The South Carolina Legislature has introduced bills that would allow unsupervised practice to nurse practitioners and physician assistants after 2000 hours of experience, as well as a bill that would expand pharmacist privileges. On the flip side, there's also a bill that would enhance team-based care, ensuring that physicians remain in the lead of medical care and strengthening requirements and enforcement of physician oversight. Today, you'll hear just a small part of the very, very l...
One patient died and 25 others were found to have been harmed when a nurse was permitted to perform complex medical procedures in the UK. Gastroenterologist Dr. Kaveh Hoda joins me to discuss the necessary training to perform an endoscopic retrograde cholangiopancreatography (ERCP), a procedure most commonly used to remove gallstones. From the BBC article: 68 patients underwent ERCPs with a 'single consultant nurse', and a review found that 58 received "substandard" care from the serv...
In this episode of 'Patients at Risk,' Angie Pereira shares the heartbreaking story of losing her father due to a misdiagnosed pulmonary embolism by a nurse practitioner in an after-hours clinic. Despite her father's presenting symptoms of shortness of breath and leg pain, strong family history of blood clots, and normal lung exam, the nurse practitioner diagnosed him with pneumonia, leading to his untimely death the next day. Angie emphasizes the need for proper physician oversight and quest...
Rebekah Bernard discusses the legislative trends and impacts of allowing non-physician practitioners (NPs and PAs) to practice medicine unsupervised. She highlights the extensive training and hours required for physicians compared to the significantly less training for NPs and PAs. Bernard explains how legislative changes have allowed NPs and PAs to practice independently in many states, often with less experience and training compared to physicians. She delves into the history of physician s...
Dr. Denise Weiss always wanted to be a physician, but circumstances led her into nursing. She earned an associate's degree as a registered nurse, and then became a family nurse practitioner. After several years of practice, she realized that her education had not prepared her for independent practice, and she decided to return to school to become a physician. Now a practicing anesthesiologist, Dr. Weiss explains the differences between nursing and medical education, and why physician-led care...
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 pr...
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. Lin...
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 sta...
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...
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 distrus...
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 tabl...
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...
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...
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 c...
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. The Miseducation of America’s Nurse PractitionersThey 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-practitione...
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. &nbs...
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 ...