Patients at Risk

Phil Shaffer, MD, is a physician and healthcare researcher focused on physician-led care and medical evidence. He examines a controversial Cochrane review claiming nurses can replace hospital physicians. The discussion scrutinizes all 82 studies, exposes flaws in the four relevant inpatient studies, questions a sweeping meta-analysis, and explores protocol-based roles, emergency-care limitations, and British criticism.

Most urgent cares are staffed by NPs/PAs, often without physician supervision - can you trust them with your life?Dr. John Lafferty shares details from a study showing that of 300 referrals from urgent cares to the ER, 55% were unnecessary and 64% resulted in a 'discordant' (different) diagnosis."Our data found that 55% of patients referred to EDs from UCCs did notrequire ED-specific care or resources and 64% carried a discordant diagnosis between UC and ED diagnosis. We suggest quality remedies, such as educational sessions and engagement with telemedicine sub-specialists as well as a coordinated formalized system for UCC to ED referrals."Poyorena C, Patel S, Keim A, et al. Evaluating urgent care center referrals to the emergency department. J Am Coll Emerg Physicians Open. 2022;3(6):e12838. Published 2022 Dec 7. doi:10.1002/emp2.12838PhysiciansForPatientProtection.org

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 to patients.PhysiciansForPatientProtection.orgPhysiciansForPatientProtection.org

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://www.amazon.com/dp/1627344438/PhysiciansForPatientProtection.org

Dr. Robert McLean, a former president of the American College of Physicians and an internist/rheumatologist, passionately discusses the need to eliminate the term 'provider' in healthcare. He uncovers its negative effects on the perception of physicians and patient care. McLean details the disparities in training among healthcare roles and critiques the rise of questionable online APRN programs. He advocates for the 'No Provider Pledge' to restore the sanctity of the physician-patient relationship, emphasizing the importance of empathy and camaraderie among doctors.

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 position in light of newer data.PhysiciansForPatientProtection.org

Jeremy Wattenbarger, a digital forensics investigator and father of the late Betty Wattenbarger, shares his heart-wrenching story of seeking accountability after his daughter died due to a misdiagnosis by a pediatric nurse practitioner. He emphasizes the importance of physician-led care for patient safety and recounts the challenges of navigating regulatory oversight. Jeremy highlights the systemic issues with the Texas Board of Nursing, and raises concerns about removing delegation requirements that could jeopardize accountability in healthcare.

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 days of testimony before the South Carolina legislature on these bills. Dr. Phil Schaffer and I were invited by the South Carolina Medical Association and we were asked specifically to focus on data - specifically, the evidence to support unsupervised practice. Take a listen to our testimony and at the end you'll hear a few questions from legislators. IF YOU'RE A SOUTH CAROLINA PHYSICIAN, please join and support the South Carolina Medical Association (SCMA) - they are working hard to fight for physician-led care. https://www.scmedical.org/PhysiciansForPatientProtection.org

Dr. Kaveh Hoda, a gastroenterologist and host of The House of Pod, sheds light on a harrowing incident in the UK where a nurse performed complex ERCPs, resulting in one death and multiple patient harms. The discussion delves into the rigorous training essential for such procedures, the tragic consequences of insufficient oversight, and the broader implications for patient safety in healthcare. Hoda raises critical questions about the qualifications of non-physicians and the necessity of high medical standards amidst a looming healthcare worker shortage.

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 questions the push for independent practice for nurse practitioners. The discussion extends to issues of legislative accountability, corporate healthcare’s role in potentially compromising patient care, and the necessity for patients to advocate for themselves to ensure high-quality medical care. Angie's story highlights the broader implications of inadequate training and supervision in healthcare, especially affecting rural communities.PhysiciansForPatientProtection.org