Physicians are usually so busy taking care of patients that we sometimes ignore the political aspects of healthcare, leaving the decisions to legislators and policymakers, many of whom do not truly understand what it is like to deliver medical trenches in the trenches. Unfortunately, the old adage, “if you’re not at the table, you’re on the table,” is nowhere truer than in the healthcare legislative process. Today, I am joined by two experts to help us understand how physicians can be effectivel...
Aug 01, 2021•36 min•Season 1Ep. 39
When it comes to discussing the differences between physician assistants (PAs) and physicians, there is no one better to address the issues than someone who has trained and worked in both professions. Christin Giordano MD was a PA before deciding to return to medical school to become a physician. She has since completed residency training and a fellowship to become a nephrologist. We are also joined by Elizabeth Ennis, PA-C, a former classmate of Dr. Giordano, who is currently practicing in Cali...
Jul 25, 2021•38 min•Season 1Ep. 38
One of the biggest issues in medicine today is physician burnout, with almost 50% of all physicians reporting making active plans to leave the practice of medicine. We are joined by an expert on the subject of physician wellness, psychiatrist Wendy Dean. Dr. Dean and her co-author have singlehandedly changed the dialogue away from ‘burnout’ and towards the concept of ‘moral injury.’ We asked Dr. Dean for her perspective on the impact of corporatization and the replacement of physicians by nonphy...
Jul 18, 2021•38 min•Season 1Ep. 37
We are joined by Eric Starkman , an investigative journalist who works to shed light on dangerous corporate practices in healthcare. Mr. Starkman is relentless in exposing the work of bad actors in the medical-industrial complex and discusses how the replacement of physicians by nonphysician practitioners is contributing to the decline of the U.S. healthcare system. Read Eric Starkman's article about the book 'Patients at Risk' here. An excerpt: "The deceit are the studies purportedly showing th...
Jul 12, 2021•31 min•Season 1Ep. 36
About 42% of physicians report feeling burned out, and about half of all doctors are making active plans to leave the practice of medicine. Unfortunately, some doctors turn to drugs and alcohol to cope with the stressors of medicine, which may result in the loss of their professional licenses. Today, we are talking with Dr. Daniel Hochman, a psychiatrist, and an online professional recovery program creator to discuss physician well-being. Get the book! https://www.amazon.com/Patients-Risk-Practi...
Jul 04, 2021•31 min•Season 1Ep. 35
On May 24, 2021, JAMA, or the Journal of the American Medical Association, published a viewpoint entitled: “Advanced Practice Clinicians—Neurology’s Underused Resource.” The article was authored by nurse practitioner Calli Cook and Dr Heidi Schwarz, a neurologist with the University of Rochester and argued that due to a shortage of neurologists across the country, non-physician practitioners should be used more widely to provide neurology care to patients. Physicians for Patient Protection submi...
Jun 27, 2021•35 min•Season 1Ep. 34
One of the ways that corporations have been successful in replacing physicians with lesser-trained medical practitioners is by creating a sense of equivalence so that patients think that the care they will receive is “the same.” For example, both physicians and nurse practitioners and physician assistants wear white coats, have similar-appearing badges, and may be referred to as “doctor” even if that doctorate is not a medical degree. Not only do these corporations elevate the role of nonphysici...
Jun 20, 2021•32 min•Season 1Ep. 33
One of the differences between physicians and nurse practitioners is that physicians are regulated by a state Board of Medicine, while in most states, nurse practitioners are regulated by a state Board of Nursing. This distinction is important, because while nurse practitioners are functioning in the same capacity as physicians—ordering and interpreting tests, making medical diagnoses, and writing prescriptions for medications—they are overseen by a regulatory body that includes nurses without e...
Jun 13, 2021•30 min•Season 1Ep. 32
In our book, we dedicate several chapters to discussing the differences in training between physicians and non-physician practitioners. One of the most important elements of physician training is learning how to create a differential diagnosis, which is a list of all the possible causes of a patient’s symptoms. Today we are joined by Dr. Mercy Hylton, a pediatric emergency medicine physician and who is also an author and a patient advocate, to discuss why physician training - including learning ...
Jun 06, 2021•32 min•Season 1Ep. 31
In part 2 of this discussion with emergency physicians Dr. Robert McNamara and Dr. Mitch Li, we learn about the dangers that patients face due to the takeover of private equity in healthcare. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ PhysiciansForPatientProtection.org
May 30, 2021•34 min•Season 1Ep. 30
When you are taken by ambulance to the nearest emergency department, you are completely vulnerable. This is not the time when you can research or negotiate prices. With the corporate takeover of hospitals, bills for emergency services have skyrocketed. Patients often receive enormous bills that can sometimes even bankrupt them. These corporate systems are also taking advantage of physicians, and in many cases, replacing them with non-physician practitioners. We are joined by two experts on the s...
May 23, 2021•31 min•Season 1Ep. 29
In recent years, there has been a massive increase in medical practitioners offering hormone therapy to patients. Since insurance doesn’t cover these treatments other than for very specific medical conditions, most patients end up paying cash, leading to big profits. These treatments are usually promoted as “wellness” products, intended to make patients feel younger, stronger, thinner, and just all-around better. But the truth is that there is no clear evidence hormones cause these benefits, and...
May 16, 2021•33 min•Season 1Ep. 28
Hospital organizations are increasingly replacing physicians with nurse practitioners and physician assistants who act as "hospitalists." John Chamberlain, the board chairman of Citizen Health and a former hospital CEO, discusses his wife's hospital stay, during which her care was supervised by a nurse practitioner. We also discuss the increasing corportization of health care and the importance in transparency among health care practitioners and hospital pricing. Citizen Health aims to redesign ...
May 09, 2021•32 min•Season 1Ep. 27
In December, Patients at Risk aired two podcasts in which we discussed the case of Gerald “Jay” Baltz, a psychiatric nurse practitioner who was under investigation by the California board of nursing for engaging in an inappropriate sexual relationship and providing questionable treatment to a patient who subsequently took her own life. While we did not provide any identifying details at that time other than what was included in public documents, since the time of that recording, friends and fami...
May 02, 2021•27 min•Season 1Ep. 26
In our book, we discuss the case of Alexus Ochoa, a healthy 19 yr old woman who died when a nurse practitioner failed to properly diagnose her. What is particularly worrisome about this case is that when Alexus was taken to the emergency room by ambulance, the only medical practitioner working there was a nurse practitioner. Unfortunately, this situation is occurring in hospitals across the country. Physicians are being replaced by non-physician practitioners, and patients often have no idea. To...
Apr 25, 2021•29 min•Season 1Ep. 25
Nearly half the states in the Union have legislated the unsupervised practice of medicine by nurse practitioners and currently, one state allows physician assistants to practice without physician supervision. This legislative season we are seeing bills to allow independent practice for nurse practitioners and physician assistants in multiple states that do not currently allow the practice. Today we are joined by two Texas physicians who are working to educate patients and legislators about the i...
Apr 18, 2021•30 min•Season 1Ep. 24
In our previous podcasts, we have focused on the differences in scope of practice between physicians and nurse practitioners. But other medical practitioners are also wading into the diagnosis and treatment of conditions that have previously been the domain of physicians. Today we are going to discuss care provided by chiropractors, specifically when chiropractors step outside of their traditional role in providing spinal adjustments and into medical treatment for neurological conditions. To hel...
Apr 11, 2021•24 min•Season 1Ep. 23
After the brain, the human eye is the most complicated organ in the body. It is for this reason that a graduating doctor must spend at least another four more years after medical school to become an ophthalmologist. Unfortunately, some states are passing laws that allow optometrists to provide eye treatments that they aren’t qualified to do, and this can put patients at risk. Today, we are joined by Laurie Barber MD, an ophthalmologist and the chair of Safe Surgery Arkansas, to explain the diffe...
Apr 04, 2021•33 min•Season 1Ep. 22
Dr. Toni Manougian has done it all. Starting as an RN diploma graduate, Dr. Manougian obtained her bachelor's in nursing, followed by a master's degree as a clinical nurse specialist and then a degree as a critical care nurse practitioner, become deciding to become a physician. Dr. Manougian explains the differences in training between the professions and tells aspiring physicians that it's never too late to become a physician if that is your dream. PhysiciansForPatientProtection.org...
Mar 28, 2021•30 min•Season 1Ep. 21
Jennifer Bryan, MD, a family physician and the chair of the Board of Trustees of the Mississippi State Medical Association, discusses how her state created a coalition to block nurse practitioner scope expansion. PhysiciansForPatientProtection.org
Mar 21, 2021•35 min•Season 1Ep. 20
Patrice Little DNP discusses limitations in nurse practitioner education and explains why she created a platform to better prepare NP students. Doctor of Nurse Practice Little shares that while she wrote her scholarly project on "full practice authority" for NPs, she realized that many NPs who prioritize patient safety - herself included - don't want independent practice. Patrice Little DNP's site: https://www.npstudentmagazine.com/ PhysiciansForPatientProtection.org
Mar 14, 2021•35 min•Season 1Ep. 19
Many advocates of nonphysician practice argue that we need to allow nurse practitioners and physician assistants to practice independently because of a “provider” shortage. The mantra “access” seems to supersede all other arguments – including concerns over patient safety. But is ‘access’ really all it’s cracked up to be? The answer is no, and here is why. A 2018 Lancet study analyzing 137 countries found that more people die worldwide due to POOR QUALITY care than die due to a lack of access to...
Mar 07, 2021•32 min•Season 1Ep. 18
Health policy experts note that there is a shortage of registered nurses across the nation and that 11 million nurses are needed to avoid a future shortage. [i] A lack of nurses puts patients at risk, with a 2002 report by the Joint Commission on Accreditation of Healthcare Organizations noting that “inadequate nurse staffing has been a factor in 24 percent of the 1,609 cases involving patient death, injury or permanent loss of function reported since 1997.” [ii] One of the reasons for the bedsi...
Feb 28, 2021•34 min•Season 1Ep. 17
On September 29, 2020, the state of California passed AB 890, a bill allowing nurse practitioners the right to practice without physician supervision. The bill received widespread support from groups that benefit from the use of non-physician practitioners, including hospitals and community health centers. Despite opposition from physicians and other patient advocates, the bill was passed with large margins and was signed into law by Governor Gavin Newsome. Today emergency medicine physician Dr....
Feb 21, 2021•33 min•Season 1Ep. 16
In April 2020, Beaumont Health, Michigan’s largest healthcare system, made the decision to terminate its established anesthesia group in favor of Texas-based NorthStar Anesthesia, a private equity firm that promised the health system lower staffing costs. According to reports, more than a dozen physicians and surgeons resigned from the hospital system due to concerns over NorthStar’s reputation. NorthStar’s contract began on January 1 of this year, and on January 25, Eric Starkman, a reporter at...
Feb 14, 2021•32 min•Season 1Ep. 15
In our last episode we discussed the rapid growth of nurse practitioner training programs and some of the challenges this has caused in ensuring that nurse practitioner graduates receive adequate clinical training to care for patients. Today we continue to explore concerns about nurse practitioner quality of education, as well as a new trend for nurse practitioners to seek work in cash-pay type practices, including opening medi-spas, infusion centers, medical marijuana clinics, and so on. To hel...
Feb 07, 2021•35 min•Season 1Ep. 14
There are over 400 nurse practitioner schools in the United States, with nearly HALF of these programs promoting online training—ranging from 50-100% of required academic training sessions. Some of these programs offer accelerated training, allowing students to become an NP in as little as 2 years, others offer flexible schedules with part-time programs allowing students to work full-time while they attend school. In contrast, there are just 179 medical schools producing physicians in the United...
Jan 31, 2021•33 min•Season 1Ep. 13
The pathway to becoming a licensed physician in the United States requires nine to eleven years of formal education, and all physicians are required to pass a series of three high stakes standardized examinations called the United States Medical Licensing Examination (USMLE) before they can be licensed as to practice medicine. Most physicians also go on to become board-certified in their specialty field, which requires an additional examination following their residency or fellowship training. C...
Jan 25, 2021•31 min•Season 1Ep. 12
Psychiatrist Torie Shatzmiller Sepah MD discusses her experiences as a chief psychiatrist at the California Department of Corrections, and her role in the "Golding Report," a whistleblower report by Michael Golding MD that alleges improper psychiatric care of inmates. Complete report here: https://www.scribd.com/document/392536943/Dr-Michael-Golding-California-prison-report-on-mental-healthcare This episode contains brief graphic descriptions of inmate harm as well as physician suicide. If you a...
Jan 17, 2021•31 min•Season 1Ep. 11
Dr. Torie Shatzmiller Sepah, a practicing psychiatrist, discusses the differences between psychologists and psychiatrists, and the increasing trend of allowing psychologists to prescribe medications. Get the book Patients at Risk: https://www.amazon.com/gp/product/B08M9YJQR3/ref=dbs_a_def_rwt_bibl_vppi_i0 To learn more about cognitive behavioral therapy, Dr. Sepah recommends the book "Thoughts and Feelings" - https://www.amazon.com/Thoughts-Feelings-Taking-Control-Moods/dp/1684035481/ Physicians...
Jan 10, 2021•19 min•Season 1Ep. 10
