1Ep. 113

"My NP education was not designed for independent practice": From RN to NP to Physician

Dr. Denise Weiss always wanted to be a physician, but circumstances led her into nursing. She earned an associate's degree as a registered nurse, and then became a family nurse practitioner. After several years of practice, she realized that her education had not prepared her for independent practice, and she decided to return to school to become a physician. Now a practicing anesthesiologist, Dr. Weiss explains the differences between nursing and medical education, and why physician-led care ma...

Jun 18, 202536 minSeason 1Ep. 112

"I have permanent nerve damage after filler by a RN - and the Board of Nursing did nothing about it"

A patient shares her story of receiving the wrong type of filler into her face by a registered nurse, leading to severe and permanent nerve damage. Francesca explains that the RN, who was in NP school at the time, was not being supervised, and worked in a for-profit clinic owned by a non-physician. While some may argue, "Let the Buyer Beware," Francesca believes that patients are not be in the position to fully understand the qualifications of clinicians being permitted to perform medical proced...

May 27, 202526 minSeason 1Ep. 111

AAPA survey claims that physicians support PA independent practice

In February 2025, the AAPA published a press release entitled: 'AAPA Releases Survey Showing Physician Support for Removing Barriers to PA Practice.' According to AAPA President Jason Prevelige (DMSc, MBA, PA-C, DFAAPA), the survey proved that, “Physicians recognize the need for change. It’s time to modernize these laws so healthcare teams can focus on what matters most, patient care.” But what did this survey REALLY show? Chandani Patel DeZure, MD, joins me to unpack the details. Links: https:/...

Apr 22, 202532 minSeason 1Ep. 110

New study: 7.4% of EDs are staffed by NP/PAs with NO physician on-site

Emergency physician Dr. Deborah Fletcher is an author of the first study to evaluate physician presence in Emergency Departments across the country. She discusses the findings, including that 7.4% of all EDs have NO physician on-site, and of those, 3% have no ability for the NP/PA staffing the ED to discuss patient care with a physician. Emergency physician Dr. Mercy Hylton discusses the dangers of this practice, including concerns from nurse researchers regarding variability and lack of standar...

Mar 31, 202535 minSeason 1Ep. 109

CDC considers allowing NP/PAs to read complex x-rays: Pulmonologist explains the dangers

Pulmonologist / Intensivist Gary Dudek, MD, joins me to discuss the CDC's call for comments regarding allowing nurse practitioners and physician assistants to become National Institute for Occupational Safety and Health (NIOSH) 'B Readers'. B-Readers are highly trained radiologists (medical school graduates with at least five years of residency as well as additional training in this particular type of x-ray) that read and interpret annual screening chest x-rays done on coal, silica, and asbestos...

Feb 24, 202532 minSeason 1Ep. 108

Regaining Patient Trust: The Importance of Physician Advocacy

Susan J. Baumgaertel, MD FACP, an internal medicine physician, author, patient advocate, and ally to colleagues discusses how physicians can fight for patients. Trust in physicians has plummeted in the last few years (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821693), making it more and more difficult for doctors to do their jobs, and potentially leading to a negative impact on patient care. While many point to handling of the COVID pandemic as the cause of growing distrust, ...

Feb 06, 202531 minSeason 1Ep. 107

What we can learn from legislator questions on scope of practice

On September 17, 2024, the Texas Senate Health and Human Services Committee held an interim hearing on scope of practice expansion for nurse practitioners and other clinicians. In this third episode related to that hearing, Texas Medical Association (TMA) president Ray Callas MD discusses the importance of physician oversight for nonphysician practitioners and answers questions from legislators. Importantly, Dr. Callas notes that in the past, TMA was asked by legislators to 'come to the table' t...

Jan 16, 202526 minSeason 1Ep. 106

Texas Scope of Practice Hearing Part 2: NP testimony

In the last episode, you heard some of my testimony at the Texas Interim Legislature hearing on Scope of Practice. Today you're going to hear from a nurse practitioner, Holly Jeffries, who is practicing in rural Texas. Her testimony was particularly impactful and really quite persuasive to legislators. I think it's important to understand the NP point of view and also learn the concerns of legislators by listening to their line of questioning. Referenced in the podcast: Facts about NP primary ca...

Dec 08, 202437 minSeason 1Ep. 105

Scope of Practice testimony at the Texas Legislature: Part 1 (Economic Impact)

On September 17, 2024, the Texas Senate Health and Human Services Committee held an interim hearing on scope of practice expansion for nurse practitioners and other clinicians. The Texas Medical Association (TMA) invited Rebekah Bernard, MD to testify regarding the economic impact of NP independence. In part 1 of this series, we hear the NP expert witness, economist Alicia Plemons, followed by Dr. Bernard's testimony, along with questioning from the committee. Learn more! https://www.amazon.com/...

Nov 17, 202426 minSeason 1Ep. 104

Physician training saved my newborn grandbaby's life: I fear future patients won't have this privilege

On the last podcast, I interviewed Dr. Anu Shokla who shared her story of her newborn baby being treated for an emergency rapid response by a nurse practitioner who had just rotated with her on the inpatient adult hematology oncology service. After hearing that podcast, Dr. Carol Nelson reached out to share a story of the alternate version: her newborn granddaughter was saved because of the outstanding care from well-trained physicians and non-physicians working together in a physician-led care ...

Sep 16, 202429 minSeason 1Ep. 102

"My newborn baby required a rapid response: The NP that showed up had just rotated with me on the adult heme/onc service."

Primary care physician Anu Shukla shares a personal story about the dangers that patients face when physicians are replaced with nonphysician practitioners. Dr. Shukla's comments on this podcast reflect her views and opinions. She does not speak for or represent her employer. Physiciansforpatientprotection.org patientsatrisk.com PhysiciansForPatientProtection.org

Aug 20, 202432 minSeason 1Ep. 101

Bloomberg Report Questions NP Education

In the first of a series 'The Nurse Will See You Now,' Bloomberg reporters investigate concerns about nurse practitioner education. The Miseducation of America’s Nurse Practitioners They don’t merely support doctors—NPs increasingly treat patients independently, including in specialty practices and emergency rooms. When they aren’t well trained, the results can be tragic. By Caleb Melby , Polly Mosendz , and Noah Buhayar https://www.bloomberg.com/news/features/2024-07-24/is-the-nurse-practitione...

Jul 30, 202425 minSeason 1Ep. 100

Dangers of nonphysician ketamine infusions

There are an estimated 500-750 clinics across the U.S. providing infusions of Ketamine for the treatment of a variety of medical conditions. This is big business, estimated to bring in $3.1 billion per year and projected to rise to 6.9 billion by 2030. But is Ketamine safe and effective? Psychiatrist Kristina Kise, MD discusses the use of ketamine infusions in psychiatry, including the potential dangers to patients when physicians are not directly involved in drug oversight. PhysiciansForPatient...

Jul 18, 202441 minSeason 1Ep. 99

Why Psychiatry Needs Psychiatrists (and not just psych NPs)

Psychiatrists are increasingly being replaced by non-physician practitioners - psychiatric mental health nurse practitioners (PMHNPs) and physician assistants (PAs). This webinar explains the difference between a psychiatrist and a PMHNP and reviews the evidence regarding unsupervised care of patients with mental illness by non-physicians. Link to webinar video: https://youtu.be/djDos6xbRos Contact me: PatientsAtRisk.com PhysiciansForPatientProtection.org

May 27, 202443 minSeason 1Ep. 98

Physician Leadership Through Self-Ownership

Over the last decade, as physicians have increasingly turned to employed practice to cope with declining reimbursement and increased administrative requirements, our role in advocacy has diminished. Doctors are afraid to speak out because we fear being fired and losing our livelihoods. But without physician advocacy, corporate interests, academic centers, and government agencies are increasingly making decisions contrary to the best interests of patients, including replacing physicians with nonp...

May 13, 202422 minSeason 1Ep. 97

JOURNAL CLUB: Article claims that NPs, PCPs have same rate of inappropriate prescribing to seniors

In today's episode, Teresa Camp-Rogers, MD, MS analyzes a study published in the Annals of Internal Medicine, the journal of the American College of Physicians, entitled Inappropriate Prescribing to Older Patients by Nurse Practitioners and Primary Care Physicians The article, which seems to call for an expansion of unsupervised practice for NPs, contends that NPs and physicians showed no differences in inappropriate prescribing to seniors based on Beers criteria, however, notes that NPs were ov...

Apr 15, 202425 minSeason 1Ep. 95

Doctors' Day revisited: What has changed in the last three years?

Three years ago, we aired a podcast criticizing Doctors' Day posts from hospitals and healthcare organizations that included non-physicians and referred to physicians as 'providers.' Fast-forward to today, and some organizations (but not all!) seem to have gotten the message. Happy Doctors' Day to all physicians - thank you for your sacrifice and dedication to patient care! PhysiciansForPatientProtection.org

Apr 01, 202426 minSeason 1Ep. 94

"I didn't know how bad it was:" NP pens report on NP education (Part 3)

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training. Canion suggests: - At least 2 years of RN experience before starting NP school - Increased standards for entry, includ...

Mar 18, 202420 minSeason 1Ep. 93

"I didn't know how bad it was:" Nurse practitioner publishes report on the dismal state of NP education and need for change (Part 2)

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training. Canion suggests: - At least 2 years of RN experience before starting NP school - Increased standards for entry, includ...

Mar 04, 202430 minSeason 1Ep. 92
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