Patients at Risk

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...

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 Lin...

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...

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...

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...

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 ex...

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...

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 fla...

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 fl...

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://...

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...

Attorney and emergency medicine physician William P. Sullivan believes that nonphysician practitioners should practice independently, but be held to the same medical standard as physicians since NP/PA leaders argue that there is "no difference in the practices and outcomes between physicians and advanced practice providers." Dr. Sullivan joins us to discuss his article on this issue - ht...

In several previous podcasts, you have heard us refer to research studies that claim to show that nurse practitioner care is just as good or better than that provided by physicians. We’ve shown that in many of these cases, the study authors are using flawed methodology or failing to disclose important information, like nurse practitioners working under physician supervision.   Today we invite you...

Douglas Farrago MD discusses why '9 out of 10 administrators' absolutely hate his new book, The Hospital Guide to Physician Retention: Why Creating A Physician-Friendly Environment Is Critical For Your Organization’s Success .   Dr. Farrago has been fighting to improve the state of medicine for decades, authoring books on direct care and pointing out the fallacies in health care at his b...

Sonal Patel MD and Jou Jou Hanna MD discuss the difficult choices that women make to become physicians, and why that training matters. PhysiciansForPatientProtection.org

One topic that gets women physicians fired up like no other is a discussion of gender issues in medicine. While medical school classes are currently made up of about 50% women, women physicians are still a significant minority in medical practice today, and women doctors face serious inequities due to their gender. One of the biggest challenges that women must face is the decision of if or when to...

Part 2 of our discussion with John Lafferty MD regarding the need for Flexner-style reform for NP and PA programs. Dr. Lafferty describes his experiences training PA students. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Thanks to our sponsor: Old Pueblo Anesthesia (OPA) is a physician-owned and operated practice that has served the southern A...

Many of our podcasts have focused on concerns about the deterioration of nurse practitioner training, with an increase in for-profit schools that compete fiercely for student tuition dollars. These programs often boast 100% acceptance rates -in other words, anyone who applies is accepted. Students who attend programs like these complain about sub-par education including open-book tests that leave...

One of the strategic goals of the American Association of Nurse Practitioners listed on their website (now behind a paywall) is for nurse practitioners to achieve pay parity:  to be paid the same as physicians. Oregon became the first state to require that insurance companies pay nurse practitioners the same as physicians and now proposed legislation would do the same in Washington state. To discu...

As nonphysician practitioners increasingly provide more patient care, experts note a commensurate increase in medical malpractice claims. Today we welcome medicolegal adviser Bob Pegritz, the co-author of ‘Hospital Confidential,’ an expose of medical malpractice cases.  As Bob wrote me, "I have worked in the medical/legal community for 32 years. Before that, I was a surgical PA. As a medical/...

As our listeners already know by now, to be licensed to practice medicine, physicians in most states must complete a minimum of three years of postgraduate medical education, called residency training. Each specialty offers its own residency program, but all must follow specific, standardized criteria created by the ACGME—the American College of Graduate Medical Education. If programs fail to meet...

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).  In part 2,  I am joined by two radiologists to discuss the use of nonphysician...

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 r...

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...