Exploring the Growing Role of Nurse Practitioners and Physician Assistants in Patient Care

J. Kelsey: Very good book

United States on Jul 04, 2023

KL: This is a well thought out, well organized book that details the rise of the non physician provider (namely NPs and PAs). It is a must read for those who have concerns about the delivery of Healthcare.

... there is a huge push by nearly, if not all, hospital systems to not only hire more NPPs but to even replace physicians with NPPs. Follow the money, NPPs are cheaper to pay, order far more unnecessary expensive tests which in turn profits the hospital and are much more easily coerced by hospital administrators to go along with their algorithms of care (saving money where it counts and making money at the same time).

... the LAW itself DOES NOT SEE NPPs AS EQUALS ... when lawsuits are brought against NPPs physicians are not allowed to testify against them, because.... THEY ARE NOT EQUAL. NPPs are held to a LOWER standard of care because they're not equal.

... many people bemoan being taken care of by an intern in the hospital (who has passed at least TEN standardized nationwide exams, has had one 10,000 hours of rigorous supervised clinical hours and had to get into medical school which requires nurses to redo their pre-requisite courses because they are not...

United States on Jan 12, 2022

eric: ++ recommend

Canada on Oct 17, 2021

Will: This book does raise important points about problems in NP education standards, and unethical activities of the medical-industrial complex with respect to the role of NPs and PAs. However, it is not truly a book about 'patients at risk,' because the meticulous data-driven analysis applied to NP-related safety concerns is not extended to discussion (nor mention) of the number one offender of unnecessary patient injury and death: inept and negligent physicians.

The authors finish their commentary on Alexus Ochoa's tragic death by suggesting she would still be alive if only she had seen a board-certified emergency physician instead of an NP. Anyone can google "pulmonary embolism physician lawsuit" and discover this alternate reality has already played out, and not surprisingly doctors also make serious mistakes. But don't take it from me, ask Peter Rosen, MD. When testifying against fellow physician Dr Price Omandi in a fatal malpractice case, Dr Rosen called his practice “grossly improper, egregious, and contrary to well-known and fundamental medical principles." Dr Omandi had failed to order a chest CT before discharging his teenage patient with an NSAID for chest pain,...

United States on Jan 13, 2021

Sparke: While I see that there are a multitude of NPs and PAs that have given poor reviews, it clearly seems to be based on the title alone and mostly by non-verified purchasers and unfortunately, not based on facts or the content of the book.

This book isn’t against NPs and PAs, whom are valuable members of physician led teams. It clearly delineates the issues of the corporatization of medicine allowed lesser trained and less costly ‘providers’ to substitute for physicians at the significant cost of patient safety when NPs and PAs are allowed (by legislation, not education) to practice medicine without a license/training to do so or physician supervision.

To be clear: nurses practice nursing, which is algorithms of common symptoms without any training in medicine. Their classes are predominantly on nursing theory and leadership, while lacking anatomy, pathophysiology, pharmacology and bios/epi that physicians receive and their clinicals are 500 hours of shadowing. Most (85%) of DNP programs are non-clinical, meaning ‘leadership’ and offer no additional clinical skills training. Many programs are online and accept and pass anyone willing to pay and the course work...

United States on Dec 02, 2020