The pathway to becoming a licensed physician in the United States requires nine to eleven years of formal education, and all physicians are required to pass a series of three high stakes standardized examinations called the United States Medical Licensing Examination (USMLE) before they can be licensed as to practice medicine. Most physicians also go on to become board-certified in their specialty field, which requires an additional examination following their residency or fellowship training.  Compared to physicians, nurse practitioners and physician assistants have a far shorter course of training, and both are required to pass one standardized examination to be licensed to practice.  

In 2008, the National Board of Medical Examiners offered down a simpler version of the USMLE Step 3, an examination all physicians take to receive a medical license. The pass rates for DNP candidates ranged from 33%-70%, and the experiment was discontinued in 2014 due to "low utilization."

Roy Stoller DO, an otolaryngologist and board examiner, joins Rebekah Bernard MD and Niran Al-Agba MD in a discussion of the differences between the exams that medical doctors and nurse practitioners and physicians assistants take.  

Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

PhysiciansForPatientProtection.org

Psychiatrist Torie Shatzmiller Sepah MD discusses her experiences as a chief psychiatrist at the California Department of Corrections, and her role in the "Golding Report," a whistleblower report by Michael Golding MD that alleges improper psychiatric care of inmates. Complete report here:  https://www.scribd.com/document/392536943/Dr-Michael-Golding-California-prison-report-on-mental-healthcare

This episode contains brief graphic descriptions of inmate harm as well as physician suicide. If you are having any thoughts of self-harm, please call your physician or the suicide prevention lifeline immediately. 

Physicians, medical students, and resident/ fellow physicians may also obtain free and confidential help through the Physician Support Line, a service offered by volunteer psychiatrists 7 days per week.  Call: 1 (888) 409-0141 or physiciansupportline.com to learn more.

Get the Patients at Risk book!  https://www.amazon.com/gp/product/B08M9YJQR3/
Learn more about Physicians for Patient Protection: PhysiciansforPatientProtection.org

PhysiciansForPatientProtection.org

Dr. Torie Shatzmiller Sepah, a practicing psychiatrist, discusses the differences between psychologists and psychiatrists, and the increasing trend of allowing psychologists to prescribe medications.

Get the book Patients at Risk: https://www.amazon.com/gp/product/B08M9YJQR3/ref=dbs_a_def_rwt_bibl_vppi_i0

To learn more about cognitive behavioral therapy, Dr. Sepah recommends the book "Thoughts and Feelings" - https://www.amazon.com/Thoughts-Feelings-Taking-Control-Moods/dp/1684035481/

Physicians: Join Physicians for Patient Protection - physiciansforpatientprotection.org

PhysiciansForPatientProtection.org

Corinthia Davidson-French shares the story of her son's missed diagnosis of aplastic anemia after multiple visits to an FNP at the local clinic. We also discuss racial disparities in the healthcare system, and what patients can do to advocate for their own medical care.

Learn more about becoming a bone marrow donor at: BeTheMatch.org.

Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

Citations:
Goldberg GA, Jolly DM, Hosek S, Chu DS. Physician's extenders' performance in Air Force clinics. Med Care. 1981;19(9):951‐965. doi:10.1097/00005650-198109000-00007

Morrison F, Shubina M, Goldberg SI, Turchin A. Performance of primary care physicians and other providers on key process measures in the treatment of diabetes. Diabetes Care. 2013;36(5):1147‐1152. doi:10.2337/dc12-1382 

Kurtzman ET, Barnow BS. A Comparison of Nurse Practitioners, Physician Assistants, and Primary Care Physicians' Patterns of Practice and Quality of Care in Health Centers. Med Care. 2017;55(6):615‐622. doi:10.1097/MLR.0000000000000689 

PhysiciansForPatientProtection.org

Gerald "Jay" Baltz, a psychiatric mental health nurse practitioner who is being investigated by the California Board of Nursing for an inappropriate sexual relationship with a patient who later took her own life, received his training at an online program that required a minimum of 500 clinical hours of experience for graduation.  Baltz continues to provide psychiatry care to patients in California and Washington state, and since receiving a doctorate degree in nursing, he now advertises as "Doctor" Jay Baltz, DNP. 

We are joined by psychiatrist Dr. Natasha Cervantes to discuss the differences in training between psychiatrists and psychiatric nurse practitioners, and why the difference in care can be a matter of life or death.

If you are someone you know is having thoughts of self-harm, help is available. Contact your physician immediately, or call the Suicide Prevention Lifeline for help at 800-273-8255.

Learn more about this issue - get the book Patients at Risk, available at Amazon and Barnes and Noble. https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

PhysiciansForPatientProtection.org

Gerald "Jay" Baltz, a psychiatric mental health nurse practitioner, was investigated by the California Board of Nursing after allegations that he had entered into a sexual relationship with a patient who subsequently took her own life.  The Board received this information in April of 2018, began its investigation, and filed a claim against Baltz on June 15, 2020. Today, six months later, Baltz continues to practice psychiatry as a nurse practitioner in California and in Washington state, where he has autonomous practice and does not require physician supervision.  We are joined by psychiatrist Dr. Natasha Cervantes to discuss details of this tragic case.

If you are someone you know is having thoughts of self-harm, help is available. Contact your physician immediately, or call the Suicide Prevention Lifeline for help at 800-273-8255.

Learn more about this issue - get the book Patients at Risk, available at Amazon and Barnes and Noble. https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/

PhysiciansForPatientProtection.org

Dr. Robin Rose, a family physician who trained as a nurse and then nurse practitioner discusses the differences in education and training between the medical disciplines. Dr. Rose, who lives on an isolated island in Hawaii, describes challenges in obtaining physician-led care, especially for vulnerable populations living in medically underserved areas.

PhysiciansForPatientProtection.org

Physicians who speak out in support of physician-led care face repercussions. Steven Maron, MD, a pediatrician with 31 years of experience, was fired from United Community Health Center in southern Arizona after writing a newspaper article explaining the difference in training between a physician and a nurse practitioner. As Maron pointed out in his op-ed, while there are excellent and experienced nurse practitioners and physician assistants, their education and training are not the same as that of a physician. He suggested that to make an informed decision about medical care, the public should know who is treating them and the critical differences in the training of clinicians. Although Maron had worked for the community health center serving socioeconomically depressed children for 10 years without any disciplinary actions, he was terminated just days after the op-ed appeared in the Green Valley News. “I was told that my article stood in opposition to the principles of the organization, specifically the principle of mutual respect."

Get the book! https://www.barnesandnoble.com/w/patients-at-risk-niran-al-agba/1137936919?ean=9781627343169

PhysiciansForPatientProtection.org

Dr. Amy Townsend discusses the incredible lengths she went through to get the Texas Board of Nursing to act to stop a dangerous nurse practitioner after he caused 2 patient deaths.  

Get the book! https://www.barnesandnoble.com/w/patients-at-risk-niran-al-agba/1137936919?ean=9781627343169

July 21, 2017
https://www.12newsnow.com/article/news/local/nederland-nurse-practitioner-says-allegations-of-inappropriate-use-of-hormones-are-unfounded/502-4583920

July 26, 2017https://kfdm.com/news/local/two-setx-families-hire-attorney-for-possible-legal-action-against-clinic-in-nederland

Oct 5 2017https://kfdm.com/news/local/nursing-board-accuses-optimum-health-owner-of-altering-document

Oct 24, 2017https://kfdm.com/news/local/angel-san-juan-breaks-optimum-clinic-raid-reports-live-on-investigation

Oct 24, 2017https://kfdm.com/news/local/law-enforcement-agencies-searching-nederland-health-clinic

May 23, 2018https://kfdm.com/news/local/kfdm-investigates-optimum-clinic

Sept 11, 2018https://kfdm.com/news/local/tmb-says-doctor-didnt-properly-supervise-two-nurse-practitioners-at-optimum-clinic

Jan 30 2019https://kfdm.com/news/local/southeast-texas-nurse-practitioner-surrenders-license-optimum-clinic-evicted

March 3 2019https://kfdm.com/news/local/owner-of-controversial-optimum-clinic-surrenders-nursing-license

Nov 14, 2019https://kfdm.com/news/local/kfdm-investigates-the-hiring-of-a-lamar-university-instructor-who-has-now-resigned

PhysiciansForPatientProtection.org

Drs. Rebekah Bernard, Niran Al-Agba, and Phil Shaffer break down the 2018 Cochrane Review "Nurses as Substitutes for Physicians in Primary Care," pointing out that of 9,000 studies reviewed over the last 50 years, just 18 were of adequate quality to include in a review of the subject. Of these 18 studies, just THREE were published in the United States, most contained high degrees of bias, had small sample sizes, were of short duration, and ALWAYS included physician supervision or nurses following physician-created protocols. Bottom line: there is no evidence that unsupervised nurse practitioners can provide the same quality of care for patients.

PhysiciansForPatientProtection.org