Patients at Risk

One of the biggest issues in medicine today is physician burnout, with almost 50% of all physicians reporting making active plans to leave the practice of medicine. We are joined by an expert on the subject of physician wellness, psychiatrist Wendy Dean. Dr. Dean and her co-author have singlehandedly changed the dialogue away from ‘burnout’ and towards the concept of ‘moral injury.’  We asked Dr. Dean for her perspective on the impact of corporatization and the replacement of physicians by nonphysician practitioners on physician morale and burnout.Dr. Dean's landmark article: https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/And Dr. Dean's article on her experience with the healthcare system:https://www.wbur.org/commonhealth/2020/01/24/moral-injury-american-medicine Dr Dean's website and podcast:  https://fixmoralinjury.org/ https://podcasts.apple.com/us/podcast/moral-matters/id1529907905Get the book: https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/PhysiciansForPatientProtection.org

We are joined by Eric Starkman, an investigative journalist who works to shed light on dangerous corporate practices in healthcare. Mr. Starkman is relentless in exposing the work of bad actors in the medical-industrial complex and discusses how the replacement of physicians by nonphysician practitioners is contributing to the decline of the U.S. healthcare system.Read Eric Starkman's article about the book 'Patients at Risk' here.An excerpt:  "The deceit are the studies purportedly showing that NP and PA patient outcomes are statistically the same as medical doctors. According to Niran Al-Agba and Rebekah Bernard, the MD authors of “Patients at Risk,” all of the studies involved NPs and PAs who worked under the supervision of doctors. The authors insist there are no credible studies evaluating patient outcomes involving NPs and PAs working without medical supervision, which they are doing with increasing frequency.The corruption is that hospitals and other healthcare facilities are increasingly foisting NPs and PAs on patients without patients knowing it. The trend in healthcare today is to refer to everyone who interacts with patients as “healthcare providers” and they all wear white coats. At some hospitals, even the orderlies and housekeeping staff wear white coats, so it’s impossible to distinguish the real doctors among the white coat brigades.Nurse practitioners and physician assistants aren’t real doctors. They can’t, don’t, and never will provide comparable medical care. They’re MD Lites – Less training. Less knowledge. Less skills."Get the book! PhysiciansForPatientProtection.org

About 42% of physicians report feeling burned out, and about half of all doctors are making active plans to leave the practice of medicine. Unfortunately, some doctors turn to drugs and alcohol to cope with the stressors of medicine, which may result in the loss of their professional licenses. Today, we are talking with Dr. Daniel Hochman, a psychiatrist, and an online professional recovery program creator to discuss physician well-being.  Get the book!  https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Dr. Daniel Hochman's online recovery program: https://www.selfrecovery.org/about-dr-hochman/Physician support line:  1 (888) 409-0141      https://www.physiciansupportline.com/ "Psychiatrists helping our US physician colleagues and medical students navigate the many intersections of our personal and professional lives"  - free and confidentialPhysiciansForPatientProtection.org

On May 24, 2021, JAMA, or the Journal of the American Medical Association, published a viewpoint entitled:  “Advanced Practice Clinicians—Neurology’s Underused Resource.” The article was authored by nurse practitioner Calli Cook and Dr Heidi Schwarz, a neurologist with the University of Rochester and argued that due to a shortage of neurologists across the country, non-physician practitioners should be used more widely to provide neurology care to patients. Physicians for Patient Protection submitted a letter to the editor expressing concerns about these viewpoints, however, JAMA Neurology declined to print our letter, citing space concerns and "your letter did not receive a high enough priority rating for publication."Neurologist/ psychiatrist Dr. Alyson Maloy and neurologist Dr. Carol Nelson join me to discuss the replacement of neurologists by nonphysician practitioners.Link to JAMA Neurology article: https://jamanetwork.com/journals/jamaneurology/article-abstract/2780419Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Join physiciansforpatientprotection.orgPhysiciansForPatientProtection.org

One of the ways that corporations have been successful in replacing physicians with lesser-trained medical practitioners is by creating a sense of equivalence so that patients think that the care they will receive is “the same.” For example, both physicians and nurse practitioners and physician assistants wear white coats, have similar-appearing badges, and may be referred to as “doctor” even if that doctorate is not a medical degree.  Not only do these corporations elevate the role of nonphysicians, they also work to bring down the level of physicians.  On many health system websites, physicians are listed as mere “providers.” The once-named “doctor’s lounge” is now the provider’s lounge. And now, some institutions have even taken aim at “Doctor’s Day,” hijacking the one day devoted to showing appreciation for physicians and turning the focus instead on the healthcare ‘team’.Today, Dr. Marsha Haley, a radiation oncologist, joins us to discuss an article that she wrote for the Buck’s County Courier Times about the appropriation of ‘Doctor’s Day’. Get the book!  https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Dr. Haley's article:  https://www.goerie.com/story/opinion/2021/04/18/op-ed-doctors-shouldnt-have-share-their-day-especially-year/7219700002/Vanity Fair article discussing group purchasing organizations (GPOs) and their contribution to a shortage of PPE - includes details that Kevin W. Sowers, RN, MSN, the president of Johns Hopkins Health System, was a board member of a GPO that began servicing the hospital system after Sowers became the system's leader.https://www.vanityfair.com/news/2020/05/corporate-deals-making-hospitals-ppe-shortages-worse May 2020PhysiciansForPatientProtection.org

One of the differences between physicians and nurse practitioners is that physicians are regulated by a state Board of Medicine, while in most states, nurse practitioners are regulated by a state Board of Nursing.  This distinction is important, because while nurse practitioners are functioning in the same capacity as physicians—ordering and interpreting tests, making medical diagnoses, and writing prescriptions for medications—they are overseen by a regulatory body that includes nurses without experience in this type of practice, which can result in a lack of appropriate action when a nurse practitioner is practicing improperly.  Today we are going to discuss the case of nurse practitioner Jeffrey Young, the so-called, “Rock Doc,” who was indicted in 2019 for prescribing controlled substances to his patients “to obtain money, notoriety, and sexual favors.” Despite multiple reports to the Tennessee board of nursing, outside agencies took five years and action before Young finally lost his prescribing privileges. Emergency medicine physician Dr. Teresa Camp-Rogers joins us to discuss the details of this case.  Atlantic article: https://www.theatlantic.com/health/archive/2021/01/rock-doc-opioids/617405/ Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/PhysiciansForPatientProtection.org

In our book, we dedicate several chapters to discussing the differences in training between physicians and non-physician practitioners. One of the most important elements of physician training is learning how to create a differential diagnosis, which is a list of all the possible causes of a patient’s symptoms.  Today we are joined by Dr. Mercy Hylton, a pediatric emergency medicine physician and who is also an author and a patient advocate, to discuss why physician training - including learning how to properly create a differential diagnosis - is so important.Get the book - now available as an audiobook from Audible and at iTunes:https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/B08Z4F1JJ6/Physicians:  Join us!  Physiciansforpatientprotection.orgDr. Hylton's articles: An Ode to the Differential Diagnosis -  https://www.kevinmd.com/blog/2021/03/an-ode-to-the-differential-diagnosis.htmlFind more blogs by Dr. Hylton at: https://www.kevinmd.com/blog/post-author/mercy-hyltonPhysiciansForPatientProtection.org

In part 2 of this discussion with emergency physicians Dr. Robert McNamara and Dr. Mitch Li, we learn about the dangers that patients face due to the takeover of private equity in healthcare.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/PhysiciansForPatientProtection.org

When you are taken by ambulance to the nearest emergency department, you are completely vulnerable. This is not the time when you can research or negotiate prices. With the corporate takeover of hospitals, bills for emergency services have skyrocketed. Patients often receive enormous bills that can sometimes even bankrupt them. These corporate systems are also taking advantage of physicians, and in many cases, replacing them with non-physician practitioners.We are joined by two experts on the subject – Dr Robert McNamara is an emergency room physician who has been publishing articles on this subject for 25 years. Dr Mitch Li is an emergency medicine physician with a practice based on the direct primary care movement and is raising awareness about the dangers of private equity and corporate healthcare.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Articles by Dr. McNamara:Corporate and Hospital Profiteering in Emergency Medicine: Problems of the Past, Present, and Future - https://www.jem-journal.com/article/S0736-4679(16)00007-X/fulltextA Survey of Emergency Physicians Regarding Due Process, Financial Pressures, and the Ability to Advocate for Patients - https://www.jem-journal.com/article/S0736-4679(12)01725-8/fulltextMore reading:The Rape of Emergency Medicine - Free download at https://www.aaemrsa.org/get-involved/the-rape-of-emPhysiciansForPatientProtection.org

In recent years, there has been a massive increase in medical practitioners offering hormone therapy to patients. Since insurance doesn’t cover these treatments other than for very specific medical conditions, most patients end up paying cash, leading to big profits.  These treatments are usually promoted as “wellness” products, intended to make patients feel younger, stronger, thinner, and just all-around better. But the truth is that there is no clear evidence hormones cause these benefits, and when used improperly, hormone therapy can cause serious risks to patient health, and even cause death.Today we are joined by Dr. Joyce Varughese, a gynecologist oncologist.  As a doctor treating women with gynecologic cancers, she has seen serious harm caused by patients from using unapproved therapies and is here to share important safety information for patients. Dr. Varughese, welcome to the show!Get the book!https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/PhysiciansForPatientProtection.org