Patients at Risk

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.Phil Shaffer MD is a recently retired radiologist and frequent guest of our show. He is also a board member of PPP. Sharon D’Souza MD MPH is a radiologist in private practice.PhysiciansForPatientProtection.org

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 nuances that the initial episode missed. Today we will discuss the initial EM RAP episode that caused so much controversy and Dr Carroll’s response. Catch Dr. Carroll at his website http://embasic.org/Get the book Patients at Risk: https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/PhysiciansForPatientProtection.org

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/EDXn7RAomTMArticle links:Original article - https://www.medicaleconomics.com/view/covid-exacerbates-physician-shortageAANP rebuttal - https://www.medicaleconomics.com/view/response-full-practice-authority-for-nurse-practitioners-needed-to-address-shortagePPP response - https://www.medicaleconomics.com/view/rebuttal-congress-not-the-aanp-can-resolve-the-physician-shortage PhysiciansForPatientProtection.org

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 ready and willing to fill the physician gap. Because the article included many mistruths, Dr Maloy and her colleague Dr Phil Shaffer, board members of Physicians for Patient Protection (PPP)  wrote a rebuttal to the rebuttal, pointing out all the flaws in Kapu’s argument. In part 1, we discuss Kapu's accusations that PPP is a 'fringe' organization out to destroy team-based care, and explain why she and the AANP are dead wrong.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/EDXn7RAomTMArticle links:Original article - https://www.medicaleconomics.com/view/covid-exacerbates-physician-shortageAANP rebuttal - https://www.medicaleconomics.com/view/response-full-practice-authority-for-nurse-practitioners-needed-to-address-shortagePPP response - https://www.medicaleconomics.com/view/rebuttal-congress-not-the-aanp-can-resolve-the-physician-shortage PhysiciansForPatientProtection.org

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 our channel Patients at Risk: https://www.youtube.com/channel/UCLLDpz_f6u7EuW-BKnar-AAPhysiciansForPatientProtection.org

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 Mercy Health Systems for replacing physicians with nurse practitioners.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Watch the video on our YouTube channel, Patients at Risk: https://www.youtube.com/channel/UCLLDpz_f6u7EuW-BKnar-AAPhysiciansForPatientProtection.org

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 experiences, and he joins to share his insights and thoughts about how we can improve our broken healthcare system.   Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Dr. Lopatin's writing:"I knew she was trouble" -   https://judiciary.pasenategop.com/wp-content/uploads/sites/42/2020/09/Article-Mark-Lopatin-MD.pdf"The facts did not matter"  = https://mail.google.com/mail/u/0/#search/mlopatin%40comcast.net/FMfcgzGljvNMgRKMzxvTnTCJSXrMsxnD?projector=1&messagePartId=0.1"This physician is retiring: here is his most valuable lesson" = https://www.kevinmd.com/blog/2020/12/this-physician-is-retiring-heres-his-most-valuable-lesson.htmlPhysiciansForPatientProtection.org

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 Fountain Direct Primary Care.  (https://fountaindirectprimarycare.com) We are also joined by Dr. Meghan Galer, a board-certified emergency physician who opened her own direct primary care practice, ColGACare, in Georgia. (https://www.colgacare.com)Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/References:BMJ 2018 - Continuity of care with doctors—a matter of life and death? A systematic review of continuity of care and mortality https://bmjopen.bmj.com/content/8/6/e021161 BMJ 2019 - US patients live longer in areas with more primary care doctors, study finds BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l804 (Published 20 February 2019) BMJ 2019;364:l804Mortality rates are lower with higher continuity of care, review finds BMJ 2020;370:m3184Lancet: http://dx.doi.org/10.1136/bmjgh-2017-000424Gray BM, Vandergrift JL, McCoy RG, et al Association between primary care physician diagnostic knowledge and death, hospitalisation and emergency department visits following an outpatient visit at risk for diagnostic error: a retrospective cohort study using medicare claims BMJ Open 2021;11:e041817. doi: 10.1136/bmjopen-2020-041817 http://dx.doi.org/10.1136/bmjopen-2020-041817PhysiciansForPatientProtection.org

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 and credential nurse practitioners to work in positions completely outside of their scope of practice, putting patients at risk to save money and increase profits. Today we talk with attorney Robert Painter about the role of the legal system in holding bad actors like this accountable.  Mr. Painter is a former hospital administrator who is now a medical malpractice and wrongful death lawyer at Painter Law Firm in Houston, Texas. https://painterfirm.com/Get the book! Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/PhysiciansForPatientProtection.org

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 a licensed physician. Moreover, 79% of respondents said that they would support legislation to require that patients be informed of the level of education, skills, and training of all health care professionals. Fortunately, some states are taking action to ensure truth and transparency among healthcare practitioners, with New Jersey leading the way.  Today we are joined by two special guests to discuss the New Jersey Health Care Transparency Act, which was passed in 2020: Marlene  Kalayilparampil, MHA, FHELA is the manager of government relations for the Medical Society of New Jersey, and Dr. Flowers is a practicing physician in New Jersey. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/premium/arc/tia-survey_0.pdfPhysiciansForPatientProtection.org