Patients at Risk

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.  

PhysiciansForPatientProtection.org

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 with nonphysician practitioners. It is time for physicians to step up and take back control of healthcare decisions, and one of the best ways to do this is through self-ownership. 

PhysiciansForPatientProtection.org

Arthur Smolensky, MD describes his experience creating a Small Democratic Group (SDG) to take over emergency department staffing from corporate contract management groups.

https://www.linkedin.com/in/arthur-smolensky-719806/

PhysiciansForPatientProtection.org

In today's episode, Teresa Camp-Rogers, MD, MS analyzes a study published in the Annals of Internal Medicine, the journal of the American College of Physicians, entitled 

The article, which seems to call for an expansion of unsupervised practice for NPs, contends that NPs and physicians showed no differences in inappropriate prescribing to seniors based on Beers criteria, however, notes that NPs were overrepresented among clinicians with the highest and lowest rates of inappropriate prescribing. 

Dr. Camp-Rogers points out that since most NPs are practicing under physician supervision, with an estimated 2-6% of NPs practicing without physician supervision, this study may simply prove what other studies have established: the physician-led care model works - NOT that unsupervised practice is safe.  Further, she argues that this study begs a follow-up question: with such variation in potentially inappropriate prescribing by NPs, what do we know about which NPs were in the top and which were in the bottom?  

https://www.acpjournals.org/doi/10.7326/m23-0827

Get the books! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438/

PhysiciansForPatientProtection.org

Three years ago, we aired a podcast criticizing Doctors' Day posts from hospitals and healthcare organizations that included non-physicians and referred to physicians as 'providers.'  Fast-forward to today, and some organizations (but not all!) seem to have gotten the message.

Happy Doctors' Day to all physicians - thank you for your sacrifice and dedication to patient care!

PhysiciansForPatientProtection.org

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training.

Canion suggests:
- At least 2 years of RN experience before starting NP school
- Increased standards for entry, including minimum GPA requirements 
- Standardized, rigorous education and program-vetted preceptorship
- An increase to 2,000 hours of base NP training and an additional 4,000 hours of training within a specialty (Family, Psych, ER, etc).

He writes, "We need a pause on independent practice or 'full practice authority' for NPs until our education has been fully reviewed."

Read the entire report here:
https://jcthenp.substack.com/p/2023-report-on-np-education-and-the

PhysiciansForPatientProtection.org

PhysiciansForPatientProtection.org

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training.

Canion suggests:
- At least 2 years of RN experience before starting NP school
- Increased standards for entry, including minimum GPA requirements 
- Standardized, rigorous education and program-vetted preceptorship
- An increase to 2,000 hours of base NP training and an additional 4,000 hours of training within a specialty (Family, Psych, ER, etc).

He writes, "We need a pause on independent practice or 'full practice authority' for NPs until our education has been fully reviewed."

Read the entire report here:
https://jcthenp.substack.com/p/2023-report-on-np-education-and-the

PhysiciansForPatientProtection.org

PhysiciansForPatientProtection.org

John Canion is an experienced nurse practitioner working within nursing for years to improve NP education. Frustrated with the lack of positive change from NP leadership, he penned the "2023 Report on Nurse Practitioner Education and the Need for Change," which outlines the current state of NP education and proposes solutions that harken back to the original days of NP training.

Canion suggests:
- At least 2 years of RN experience before starting NP school
- Increased standards for entry, including minimum GPA requirements 
- Standardized, rigorous education and program-vetted preceptorship
- An increase to 2,000 hours of base NP training and an additional 4,000 hours of training within a specialty (Family, Psych, ER, etc).

He writes, "We need a pause on independent practice or 'full practice authority' for NPs until our education has been fully reviewed."

Read the entire report here:
https://jcthenp.substack.com/p/2023-report-on-np-education-and-the

PhysiciansForPatientProtection.org

In part 2 of my discussion of the Assistant Physician (AP) role, Dr. Keith Frederick meets Dr. Liz Troilo, who benefited from his legislation. After working as an AP, Dr. Troilo matched into residency and now provides critical access care as a Family physician in Missouri.  Dr. Frederick proposes a possible alternate pathway to independent practice for physicians other than formal residency training.  

Learn more about the importance of physician-led care - https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438
https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

PhysiciansForPatientProtection.org