In Jan 2022, the Journal of Nursing Regulation published an article entitled: Analysis of Nurse Practitioners’ Educational Preparation, Credentialing, and Scope of Practice in U.S. Emergency Departments The summary: “Due to the variability in educational preparation, NPs should not perform independent unsupervised care in the ED regardless of state law or hospital regulations.” This unequivocal statement contradicts the rhetoric of NP leadership which insists that NPs should be allowed to practi...
Jul 05, 2022•29 min•Season 1Ep. 66
Attorney and emergency medicine physician William P. Sullivan believes that nonphysician practitioners should practice independently, but be held to the same medical standard as physicians since NP/PA leaders argue that there is "no difference in the practices and outcomes between physicians and advanced practice providers." Dr. Sullivan joins us to discuss his article on this issue - https://sullivanlegal.us/nurse-practitioner-and-physician-assistant-standard-of-care/ Get the book! https://www....
Jun 20, 2022•34 min•Season 1Ep. 65
In several previous podcasts, you have heard us refer to research studies that claim to show that nurse practitioner care is just as good or better than that provided by physicians. We’ve shown that in many of these cases, the study authors are using flawed methodology or failing to disclose important information, like nurse practitioners working under physician supervision. Today we invite you to attend Patients at Risk ’s first “Journal Club” session as we dissect a study that claims to show t...
Jun 06, 2022•34 min•Season 1Ep. 64
Douglas Farrago MD discusses why '9 out of 10 administrators' absolutely hate his new book, The Hospital Guide to Physician Retention: Why Creating A Physician-Friendly Environment Is Critical For Your Organization’s Success . Dr. Farrago has been fighting to improve the state of medicine for decades, authoring books on direct care and pointing out the fallacies in health care at his blog, AuthenticMedicine.com . His newest book, The Hospital Guide to Physician Retention is focused on improving ...
May 23, 2022•36 min•Season 1Ep. 63
Sonal Patel MD and Jou Jou Hanna MD discuss the difficult choices that women make to become physicians, and why that training matters. PhysiciansForPatientProtection.org
May 09, 2022•20 min•Season 1Ep. 62
One topic that gets women physicians fired up like no other is a discussion of gender issues in medicine. While medical school classes are currently made up of about 50% women, women physicians are still a significant minority in medical practice today, and women doctors face serious inequities due to their gender. One of the biggest challenges that women must face is the decision of if or when to have children, because of the intense and lengthy educational training process that doctors must co...
Apr 25, 2022•33 min•Season 1Ep. 62
Part 2 of our discussion with John Lafferty MD regarding the need for Flexner-style reform for NP and PA programs. Dr. Lafferty describes his experiences training PA students. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Thanks to our sponsor: Old Pueblo Anesthesia (OPA) is a physician-owned and operated practice that has served the southern Arizona community for over 40 years. They are committed to delivering anesthetic care exclusively by ...
Apr 11, 2022•20 min•Season 1Ep. 61
Many of our podcasts have focused on concerns about the deterioration of nurse practitioner training, with an increase in for-profit schools that compete fiercely for student tuition dollars. These programs often boast 100% acceptance rates -in other words, anyone who applies is accepted. Students who attend programs like these complain about sub-par education including open-book tests that leave graduates inadequately prepared to care for patients. The rise of these diploma mills has led many t...
Apr 04, 2022•23 min•Season 1Ep. 60
One of the strategic goals of the American Association of Nurse Practitioners listed on their website (now behind a paywall) is for nurse practitioners to achieve pay parity: to be paid the same as physicians. Oregon became the first state to require that insurance companies pay nurse practitioners the same as physicians and now proposed legislation would do the same in Washington state. To discuss the implications of pay parity in Washington and elsewhere, we are also joined by the past preside...
Mar 28, 2022•33 min•Season 1Ep. 59
As nonphysician practitioners increasingly provide more patient care, experts note a commensurate increase in medical malpractice claims. Today we welcome medicolegal adviser Bob Pegritz, the co-author of ‘Hospital Confidential,’ an expose of medical malpractice cases. As Bob wrote me, "I have worked in the medical/legal community for 32 years. Before that, I was a surgical PA. As a medical/legal consultant, I have seen a trend over the past 5 years of more PAs crossing my desk for merit review ...
Mar 14, 2022•35 min•Season 1Ep. 58
As our listeners already know by now, to be licensed to practice medicine, physicians in most states must complete a minimum of three years of postgraduate medical education, called residency training. Each specialty offers its own residency program, but all must follow specific, standardized criteria created by the ACGME—the American College of Graduate Medical Education. If programs fail to meet these criteria, they will not be credentialed by the ACGME, and graduates will not be licensed to p...
Feb 28, 2022•35 min•Season 1Ep. 57
Almost every field of medicine today involves some type of nonphysician practitioner, whose role was originally created to help physicians see patients more efficiently. The specialty of radiology is no exception, and radiologists often work with NPs, PAs, and another type of extender called a radiology assistant (RA). In part 2, I am joined by two radiologists to discuss the use of nonphysicians in radiology and concerns that an increased push for these extenders may negatively impact patient c...
Feb 14, 2022•34 min•Season 1Ep. 57
Almost every field of medicine today involves some type of nonphysician practitioner, whose role was originally created to help physicians see patients more efficiently. The specialty of radiology is no exception, and radiologists often work with NPs, PAs, and another type of extender called a radiology assistant (RA). Today I am joined by two radiologists to discuss the use of nonphysicians in radiology and concerns that an increased push for these extenders may negatively impact patient care. ...
Jan 28, 2022•34 min•Season 1Ep. 56
A few months ago, EM:RAP, a well-known and respected EM CME provider hosted a discussion about nonphysician practitioners in the emergency room. Many physicians who listened felt was one-sided and glossed over concerns about independent practice by NPs and PAs. Dr. Steve Carroll, an EM physician and the host of the podcast EM Basics, was so concerned that he reached out to the program to ask for a more even discussion. To their credit, the program allowed him come on to discuss some of the nuanc...
Jan 17, 2022•39 min•Season 1Ep. 55
In part 2 of our discussion, Dr. Alyson Maloy and Dr. Phil Shaffer break down the mistruths in AANP president April Kapu's article, 'Full practice authority for nurse practitioners needed to address physician shortage.' Get the book, now available on Audible! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Watch the video on our YouTube channel: https://youtu.be/EDXn7RAomTM Article links: Original article - https://www.medicaleconomics.com/view/covid-exacerb...
Jan 03, 2022•32 min•Season 1Ep. 54
On September 29, 2021, the journal Medical Economics published an interview with Dr. Alyson Maloy entitled “Covid exacerbates physician shortage.” In the article, Dr. Maloy discussed the effects of covid19 including a push to increase practice authority for nurse practitioners. A week later, Medical Economics posted a rebuttal written by April Kapu, the president of the AANP, called “Full practice authority for nurse practitioners needed to address physician shortage,” arguing that NPs were read...
Dec 20, 2021•23 min•Season 1Ep. 53
In part 2 of this discussion with plaintiff's attorney Travis Dunn, we analyze the tragic case of Alexus Ochoa, who died because a multi-billion dollar corporation elected to replace physician with unprepared NPs. Mr. Dunn discusses the role of the expert witness in NP malpractice cases and what he has learned about the limited scope of practice of nurse practitioners. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Please like and subscribe to...
Dec 05, 2021•23 min•Season 1Ep. 53
In the book Patients at Risk, we discuss the tragic case of Alexus Ochoa, a 19-year-old woman who died when a nurse practitioner failed to diagnose the blood clot in her lungs. The nurse practitioner was unprepared to treat emergency room patients and there was no physician on-site, even though the hospital advertised that physicians were available 24/7. Today we are joined with attorney Travis Dunn, one of the lead attorneys who helped Alexus’s family win a major financial settlement against Me...
Nov 13, 2021•34 min•Season 1Ep. 52
There are so many challenges in healthcare today, and it’s becoming ever more difficult to practice medicine. In fact, many physicians that could continue to work well into their golden years are retiring as soon as they can because the struggle of practicing medicine is just no longer worth it to them. Today we are joined by an amazing physician who has experienced his share of heartache within our healthcare system. Dr. Mark Lopatin is a rheumatologist who has written extensively about his exp...
Nov 08, 2021•36 min•Season 1Ep. 51
Today, we discuss a topic that is near and dear to my heart as a family physician: the role of primary care. We’re going to focus especially on the misconception often held by legislators that primary care is somehow ‘easy,’ and can therefore be relegated to allied health professionals, especially nurse practitioners. Today, I am joined by two special guests who are experts in the role of primary care in the healthcare system. Dr. Emily O’Rourke is a Family Physician in Virginia and the owner of...
Oct 17, 2021•33 min•Season 1Ep. 50
In our book, we outline the tragic case of Alexus Ochoa, a 19-year-old woman who died when a nurse practitioner failed to properly diagnose and treat the blood clot in her lungs. The only reason that the details of this case became public was because of a lawsuit filed by the patient’s family. Court records reveal not only a lack of appropriate medical care, but more importantly, the incredible efforts that Mercy Health Systems, a multi-billion-dollar corporation, routinely went through to hire ...
Oct 10, 2021•33 min•Season 1Ep. 49
One of the biggest challenges in healthcare today is a lack of transparency when it comes to the training and licensure of healthcare professionals. As members of the healthcare team have taken an increased role in providing medical care, patients may be treated by physicians, nurse practitioners, physician assistants, and other healthcare practitioners, and understanding who is who can be difficult. In fact, an AMA study found that only 55% of respondents thought it was easy to identify who is ...
Oct 03, 2021•28 min•Season 1Ep. 48
There is an increasing double standard in the practice of medicine and the practice of advanced nursing, and one of these is the difference in ‘board certification.’ Nurse practitioners take just one board examination in the course of their career, which is 3 hours long and 200 questions. Nurse practitioners never have to take another exam – they just have to submit their work hours, which can even be volunteer hours. In contrast, physician board exams are most more rigorous, lasting 9-10 hours ...
Sep 26, 2021•37 min•Season 1Ep. 47
Seven-year-old Betty died just 15 hours after she was evaluated by a pediatric nurse practitioner in a pediatric urgent care without any physician on site. Betty's father, Jeremy Wattenbarger discusses the efforts he has made to seek accountability and ensure that other children receive physician-led care. Get the book: https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ PhysiciansForPatientProtection.org
Sep 19, 2021•35 min•Season 1Ep. 46
Many of our critics accuse us of exaggerating the risks that patients face when physicians are replaced by lesser trained members of the healthcare team. We are often told that we are engaging in a ‘turf war’ with nurse practitioners and physician assistants and that we should support these nonphysicians practicing ‘to the full extent of their license and training. ’ Today we are going to explain exactly why we take such a hardline stance against the independent practice by nonphysicians. It’s n...
Sep 12, 2021•28 min•Season 1Ep. 45
In part 2 of our discussion about healthcare politics, Dr. Kermit Jones, a California internal medicine physician, attorney, and military veteran discusses his run for California's 4th Congressional District. Learn more about Dr. Jones at his website - https://kermitjonesmdjd.com/ Donate to Dr. Jones' political campaign here - https://secure.actblue.com/donate/kermitjonesforcongress2 Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Physicians: J...
Sep 05, 2021•26 min•Season 1Ep. 44
More than ever, healthcare and politics are intertwined. Decisions made by politicians and have a major impact on not only healthcare policy, but on the day-to-day practice of medicine by physicians. Today we are excited to be talking about healthcare politics with Dr. Kermit Jones, a California internal medicine physician, attorney, and military veteran who is working to bring his medical expertise into the political arena. Learn more about Dr. Jones at his website - https://kermitjonesmdjd.com...
Aug 29, 2021•34 min•Season 1Ep. 43
In part 2 of this discussion with Dr. Marion Mass, a pediatrician and the co-founder of Practicing Physicians of America, we learn about the impact of group purchasing organizations (GPOs) on the high cost of healthcare. In 1987, the federal legislature granted GPOs safe harbor from anti-kickback statutes, allowing them to reap millions of dollars. Dr Mass also explains how these GPOs have created artificial shortages in essential medical supplies, leading to patient and clinician harm. Practici...
Aug 22, 2021•35 min•Season 1Ep. 42
We all know that the health care system in the United States is expensive, with the U.S. spending more than any other developed nation. Although it’s convenient to scapegoat doctors as the reason for high medical costs, the truth is that physician compensation makes up just 20% of total health spending. So, who is really responsible for the astronomical cost of health care today? To get some answers, we are joined by Dr. Marion Mass, a pediatrician and the co-founder of Practicing Physicians of ...
Aug 15, 2021•34 min•Season 1Ep. 41
On our last podcast, advocacy experts Dr. Purvi Parikh and Linda Lambert discussed steps that physicians can take to advocate for their patients and for the profession of medicine. In part 2, we learn from the legislative successes of the nursing profession. We discuss how to write a resolution for your medical society to help influence policy, and how advocacy can be a solution to burnout. Get the book: https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Physic...
Aug 08, 2021•34 min•Season 1Ep. 40
