Patients at Risk

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

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