Patients at Risk

A patient shares her story of receiving the wrong type of filler into her face by a registered nurse, leading to severe and permanent nerve damage. Francesca explains that the RN, who was in NP school at the time, was not being supervised, and worked in a for-profit clinic owned by a non-physician.While some may argue, "Let the Buyer Beware," Francesca believes that patients are not be in the position to fully understand the qualifications of clinicians being permitted to perform medical procedures, and asks legislators to protect patients like her.Tell us your story: https://www.physiciansforpatientprotection.org/patient-resources/tell-us-your-story/Learn more: PatientsAtRisk.comPhysiciansForPatientProtection.org

Chandani Patel DeZure, a double board-certified physician in pediatrics, joins to discuss a recent AAPA survey highlighting physician support for the independent practice of Physician Assistants (PAs). They delve into the complexities of healthcare autonomy and the implications of the findings, including concerns about misinformation. The conversation sheds light on the evolving dynamics between PAs and physicians, emphasizing the need for accurate data in shaping healthcare legislation and ensuring effective patient care.

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/fulltexthttps://www.journalofnursingregulation.com/article/S2155-8256(22)00010-2/abstractSend me an email through the contact link www.PatientsAtRisk.comPhysiciansForPatientProtection.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-2024-0103-0001PhysiciansForPatientProtection.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.orgPhysiciansForPatientProtection.orgPhysiciansForPatientProtection.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-9fYSupervising physicians sued without ever seeing or being consulted on a patient: https://www.medscape.com/viewarticle/990494?form=fpfhttps://youtu.be/GlfPSnHgC1Ahttps://www.jucm.com/supervising-doctors-may-be-held-liable-in-malpractice-suits/https://www.medpagetoday.com/meetingcoverage/acep/106708Increasing rates of malpractice and adverse reports for NPs: https://youtu.be/EOeGhR2uUSUPhysiciansForPatientProtection.org

Alicia Plemons, an economist from West Virginia University with expertise in healthcare regulation, discusses the vital economic implications of expanding nurse practitioner roles. She explores how a modest increase in primary care providers could ease emergency care pressures and improve access in rural Texas. The conversation raises critical questions about training standards and safety in independent NP practices, while also examining the impact of private equity on healthcare quality and provider dynamics.

Christopher Garofolo, MD, a primary care expert, explores the pitfalls of advice shared on social media among nurse practitioners. He highlights the risks of misinformation from seasoned practitioners to novices, particularly regarding patient care. The discussion emphasizes the critical need for structured medical education over informal guidance, addressing the gaps in NP training. Garofolo critiques the reliance on social media for support and urges for improved communication and foundational knowledge to enhance healthcare outcomes.

Dr. Carol Nelson, a neurologist with nearly three decades of experience, shares a heartfelt tale about her newborn granddaughter's life-saving treatment through a skilled physician-led care team. She emphasizes the crucial role of medical training and teamwork in handling emergencies. The discussion includes how a mother's instinct can lead to timely interventions and critiques the involvement of non-physician providers in critical situations. Nelson advocates for the need for well-trained physicians, especially in rural healthcare, to ensure quality patient outcomes.