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 questions the push for independent practice for nurse practitioners. The discussion extends to issues of legislative accountability, corporate healthcare’s role in potentially compromising patient care, and the necessity for patients to advocate for themselves to ensure high-quality medical care. Angie's story highlights the broader implications of inadequate training and supervision in healthcare, especially affecting rural communities.

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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 shortage concerns, influenced by flawed reports from the 1980s that led to restricted physician production and the promotion of NPs and PAs as substitutes. Bernard outlines the growth of NP and PA roles, the diluted quality of NP education, and the increasing trend of independent practice. The talk also addresses the disparities in healthcare quality and outcomes when care is provided by non-physician practitioners instead of physicians. Bernard advocates for prioritizing the production of properly trained physicians and ensuring physician-led care as well as holding NP leadership accountable for maintaining educational standards.

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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 matters.

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Get the books, available in paperback, eBook, and Audible:

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

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

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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.com

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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

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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

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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

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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.

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