Explorez tous les épisodes du podcast Patients at Risk

In February 2025, the AAPA published a press release entitled: 'AAPA Releases Survey Showing Physician Support for Removing Barriers to PA Practice.'   According to AAPA President Jason Prevelige (DMSc, MBA, PA-C, DFAAPA), the survey proved that, “Physicians recognize the need for change. It’s time to modernize these laws so healthcare teams can focus on what matters most, patient care.” But what did this survey REALLY show? Chandani Patel DeZure, MD, joins me to unpack the details.

Links:
https://www.aapa.org/news-central/2025/02/aapa-releases-survey-showing-physician-support-for-removing-barriers-to-pa-practice/
https://www.aapa.org/wp-content/uploads/2025/02/AAPA_Morning-Consult-Survey.pdf

Join us! PhysiciansForPatientProtection.org
Learn more: https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438

PhysiciansForPatientProtection.org

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/fulltext
https://www.journalofnursingregulation.com/article/S2155-8256(22)00010-2/abstract

Send me an email through the contact link www.PatientsAtRisk.com

PhysiciansForPatientProtection.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-2024-0103-0001

PhysiciansForPatientProtection.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.org

PhysiciansForPatientProtection.org

PhysiciansForPatientProtection.org

 In the last episode, you heard some of my testimony at the Texas Interim Legislature hearing on Scope of Practice. Today you're going to hear from a nurse practitioner, Holly Jeffries, who is practicing in rural Texas.

Her testimony was particularly impactful and really quite persuasive to legislators. I think it's important to understand the NP point of view and also learn the concerns of legislators by listening to their line of questioning.

Referenced in the podcast:
Facts about NP primary care numbers (HRSA shows much fewer doing primary care than AANP represents): https://youtu.be/AqyUdQZ-9fY

Supervising physicians sued without ever seeing or being consulted on a patient: https://www.medscape.com/viewarticle/990494?form=fpf
https://youtu.be/GlfPSnHgC1A
https://www.jucm.com/supervising-doctors-may-be-held-liable-in-malpractice-suits/
https://www.medpagetoday.com/meetingcoverage/acep/106708

Increasing rates of malpractice and adverse reports for NPs: 
https://youtu.be/EOeGhR2uUSU

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. The Texas Medical Association (TMA) invited Rebekah Bernard, MD to testify regarding the economic impact of NP independence.

In part 1 of this series, we hear the NP expert witness, economist Alicia Plemons, followed by Dr. Bernard's testimony, along with questioning from the committee.

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.org

PhysiciansForPatientProtection.org

Christopher Garofolo, MD, unpacks the many errors shared by a more seasoned NP to a brand new NP seeking advice on a Facebook post.

Learn more: https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438/

PhysiciansForPatientProtection.org

On the last podcast, I interviewed Dr. Anu Shokla who shared her story of her newborn baby being treated for an emergency rapid response by a nurse practitioner who had just rotated with her on the inpatient adult hematology oncology service.

After hearing that podcast, Dr. Carol Nelson reached out to share a story of the alternate version: her newborn granddaughter was saved because of the outstanding care from well-trained physicians and non-physicians working together in a physician-led care team.

Please enjoy this inspiring and uplifting story of why physician training matters.

PhysiciansForPatientProtection.org

Primary care physician Anu Shukla shares a personal story about the dangers that patients face when physicians are replaced with nonphysician practitioners.

Dr. Shukla's comments on this podcast reflect her views and opinions. She does not speak for or represent her employer.

Physiciansforpatientprotection.org
patientsatrisk.com

PhysiciansForPatientProtection.org

In the first of a series 'The Nurse Will See You Now,' Bloomberg reporters investigate concerns about nurse practitioner education.

They don’t merely support doctors—NPs increasingly treat patients independently, including in specialty practices and emergency rooms. When they aren’t well trained, the results can be tragic. By Caleb Melby, Polly Mosendz, and Noah Buhayar

https://www.bloomberg.com/news/features/2024-07-24/is-the-nurse-practitioner-job-boom-putting-us-health-care-at-risk

Patients at Risk podcast episodes with nurses interviewed for the Bloomberg article:
Rayne Thoman, RN - Episodes 13, 14
John Canion, NP - Episodes 91-93

PhysiciansForPatientProtection.org

There are an estimated 500-750 clinics across the U.S. providing infusions of Ketamine for the treatment of a variety of medical conditions. This is big business, estimated to bring in $3.1 billion per year and projected to rise to 6.9 billion by 2030.  But is Ketamine safe and effective? 

Psychiatrist Kristina Kise, MD discusses the use of ketamine infusions in psychiatry, including the potential dangers to patients when physicians are not directly involved in drug oversight.  

PhysiciansForPatientProtection.org

Psychiatrists are increasingly being replaced by non-physician practitioners - psychiatric mental health nurse practitioners (PMHNPs) and physician assistants (PAs). This webinar explains the difference between a psychiatrist and a PMHNP and reviews the evidence regarding unsupervised care of patients with mental illness by non-physicians.

Link to webinar video: https://youtu.be/djDos6xbRos
Contact me: PatientsAtRisk.com

PhysiciansForPatientProtection.org

Over the last decade, as physicians have increasingly turned to employed practice to cope with declining reimbursement and increased administrative requirements, our role in advocacy has diminished. Doctors are afraid to speak out because we fear being fired and losing our livelihoods.  But without physician advocacy, corporate interests, academic centers, and government agencies are increasingly making decisions contrary to the best interests of patients, including replacing physicians with nonphysician practitioners. It is time for physicians to step up and take back control of healthcare decisions, and one of the best ways to do this is through self-ownership. 

PhysiciansForPatientProtection.org

Arthur Smolensky, MD describes his experience creating a Small Democratic Group (SDG) to take over emergency department staffing from corporate contract management groups.

https://www.linkedin.com/in/arthur-smolensky-719806/

PhysiciansForPatientProtection.org

In today's episode, Teresa Camp-Rogers, MD, MS analyzes a study published in the Annals of Internal Medicine, the journal of the American College of Physicians, entitled 

The article, which seems to call for an expansion of unsupervised practice for NPs, contends that NPs and physicians showed no differences in inappropriate prescribing to seniors based on Beers criteria, however, notes that NPs were overrepresented among clinicians with the highest and lowest rates of inappropriate prescribing. 

Dr. Camp-Rogers points out that since most NPs are practicing under physician supervision, with an estimated 2-6% of NPs practicing without physician supervision, this study may simply prove what other studies have established: the physician-led care model works - NOT that unsupervised practice is safe.  Further, she argues that this study begs a follow-up question: with such variation in potentially inappropriate prescribing by NPs, what do we know about which NPs were in the top and which were in the bottom?  

https://www.acpjournals.org/doi/10.7326/m23-0827

Get the books! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438/

PhysiciansForPatientProtection.org

Three years ago, we aired a podcast criticizing Doctors' Day posts from hospitals and healthcare organizations that included non-physicians and referred to physicians as 'providers.'  Fast-forward to today, and some organizations (but not all!) seem to have gotten the message.

Happy Doctors' Day to all physicians - thank you for your sacrifice and dedication to patient care!

PhysiciansForPatientProtection.org

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training.

Canion suggests:
- At least 2 years of RN experience before starting NP school
- Increased standards for entry, including minimum GPA requirements 
- Standardized, rigorous education and program-vetted preceptorship
- An increase to 2,000 hours of base NP training and an additional 4,000 hours of training within a specialty (Family, Psych, ER, etc).

He writes, "We need a pause on independent practice or 'full practice authority' for NPs until our education has been fully reviewed."

Read the entire report here:
https://jcthenp.substack.com/p/2023-report-on-np-education-and-the

PhysiciansForPatientProtection.org

PhysiciansForPatientProtection.org

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training.

Canion suggests:
- At least 2 years of RN experience before starting NP school
- Increased standards for entry, including minimum GPA requirements 
- Standardized, rigorous education and program-vetted preceptorship
- An increase to 2,000 hours of base NP training and an additional 4,000 hours of training within a specialty (Family, Psych, ER, etc).

He writes, "We need a pause on independent practice or 'full practice authority' for NPs until our education has been fully reviewed."

Read the entire report here:
https://jcthenp.substack.com/p/2023-report-on-np-education-and-the

PhysiciansForPatientProtection.org

PhysiciansForPatientProtection.org

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training.

Canion suggests:
- At least 2 years of RN experience before starting NP school
- Increased standards for entry, including minimum GPA requirements 
- Standardized, rigorous education and program-vetted preceptorship
- An increase to 2,000 hours of base NP training and an additional 4,000 hours of training within a specialty (Family, Psych, ER, etc).

He writes, "We need a pause on independent practice or 'full practice authority' for NPs until our education has been fully reviewed."

Read the entire report here:
https://jcthenp.substack.com/p/2023-report-on-np-education-and-the

PhysiciansForPatientProtection.org

In part 2 of my discussion of the Assistant Physician (AP) role, Dr. Keith Frederick meets Dr. Liz Troilo, who benefited from his legislation. After working as an AP, Dr. Troilo matched into residency and now provides critical access care as a Family physician in Missouri.  Dr. Frederick proposes a possible alternate pathway to independent practice for physicians other than formal residency training.  

Learn more about the importance of physician-led care - https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438
https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

PhysiciansForPatientProtection.org

Emergency physician Dr. Amish Shah has served the Arizona State House for the last five years and is now running for U.S. Congress. In this special bonus episode, Dr. Shah explains why he entered into politics, the work he has done to support the practice of medicine, and why physicians should donate to his campaign.

Learn more / contribute to Dr. Shah's campaign here: https://www.amishforarizona.com/

 Meet Dr. Shah at his fundraiser at the Take Medicine Back meeting February 9, 2024 in Palm Springs https://www.takemedicineback.org/

PhysiciansForPatientProtection.org

There is no doubt that America is facing a physician shortage, due in large part to a lack of residency positions, the mandatory 1-3 years that medical school graduates must complete to receive a license to practice medicine. Today we are talking about a proposed solution to this problem—a new professional designation for unmatched medical school graduates called the “Assistant Physician” (AP). 

I am joined by Dr. Keith Frederick, the originator of the first legislation to create the AP role, and Dr. Liz Troilo, who worked as an AP before becoming a board-certified family physician.

Learn more about physician-led care - get the book IMPOSTER DOCTORS.

PhysiciansForPatientProtection.org

In July 2023, 47 year old Jenifer Cleveland, a mother of four, died after receiving treatments at a Texas medispa. We reported on this tragic story in a podcast with plastic surgeon Alina Sholar (https://www.buzzsprout.com/1475923/13329411-when-wellness-turns-deadly-patient-dies-during-npp-medspa-visit.mp3?download=true). 

Today, we are discussing the aftermath of this case and efforts by Texas physicians to ensure that no more patients die from ‘wellness’ treatments. Dr. Mary Kelly Green is an ophthalmologist and founding member of Texas 400, and advocacy group protection fighting to protect patients.

PatientsAtRisk.com

PhysiciansForPatientProtection.org

Malpractice insurance company CNA, along with Nurses Service Organization (NSO) has been providing malpractice coverage for nurse practitioners across the country in a variety of practice settings for the last 30 years. The organization released its first report on NP malpractice claims in 2005, and recently released its 5th report analyzing data between 2017 and 2022.  Dr. Kevin Zhang joins me to discuss the findings of this report including:

• Increase in average total claims for NPs
• Highest average claim among NPs covered through an NP-office practice
• Most frequent claim: Failure to diagnose

https://www.nso.com/Learning/Artifacts/Claim-Reports/Nurse-Practitioner-Claim-Report-5th-Edition

 Get the new book! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438

PhysiciansForPatientProtection.org

Nurse practitioner and Wisconsin Senator Rachael Cabral-Guevara jokes about 'missing' lobbyist Mark Grapentine's IV... and using the largest bore needle to try again. Bill co-sponsor Rep. Barbara Dittrich responds by pulling her name off the legislation.

Get the books!
https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/
https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438

PhysiciansForPatientProtection.org

There has been a dramatic rise in the number of clinics offering intravenous infusions of fluids and vitamins to treat an array of conditions and for a supposed wellness benefit. But do these treatments actually work? To discuss the risks and benefits of IV infusions outside of a traditional medical setting I am joined by nephrologist Dr. Christin Giordano. 

Get the new book! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438

PhysiciansForPatientProtection.org

Interventional cardiologist Dan Sraow, MD, FACC discusses the election of a nurse rather than a physician to lead the American College of Cardiology (ACC), as well as the risks of non-physicians performing cardiac interventions.

PhysiciansForPatientProtection.org

There is no doubt that America is facing a physician shortage, due in large part to a lack of residency positions, the mandatory 1-3 years that medical school graduates must complete to receive a license to practice medicine. To alleviate this shortage, some states have a new professional designation for unmatched medical school graduates called 'assistant physician' or 'graduate physician.'  

Representatives for Louisiana Physicians for Patients discuss their role in passing legislation to allow graduate physicians the opportunity to work under the supervision of a licensed physician in the state.

PhysiciansForPatientProtection.org

Louisiana physicians discuss their successful effort to block scope of practice expansion in the state.

PhysiciansForPatientProtection.org

In 2023, three nurse practitioners sued the state of California for the right to call themselves 'doctors' in a clinical setting. Bioethicist Arthur L. Caplan, PhD, discusses the ethics of titles in healthcare.

Dr. Caplan's article -  https://www.medscape.com/viewarticle/994536

Get the book Patients at Risk and Imposter Doctors!

PhysiciansForPatientProtection.org

At 39 years old, Hasina Hafiz wanted a physician to oversee her pregnancy and delivery. However, the only clinic in the area that accepted her insurance refused, allowing only CNM/ WHNP care.  Retired OB/GYN John Lafferty, MD discusses complications that can occur during pregnancy and delivery, and why team-based care should always be led by a physician.

PhysiciansForPatientProtection.org

Jacqui O'Kane, DO was fulfilling the promise of Family Medicine, providing expert physician care to rural residents of Georgia.  Burned out from overwork and support staff challenges, she decided to leave hospital employment. But instead of allowing her to open her own direct primary care practice, the hospital enforced a 50-mile radius noncompete contract, limiting patient access to care. Listen in on our discussion of noncompete contracts and why some physicians are leaving employed practice in favor of self-ownership.

For tips and tricks on surviving the fee-for-service world, check out my book,  How To Be a Rock Star Doctor.

Docs, join our fight for physician-led care and truth and transparency among healthcare practitioners - Physicians for Patient Protection.

PhysiciansForPatientProtection.org

Sara O'Heron, MD discusses changes in the education and training of NPs and PAs over her 35-year career.

Learn more at PatientsAtRisk.com

Get the new book, Imposter Doctors, available in paperback, eBook and Audible: https://www.amazon.com/Imposter-Doctors-Patients-at-Risk-ebook/dp/B0C4J3P3Z1/

PhysiciansForPatientProtection.org

Plastic surgeon Alina Sholar, MD discusses the risks and dangers associated with non-physician supervised medspa medical procedures. 

Get the new book! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438/

Join PPP: PhysiciansForPatientProtection.org

PhysiciansForPatientProtection.org

Employment attorney Dennis Hursh, Esq advises physicians on best practices for a fair employment contract.

Mr. Hursh is the owner of Physicians Agreements Health Law and the author of The Final Hurdle: A Physician's Guide to Negotiating a Fair Employment Agreement
https://www.amazon.com/Final-Hurdle-Physicians-Negotiating-Employment-ebook/dp/B07R596D28/

Contact him at https://pahealthlaw.com/

Get the new book, Imposter Doctors, a sequel to Patients at Risk. https://www.amazon.com/Imposter-Doctors-Patients-at-Risk-ebook/dp/B0C4J3P3Z1/

PhysiciansForPatientProtection.org

Lead author Andrew W. Phillips, MD, MEd, joins me to discuss the brand new study 'Effects of Non-physician Practitioners on Emergency Medicine Physician Resident Education,' the first study to evaluate the impact of NPPs on EM resident physicians.

Permalink https://escholarship.org/uc/item/9g14r2jx

Journal Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 24(3) ISSN 1936-900X Authors Phillips, Andrew W Sites, Jeremy P Quenzer, Faith C et al. Publication Date 2023 DOI 10.5811/westjem.58759

Andrew Phillips MD EdD is the author of  Survey Methods for Medical and Health Professions Education - E-Book: A Six-Step Approach

PhysiciansForPatientProtection.org

Hear details about the new book, Imposter Doctors: Patients at Risk, available NOW at Amazon and Barnes and Noble.

PhysiciansForPatientProtection.org

Can't find a job that doesn't require you to supervise non-physician practitioners?  It's time to consider a return to self-ownership!  Psychiatrist Dr. Rashida Gray discusses her journey and encourages physicians to take back control of medicine by opening their own practices. Learn more about Dr. Gray at her website: GrayMDPsychiatry.com

Join us: PhysiciansforPatientProtection.org

PhysiciansForPatientProtection.org

Emergency physician Andrew Wilson, MD, discusses a case in which a routine work physical at an Urgent Care resulted in an unnecessary ER visit for a patient.

Get the book!  https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164

PhysiciansForPatientProtection.org

Last week was Match week, and while thousands will celebrate matching into residency, 2,500 medical school grads will face an uncertain future due to a shortage of residency positions. If you know someone who might need help through this difficult time, the Physician Support Line is a free, confidential, and anonymous resource. Dr. Mona Masood, psychiatrist and founder of the Physician Support Line, discusses the importance of help for doctors.

https://www.physiciansupportline.com/

Psychiatrists helping our US physician and medical student colleagues navigate the many intersections of our personal and professional lives.            
Free, Confidential & Anonymous
No appointment necessary          
Call for any issue, not just a crisis

PhysiciansForPatientProtection.org

Nurse practitioner and physician assistant use are often justified because of a shortage of physicians, especially in underserved areas. One major cause of the physician shortage is a lack of residency positions, the required minimum training that must be completed after medical school to be licensed as a physician. Every year, thousands of aspiring physicians cannot complete that training because of a lack of funding for more residency positions. 

While physician advocacy groups are lobbying Congress for more residency funding, some doctors are taking direct action to help medical school graduates to continue their journey toward becoming licensed physicians. Today we are joined by Mary Tipton MD, an internal medicine and pediatric physician, who has created opportunities for unmatched medical school graduates to gain additional training and experience at her medical clinic. 

Contact Dr. Tipton at Mary.tipton@copperviewmedical.com

PhysiciansForPatientProtection.org

The COVID19 pandemic created both challenges and opportunities in the healthcare sector. One major winner: telehealth startup companies offering ‘virtual’ medical care, including psychiatric care. But instead of hiring physicians, these companies hire nurse practitioners to care for some of the most complex and vulnerable patients in our nation. 

These companies got an even bigger boost when the U.S. Drug Enforcement Agency relaxed requirements for the prescribing of controlled substances due to the COVID19 pandemic. Online mental health companies quickly shifted gears to prescribing medications typically available only through a face-to-face visit, especially stimulant medications for attention deficit hyperactivity disorder (ADHD).

Today we are joined by psychiatrist Ziba Rezaee, MD to help us understand the rise of for-profit online mental health companies and the risks to patients. 

Learn more: https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164

Physicians, join us: physiciansforpatientprotection.org

PhysiciansForPatientProtection.org

Nurse practitioner and physician assistant advocates often assure physicians that they face little liability or risk when performing supervision, insisting that NPs and PAs are liable for their own errors. But case law examples demonstrate this to be false. If state law requires physician supervision or collaboration, the physician may be held vicariously liable in the event of negligence, even if they were not consulted by the nonphysician about the patient’s care.

Today we are talking with Nancy Berley MD and Shenary Cotter MD,  family physicians who experienced negative repercussions when errors were made by associated nonphysicians.

PhysiciansForPatientProtection.org

Imagine this scenario: You are rolled into an operating room in a surgical center for an outpatient elective procedure. But when you wake up; you’re in an emergency department, and you learn that you nearly died from anesthesia complications. Even worse, you find out that your anesthesia was provided not by an anesthesiologist, but by a nurse anesthetist.

Paul Ambruster discusses his near-death experience after receiving anesthesia from a CRNA without anesthesiologist supervision. This is a cautionary tale for patients and physicians involved in the care of surgical patients. 

PhysiciansForPatientProtection.org

Physicians train for at least 15,000 hours before we are permitted to practice independently, and one of the reasons is that it takes a long time and a lot of patient volume to be exposed to the many different presentations of disease processes to learn how to recognize true emergencies that need immediate interventions. 

Today’s guest brings us a perfect example of the importance of this training. Karen Wilson Saintsing DVM is a veterinarian who nearly lost her arm after a nurse practitioner in an urgent care failed to recognize the onset of compartment syndrome. Fortunately, an astute emergency physician immediately recognized the condition and transferred her to a surgical center for treatment.  To help us understand compartment syndrome, we are also joined by trauma surgeon Stephanie Markle DO MPH.

PhysiciansForPatientProtection.org

Increasingly, nurse practitioners and physician assistants are being asked to step into the role of physicians. While surgeons and procedural doctors have been fairly insulated from this phenomenon, the tide is beginning to turn. Today we are going to explore the phenomenon of NPs and PAs performing colonoscopies, screening tests for colon cancer.

Colorectal surgeon Amer Alame MD discusses the flaws in a study that claims to show that PAs can safely perform colonoscopies.

Fejleh MP, Shen C, Chen J, Bushong J, Dieckgraefe, B, Sayuk G. Quality metrics of screening colonoscopies performed by PAs. JAAPA. 2020;33(4):43-48.

Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

PhysiciansForPatientProtection.org

Increasingly, nurse practitioners and physician assistants are being asked to step into the role of physicians. While surgeons and procedural doctors have been fairly insulated from this phenomenon, the tide is beginning to turn. Today we are going to explore the phenomenon of NPs and PAs performing colonoscopies, screening tests for colon cancer. 

Colorectal surgeon Amer Alame MD discusses the flaws in a 2020 Johns Hopkins study advocating for the use of NPs to perform colonoscopies. 

 Riegert M, Nandwani M, Thul B, Chiu AC, Mathews SC, Khashab MA, Kalloo AN. Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients. Endosc Int Open. 2020 Oct;8(10):E1423-E1428. doi: 10.1055/a-1221-4546. Epub 2020 Sep 22. PMID: 33015346; PMCID: PMC7508647.

Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

PhysiciansForPatientProtection.org

Tired of being owned by corporations, but don't want to open your own practice? Stephanie Freeman, MD, a critical care physician and entrepreneur, teaches physicians how to become self-employed through contract work and locums.  

Learn more at DrStephanieICU.com

http://www.freelocumstraining.com for free online locums training.

National Association of Locums and Independent Physicians
http://www.na-lip.com

PhysiciansForPatientProtection.org

In Jan 2022, the Journal of Nursing Regulation published an article entitled: 

Analysis of Nurse Practitioners’ Educational Preparation, Credentialing, and Scope of Practice in U.S. Emergency Departments

The summary:  “Due to the variability in educational preparation, NPs should not perform independent unsupervised care in the ED regardless of state law or hospital regulations.” 

This unequivocal statement contradicts the rhetoric of NP leadership which insists that NPs should be allowed to practice virtually anywhere and everywhere without supervision. Today I’m joined by family physician Christopher Garofalo, and radiologist and PPP board member Phil Shaffer to discuss this important paper. 

PhysiciansForPatientProtection.org