Bests & Worsts Reviews from Amazon

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, resulting in subsequent death via bilateral pulmonary embolism - the exact same fate as Alexus Ochoa. Google it. So where do Dr Bernard and Dr Al-Agba stand on THIS case, and why isn't it in their book? Do they find it acceptable for patients to die as a result of malpractice, so long as it's at the hands of physicians? Maybe they believe the dead patients of negligent physicians are peacefully resting in eternal contentedness because "at least they saw the real doctor and not a 'midlevel' provider." If you need proof of the amazingly high doctor malpractice rates in America, read 'Malpractice' by Lawrence Schlachter, MD and 'Unaccountable' by Marty Makary, MD. An ironic quote from the former: "...most new laws (and media coverage of them) are the opposite of what their titles imply. 'Patient protection' legislation is often anything but. 'Physician protection' probably wouldn't sell. Smart wolves come in sheep's clothing." That was published in 2017, three years before the founding of the unfortunately named "Physicians for Patient Protection" by Dr Al-Agba and Dr Bernard. A humorous coincidence, because the founders of PPP obviously did not read Dr Schlachter's book (dare I say, ANY book on preventable medical errors) before agreeing on their advocacy group's name. This book is just one piece of their larger propaganda campaign. So what is this book's real purpose, if not simply to educate and protect patients? To sculpt public view of healthcare professionals, to be heavily in favor of MDs & DOs, and heavily biased against NPs and PAs. How would they benefit from such a priority? If you guessed "money," you are correct: Dr Al-Agba and Dr Bernard compare the physician-per-citizen ratio in the US (7.26 per 100,000) with other countries like Australia (15.44). However they omit how US physicians have benefited from this circumstance: average earnings of US primary care physicians is $186k annually, with orthopaedists earning $442.5k (54% and >100% more than the average of their European counterparts, respectively). Doctors are the 2nd largest occupation in the top 1% of income earners in the US (not the case in all other industrialized nations, where the physician-citizen ratio is more balanced). It's simple supply and demand: more competition is bad for doctors' pocketbooks (reference: 'The Captured Economy’). Dr Bernard and Dr Al-Agba claim that state medical boards rigorously screen doctors and regulate their licensure, but this is false. Physician negligence and failure by their oversight agencies is not rare at all: among physicians who have made four malpractice payments, fewer than 1 in 6 have been disciplined by their state medical boards. Among doctors who've made 10 or more malpractice payments, 66% have never been disciplined by their medical boards (reference: 'The Captured Economy’). How unfortunate Dr Bernard and Dr Al-Agba are either unaware of these facts despite a combined 42 years of practice, or carefully omitted it from their book because it didn't fit their narrative of "NPs and PAs are dangerous, make sure you always see an MD or DO." If you are shocked by the tales of NP medical errors in this book, and their state Nursing Boards' sadly slow action to stop them from practicing, you should be. But their errors can never compare to physician malpractice tales, and the mind-blowing decisions by their state Medical Boards not to discipline. For example, Christopher Duntsch, MD, maimed, killed, and paralyzed over 30 patients as a neurosurgeon before the Texas Medical Board suspended his license (one year after he was reported for egregious incompetence by fellow surgeons and other concerned professionals). Ironically, Texas was also the home state for two of the 'NP horror stories' from Dr Al-Agba and Dr Bernard's book. Yet again, this and similar physician malpractice tales are awkwardly absent from the book, as if its authors are from an alternate universe in which MDs walk on water and their feces smells of lavender. Never underestimate the power of hubris, denial, and narcissism to sever an individual's connection to reality and lead them to blame the world's problems on everyone else. In the words of Larry Schlachter, MD, JD, lack of intervention by state medical boards "leads an objective observer to think the professional societies are more invested in protecting their professional colleagues from consequences of sloppy and grossly negligent work than in protecting patients." More clues this book is propaganda: the authors have a complete lack of scholarship on the subject matter, and some of their cited 'reputable sources' include Reddit and Quora. There is an entire subspecialty of medicine and public health in which doctors dedicate their careers to the study of, and system-wide prevention of, avoidable patient injury. They have their own academic peer-reviewed journal: "The Journal of Patient Safety," which Dr Bernard and Dr Al-Agba have never been published in (nor do either of them have any peer-reviewed publications on patient outcomes or preventable injury from medical errors). Perhaps that's because their sole amateur work on the subject, as published in this typo-filled book, would never pass peer review. William Osler said "by practice alone can you become expert." Despite describing Osler in their book as the father of modern medicine, these authors have apparently forgotten his teachings and are compulsively fixated on the length of a profession's formal education as the sole metric of its legitimacy. And despite these authors' claims, you really can’t presume a practitioner's competence based on the letters after his or her name. As Abraham Verghese, MD once put it well:: "Your patients will judge you not by the diplomas on your wall, but by the manner in which you perform the slightest act."