Dr. Phil Shaffer and I are back in SC to testify yet again against a bill that would permit unsupervised NP and PA practice after 2,000 hours of experience. In this episode, I share subcommittee chair Senator Tom Davis's perspectives that SC will lose funding from the Rural Health Transformation project without scope expansion. You'll also hear a letter of support from the FTC Office of Policy Planning supporting scope expansion, and PPP's response explaining why the FTC should reconsider it's position in light of newer data.

PhysiciansForPatientProtection.org

7 year old Betty Wattenbarger died hours after being evaluated by a pediatric nurse practitioner at a pediatric urgent care in Texas. Her father testifies to the Texas Legislature about his experience seeking accountability from the Board of Nursing and why he believes physician-led care matters for patient safety.

Patients at risk video interview with Jeremy Wattenbarger 

Part 1 - https://youtu.be/Su43DKxNZoY

Part 2- https://youtu.be/pNSWr1GSBnU

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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 long two days of testimony before the South Carolina legislature on these bills. Dr. Phil Schaffer and I were invited by the South Carolina Medical Association and we were asked specifically to focus on data - specifically, the evidence to support unsupervised practice. 

Take a listen to our testimony and at the end you'll hear a few questions from legislators. 

IF YOU'RE A SOUTH CAROLINA PHYSICIAN, please join and support the South Carolina Medical Association (SCMA) - they are working hard to fight for physician-led care. https://www.scmedical.org/

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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 service between 2016-21, including 25 who "suffered some degree of harm". https://www.bbc.com/news/articles/clym224qgdyo

As nurses and PAs continue to advocate for more privileges, could this happen in the US?

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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.

PatientsAtRisk.com

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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