Patients at Risk

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

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 shortage concerns, influenced by flawed reports from the 1980s that led to restricted physician production and the promotion of NPs and PAs as substitutes. Bernard outlines the growth of NP and PA roles, the diluted quality of NP education, and the increasing trend of independent practice. The talk also addresses the disparities in healthcare quality and outcomes when care is provided by non-physician practitioners instead of physicians. Bernard advocates for prioritizing the production of properly trained physicians and ensuring physician-led care as well as holding NP leadership accountable for maintaining educational standards.PhysiciansForPatientProtection.org

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 matters.PatientsAtRisk.comGet the books, available in paperback, eBook, and Audible: Patients at Risk: https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164Imposter Doctors: https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438/PhysiciansForPatientProtection.org

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 procedures, and asks legislators to protect patients like her.Tell us your story: https://www.physiciansforpatientprotection.org/patient-resources/tell-us-your-story/Learn more: PatientsAtRisk.comPhysiciansForPatientProtection.org

Chandani Patel DeZure, a double board-certified physician in pediatrics, joins to discuss a recent AAPA survey highlighting physician support for the independent practice of Physician Assistants (PAs). They delve into the complexities of healthcare autonomy and the implications of the findings, including concerns about misinformation. The conversation sheds light on the evolving dynamics between PAs and physicians, emphasizing the need for accurate data in shaping healthcare legislation and ensuring effective patient care.

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 standards for nurse practitioners working in EDs, and her effort to help Indiana become the first state to require that all emergency departments must have a physician on-site. https://www.jacepopen.com/article/S2688-1152(25)00008-6/fulltexthttps://www.journalofnursingregulation.com/article/S2155-8256(22)00010-2/abstractSend me an email through the contact link www.PatientsAtRisk.comPhysiciansForPatientProtection.org

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 workers to look for early signs of a lung condition called pneumoconiosis. According to radiologists, these x-rays are notoriously difficult to read, and a misread can be a matter of life or death.  Dr. Dudek discusses why allowing NPPs to read these x-rays is the wrong decision.Comment by March 17, 2025: https://www.regulations.gov/document/CDC-2024-0103-0001PhysiciansForPatientProtection.org

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, a larger part of the problem may be that ordinary physicians virtually no control over the healthcare system or even the day-to-day practice of medicine.Dr Baumgaertal (myMDadvocate) discusses her fight to help physicians regain the trust of our patients by making sure that they get the best care. PhysiciansForPatientProtection.org

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' to collaborate with nurse practitioners and to loosen supervision as a compromise to independent practice. But complying with this request is now being used as rationale for removing oversight completely, with legislators arguing, "Well, if you don't need to be on site / can supervise multiple NPs, then are you even necessary?" Learn more! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438/Support our vision of physician-led care and truth and transparency for all medical practitioners: physiciansforpatientprotection.orgPhysiciansForPatientProtection.orgPhysiciansForPatientProtection.org