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Patients at Risk
38 minutes | Jul 25, 2021
Physician assistant and former-PA-turned-physician discuss the state of the profession
When it comes to discussing the differences between physician assistants (PAs) and physicians, there is no one better to address the issues than someone who has trained and worked in both professions. Christin Giordano MD was a PA before deciding to return to medical school to become a physician. She has since completed residency training and a fellowship to become a nephrologist. We are also joined by Elizabeth Ennis, PA-C, a former classmate of Dr. Giordano, who is currently practicing in California. Together, we discuss the state of the PA profession, including the proposed name change from 'physician assistant' to 'physician associate' and independent practice for PAs.Read Dr Giordano's KevinMD post: From PA to MD: An appreciation for physician educationGet the book Patients at Risk!
38 minutes | Jul 18, 2021
The impact of corporate medicine on physician moral injury
One of the biggest issues in medicine today is physician burnout, with almost 50% of all physicians reporting making active plans to leave the practice of medicine. We are joined by an expert on the subject of physician wellness, psychiatrist Wendy Dean. Dr. Dean and her co-author have singlehandedly changed the dialogue away from ‘burnout’ and towards the concept of ‘moral injury.’ We asked Dr. Dean for her perspective on the impact of corporatization and the replacement of physicians by nonphysician practitioners on physician morale and burnout.Dr. Dean's landmark article: https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/And Dr. Dean's article on her experience with the healthcare system:https://www.wbur.org/commonhealth/2020/01/24/moral-injury-american-medicine Dr Dean's website and podcast: https://fixmoralinjury.org/ https://podcasts.apple.com/us/podcast/moral-matters/id1529907905Get the book: https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/
31 minutes | Jul 12, 2021
Investigative journalist Eric Starkman discusses the dangers of 'MD Lites'
We are joined by Eric Starkman, an investigative journalist who works to shed light on dangerous corporate practices in healthcare. Mr. Starkman is relentless in exposing the work of bad actors in the medical-industrial complex and discusses how the replacement of physicians by nonphysician practitioners is contributing to the decline of the U.S. healthcare system.Read Eric Starkman's article about the book 'Patients at Risk' here.An excerpt: "The deceit are the studies purportedly showing that NP and PA patient outcomes are statistically the same as medical doctors. According to Niran Al-Agba and Rebekah Bernard, the MD authors of “Patients at Risk,” all of the studies involved NPs and PAs who worked under the supervision of doctors. The authors insist there are no credible studies evaluating patient outcomes involving NPs and PAs working without medical supervision, which they are doing with increasing frequency.The corruption is that hospitals and other healthcare facilities are increasingly foisting NPs and PAs on patients without patients knowing it. The trend in healthcare today is to refer to everyone who interacts with patients as “healthcare providers” and they all wear white coats. At some hospitals, even the orderlies and housekeeping staff wear white coats, so it’s impossible to distinguish the real doctors among the white coat brigades.Nurse practitioners and physician assistants aren’t real doctors. They can’t, don’t, and never will provide comparable medical care. They’re MD Lites – Less training. Less knowledge. Less skills."Get the book!
31 minutes | Jul 4, 2021
Psychiatry tips for physician wellness: preventing and treating burnout and addiction
About 42% of physicians report feeling burned out, and about half of all doctors are making active plans to leave the practice of medicine. Unfortunately, some doctors turn to drugs and alcohol to cope with the stressors of medicine, which may result in the loss of their professional licenses. Today, we are talking with Dr. Daniel Hochman, a psychiatrist, and an online professional recovery program creator to discuss physician well-being. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Dr. Daniel Hochman's online recovery program: https://www.selfrecovery.org/about-dr-hochman/Physician support line: 1 (888) 409-0141 https://www.physiciansupportline.com/ "Psychiatrists helping our US physician colleagues and medical students navigate the many intersections of our personal and professional lives" - free and confidential
35 minutes | Jun 27, 2021
JAMA Neurology's solution to neurologist shortage: Just substitute NPs/ PAs
On May 24, 2021, JAMA, or the Journal of the American Medical Association, published a viewpoint entitled: “Advanced Practice Clinicians—Neurology’s Underused Resource.” The article was authored by nurse practitioner Calli Cook and Dr Heidi Schwarz, a neurologist with the University of Rochester and argued that due to a shortage of neurologists across the country, non-physician practitioners should be used more widely to provide neurology care to patients. Physicians for Patient Protection submitted a letter to the editor expressing concerns about these viewpoints, however, JAMA Neurology declined to print our letter, citing space concerns and "your letter did not receive a high enough priority rating for publication."Neurologist/ psychiatrist Dr. Alyson Maloy and neurologist Dr. Carol Nelson join me to discuss the replacement of neurologists by nonphysician practitioners.Link to JAMA Neurology article: https://jamanetwork.com/journals/jamaneurology/article-abstract/2780419Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Join physiciansforpatientprotection.org
32 minutes | Jun 20, 2021
Health system hijacking of 'Doctors' Day' another step towards false equivalence among clinicians
One of the ways that corporations have been successful in replacing physicians with lesser-trained medical practitioners is by creating a sense of equivalence so that patients think that the care they will receive is “the same.” For example, both physicians and nurse practitioners and physician assistants wear white coats, have similar-appearing badges, and may be referred to as “doctor” even if that doctorate is not a medical degree. Not only do these corporations elevate the role of nonphysicians, they also work to bring down the level of physicians. On many health system websites, physicians are listed as mere “providers.” The once-named “doctor’s lounge” is now the provider’s lounge. And now, some institutions have even taken aim at “Doctor’s Day,” hijacking the one day devoted to showing appreciation for physicians and turning the focus instead on the healthcare ‘team’.Today, Dr. Marsha Haley, a radiation oncologist, joins us to discuss an article that she wrote for the Buck’s County Courier Times about the appropriation of ‘Doctor’s Day’. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Dr. Haley's article: https://www.goerie.com/story/opinion/2021/04/18/op-ed-doctors-shouldnt-have-share-their-day-especially-year/7219700002/Vanity Fair article discussing group purchasing organizations (GPOs) and their contribution to a shortage of PPE - includes details that Kevin W. Sowers, RN, MSN, the president of Johns Hopkins Health System, was a board member of a GPO that began servicing the hospital system after Sowers became the system's leader.https://www.vanityfair.com/news/2020/05/corporate-deals-making-hospitals-ppe-shortages-worse May 2020
30 minutes | Jun 13, 2021
Board of Nursing vs Board of Medicine: A case study of nurse practitioner 'Rock Doc' Jeffrey Young
One of the differences between physicians and nurse practitioners is that physicians are regulated by a state Board of Medicine, while in most states, nurse practitioners are regulated by a state Board of Nursing. This distinction is important, because while nurse practitioners are functioning in the same capacity as physicians—ordering and interpreting tests, making medical diagnoses, and writing prescriptions for medications—they are overseen by a regulatory body that includes nurses without experience in this type of practice, which can result in a lack of appropriate action when a nurse practitioner is practicing improperly. Today we are going to discuss the case of nurse practitioner Jeffrey Young, the so-called, “Rock Doc,” who was indicted in 2019 for prescribing controlled substances to his patients “to obtain money, notoriety, and sexual favors.” Despite multiple reports to the Tennessee board of nursing, outside agencies took five years and action before Young finally lost his prescribing privileges. Emergency medicine physician Dr. Teresa Camp-Rogers joins us to discuss the details of this case. Atlantic article: https://www.theatlantic.com/health/archive/2021/01/rock-doc-opioids/617405/ Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/
32 minutes | Jun 6, 2021
Physician training: the "differential diagnosis" and why it matters to your health
In our book, we dedicate several chapters to discussing the differences in training between physicians and non-physician practitioners. One of the most important elements of physician training is learning how to create a differential diagnosis, which is a list of all the possible causes of a patient’s symptoms. Today we are joined by Dr. Mercy Hylton, a pediatric emergency medicine physician and who is also an author and a patient advocate, to discuss why physician training - including learning how to properly create a differential diagnosis - is so important.Get the book - now available as an audiobook from Audible and at iTunes:https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/B08Z4F1JJ6/Physicians: Join us! Physiciansforpatientprotection.orgDr. Hylton's articles: An Ode to the Differential Diagnosis - https://www.kevinmd.com/blog/2021/03/an-ode-to-the-differential-diagnosis.htmlFind more blogs by Dr. Hylton at: https://www.kevinmd.com/blog/post-author/mercy-hylton
34 minutes | May 30, 2021
Patients at risk from private equity takeover of emergency departments - part 2
In part 2 of this discussion with emergency physicians Dr. Robert McNamara and Dr. Mitch Li, we learn about the dangers that patients face due to the takeover of private equity in healthcare.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/
31 minutes | May 23, 2021
Patients at risk from private equity takeover in the emergency department
When you are taken by ambulance to the nearest emergency department, you are completely vulnerable. This is not the time when you can research or negotiate prices. With the corporate takeover of hospitals, bills for emergency services have skyrocketed. Patients often receive enormous bills that can sometimes even bankrupt them. These corporate systems are also taking advantage of physicians, and in many cases, replacing them with non-physician practitioners.We are joined by two experts on the subject – Dr Robert McNamara is an emergency room physician who has been publishing articles on this subject for 25 years. Dr Mitch Li is an emergency medicine physician with a practice based on the direct primary care movement and is raising awareness about the dangers of private equity and corporate healthcare.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Articles by Dr. McNamara:Corporate and Hospital Profiteering in Emergency Medicine: Problems of the Past, Present, and Future - https://www.jem-journal.com/article/S0736-4679(16)00007-X/fulltextA Survey of Emergency Physicians Regarding Due Process, Financial Pressures, and the Ability to Advocate for Patients - https://www.jem-journal.com/article/S0736-4679(12)01725-8/fulltextMore reading:The Rape of Emergency Medicine - Free download at https://www.aaemrsa.org/get-involved/the-rape-of-em
33 minutes | May 16, 2021
Hormone pellet therapy: Is it worth the risk?
In recent years, there has been a massive increase in medical practitioners offering hormone therapy to patients. Since insurance doesn’t cover these treatments other than for very specific medical conditions, most patients end up paying cash, leading to big profits. These treatments are usually promoted as “wellness” products, intended to make patients feel younger, stronger, thinner, and just all-around better. But the truth is that there is no clear evidence hormones cause these benefits, and when used improperly, hormone therapy can cause serious risks to patient health, and even cause death.Today we are joined by Dr. Joyce Varughese, a gynecologist oncologist. As a doctor treating women with gynecologic cancers, she has seen serious harm caused by patients from using unapproved therapies and is here to share important safety information for patients. Dr. Varughese, welcome to the show!Get the book!https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/
32 minutes | May 9, 2021
If you are hospitalized, will your care be overseen by a physician?
Hospital organizations are increasingly replacing physicians with nurse practitioners and physician assistants who act as "hospitalists." John Chamberlain, the board chairman of Citizen Health and a former hospital CEO, discusses his wife's hospital stay, during which her care was supervised by a nurse practitioner.We also discuss the increasing corportization of health care and the importance in transparency among health care practitioners and hospital pricing. Citizen Health aims to redesign healthcare by putting patients and physicians in control. Learn more at https://citizenhealth.io/.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/
27 minutes | May 2, 2021
Friend of YouTube sensation Stevie Ryan speaks out about her care by psych NP
In December, Patients at Risk aired two podcasts in which we discussed the case of Gerald “Jay” Baltz, a psychiatric nurse practitioner who was under investigation by the California board of nursing for engaging in an inappropriate sexual relationship and providing questionable treatment to a patient who subsequently took her own life. While we did not provide any identifying details at that time other than what was included in public documents, since the time of that recording, friends and family members have come forward to identify the patient as Stevie Ryan, a Hollywood comedienne and YouTube sensation who seemed to be on the verge of stardom when her life came to a tragic end at the age of just 33 years old.We are joined today by Yuni Kim, Stevie Ryan’s close friend and confidant, to discuss mental health issues and care provided by different types of mental health clinicians. Yuni previously shared this information with the LA Times as discussed in this article: https://www.latimes.com/business/story/2021-04-01/stevie-ryan-death-nurse-practitionerIf you are having concerns about mental health, help is available. Please call the suicide prevention lifeline at 800-273-8255.Links to previous discussions of this case:https://podcasts.apple.com/us/podcast/psych-np-patient-affair-ends-tragically-case-jay-baltz/id1539719940?i=1000503087095https://podcasts.apple.com/us/podcast/differences-between-psychiatrists-psych-nps-case-jay/id1539719940?i=1000503719243Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Learn more: PatientsatRisk.comPhysicians: Join Physicians for Patient Protection: www.pppofficialsupporter.com
29 minutes | Apr 25, 2021
If you need emergency medical care, will you be treated by a physician?
In our book, we discuss the case of Alexus Ochoa, a healthy 19 yr old woman who died when a nurse practitioner failed to properly diagnose her. What is particularly worrisome about this case is that when Alexus was taken to the emergency room by ambulance, the only medical practitioner working there was a nurse practitioner. Unfortunately, this situation is occurring in hospitals across the country. Physicians are being replaced by non-physician practitioners, and patients often have no idea.Today we are joined by two emergency physicians who have become aware of this trend and are publicly speaking out about their concerns, Dr. Thomas Cook and Dr. Jason Adler.Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/Articles by Drs. Adler and Cookhttps://journals.lww.com/em-news/Fulltext/2021/02000/After_the_Match__Boosting_Profits_Drives_NP.6.aspxhttps://journals.lww.com/em-news/Fulltext/2021/03000/After_the_Match__NPs_Pushing_Expansion_of.2.aspx?context=FeaturedArticles&collectionId=3
30 minutes | Apr 18, 2021
Fighting the replacement of physicians in Texas
Nearly half the states in the Union have legislated the unsupervised practice of medicine by nurse practitioners and currently, one state allows physician assistants to practice without physician supervision. This legislative season we are seeing bills to allow independent practice for nurse practitioners and physician assistants in multiple states that do not currently allow the practice. Today we are joined by two Texas physicians who are working to educate patients and legislators about the importance of physician-led care. Cathy McLaughlin MD is a urologist practicing in Texas and Saba Rizvi MD is a Texas emergency physician who authored a paper on the Private equity takeover of EM groups and their push for more NP staffing models.
24 minutes | Apr 11, 2021
Chiropractor-owned "neuropathy" clinic scams patient for $8000
In our previous podcasts, we have focused on the differences in scope of practice between physicians and nurse practitioners. But other medical practitioners are also wading into the diagnosis and treatment of conditions that have previously been the domain of physicians. Today we are going to discuss care provided by chiropractors, specifically when chiropractors step outside of their traditional role in providing spinal adjustments and into medical treatment for neurological conditions.To help us understand this topic, we are joined today by two special guests, patient Nancy Murphy and her neurologist Dr. Dhruv Joshi.
33 minutes | Apr 4, 2021
Should you let an optometrist operate on your eyes? The difference between ophthalmologists and optometrists
After the brain, the human eye is the most complicated organ in the body. It is for this reason that a graduating doctor must spend at least another four more years after medical school to become an ophthalmologist.Unfortunately, some states are passing laws that allow optometrists to provide eye treatments that they aren’t qualified to do, and this can put patients at risk. Today, we are joined by Laurie Barber MD, an ophthalmologist and the chair of Safe Surgery Arkansas, to explain the differences between types of eye doctors and to help patients know how to protect their vision and their health.
30 minutes | Mar 28, 2021
A nurse's journey to becoming a physician: From RN, BSN, MSN, CNS, CCNP to MD-MBA
Dr. Toni Manougian has done it all. Starting as an RN diploma graduate, Dr. Manougian obtained her bachelor's in nursing, followed by a master's degree as a clinical nurse specialist and then a degree as a critical care nurse practitioner, become deciding to become a physician. Dr. Manougian explains the differences in training between the professions and tells aspiring physicians that it's never too late to become a physician if that is your dream.
35 minutes | Mar 21, 2021
Success story: How Mississippi physicians stopped NP scope expansion
Jennifer Bryan, MD, a family physician and the chair of the Board of Trustees of the Mississippi State Medical Association, discusses how her state created a coalition to block nurse practitioner scope expansion.
35 minutes | Mar 14, 2021
Nurse practitioner describes gaps in education: "I wasn't fully equipped like I thought I was"
Patrice Little DNP discusses limitations in nurse practitioner education and explains why she created a platform to better prepare NP students. Doctor of Nurse Practice Little shares that while she wrote her scholarly project on "full practice authority" for NPs, she realized that many NPs who prioritize patient safety - herself included - don't want independent practice.Patrice Little DNP's site: https://www.npstudentmagazine.com/
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