Patients at Risk

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 healthcare by putting patients and physicians in control. Learn more at https://citizenhealth.io/.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/PhysiciansForPatientProtection.org

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 family members have come forward to identify the patient as Stevie Ryan, a Hollywood comedienne and YouTube sensation who seemed to be on the verge of stardom when her life came to a tragic end at the age of just 33 years old.We are joined today by Yuni Kim, Stevie Ryan’s close friend and confidant, to discuss mental health issues and care provided by different types of mental health clinicians.  Yuni previously shared this information with the LA Times as discussed in this article: https://www.latimes.com/business/story/2021-04-01/stevie-ryan-death-nurse-practitionerIf you are having concerns about mental health, help is available.  Please call the suicide prevention lifeline at 800-273-8255.Links to previous discussions of this case:https://podcasts.apple.com/us/podcast/psych-np-patient-affair-ends-tragically-case-jay-baltz/id1539719940?i=1000503087095https://podcasts.apple.com/us/podcast/differences-between-psychiatrists-psych-nps-case-jay/id1539719940?i=1000503719243Get the book!  https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Learn more: PatientsatRisk.comPhysicians: Join Physicians for Patient Protection: www.pppofficialsupporter.comPhysiciansForPatientProtection.org

 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.Today we are joined by two emergency physicians who have become aware of this trend and are publicly speaking out about their concerns, Dr. Thomas Cook and Dr. Jason Adler.Get the book!  https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Articles by Drs. Adler and Cookhttps://journals.lww.com/em-news/Fulltext/2021/02000/After_the_Match__Boosting_Profits_Drives_NP.6.aspxhttps://journals.lww.com/em-news/Fulltext/2021/03000/After_the_Match__NPs_Pushing_Expansion_of.2.aspx?context=FeaturedArticles&collectionId=3PhysiciansForPatientProtection.org

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 importance of physician-led care. Cathy McLaughlin MD is a urologist practicing in Texas and Saba Rizvi MD is a Texas emergency physician who authored a paper on the Private equity takeover of EM groups and their push for more NP staffing models. PhysiciansForPatientProtection.org

 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 help us understand this topic, we are joined today by two special guests, patient Nancy Murphy and her neurologist Dr. Dhrupad Joshi.  Dr Joshi's website:  https://wecareneuro.com/PhysiciansForPatientProtection.org

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 differences between types of eye doctors and to help patients know how to protect their vision and their health.  PhysiciansForPatientProtection.org

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

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

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

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 care (reference below). Linda Anegawa MD, an internal medicine and obesity specialist, discusses concerns over safety when non-physician practitioners provide healthcare independently without physician supervision, and describes her own story of how a trigger point injection by a nurse practitioner resulted in a punctured lung. Rather than sending her to the emergency department, the nurse practitioner told Anegawa that her shortness of breath was just "procedure anxiety."  The truth was that the NP had caused a pneumothorax, or punctured lung, which can be fatal if left untreated. Get the book!  https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Lancet articleM.E. Kruk, A.D. Gage, N.T. Joseph, G. Danaei, S. Garcia-Saiso, and J. Salomon. 2018. “ Mortality due to low quality health systems in the Universal Health Coverage era: a systematic analysis of amenable deaths in 137 countries.” The Lancet, 392, 10160, Pp. 2203-2212 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31668-4/fulltext?fbclid=IwAR1uwXVAsi-pOXSTEzJRTyX9nbdLtf8V-cGYMK6BuK_p77lTpNegyaCuUaICommentary: https://www.npr.org/sections/goatsandsoda/2018/09/05/644928153/what-kills-5-million-people-a-year-its-not-just-disease?fbclid=IwAR352fPMuZ9Z482Qb6_nFGQ-2bkcovCA3UdARsJDCvdbiHrLvhUasl0VxLoPhysiciansForPatientProtection.org