Patients at Risk
109 episodes - English - Latest episode: 10 days ago - ★★★★ - 242 ratingsPatients at Risk exposes the political maneuvering and corporate greed that has led to the replacement of physicians by lesser trained practitioners, including nurse practitioners and physician assistants. As corporations seek to save money and government agencies aim to increase constituent access, minimum qualifications for our nation’s healthcare guardians continue to decline—with deadly consequences. This is a story that has not yet been told, and one that has dangerous repercussions for all Americans.
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Episodes
"I didn't know how bad it was:" NP pens report on NP education (Part 3)
March 18, 2024 09:00 - 20 minutes - 14.1 MBJohn 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, i...
"I didn't know how bad it was:" Nurse practitioner publishes report on the dismal state of NP education and need for change (Part 2)
March 04, 2024 10:00 - 29 minutes - 20.5 MBJohn 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, i...
"I didn't know how bad it was:" Nurse practitioner publishes report on the dismal state of NP education and need for change (Part 1)
February 19, 2024 13:00 - 30 minutes - 20.8 MBJohn 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, i...
The Assistant Physician (AP) - A pathway to independent practice?
February 05, 2024 10:00 - 18 minutes - 12.7 MBIn 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-D...
BONUS EPISODE: AZ State Rep and ER physician Dr. Amish Shah discusses his run for U.S. Congress
January 24, 2024 14:00 - 19 minutes - 13.6 MBEmergency physician Dr. Amish Shah has served the Arizona State House for the last five years and is now running for U.S. Congress. In this special bonus episode, Dr. Shah explains why he entered into politics, the work he has done to support the practice of medicine, and why physicians should donate to his campaign. Learn more / contribute to Dr. Shah's campaign here: https://www.amishforarizona.com/ Meet Dr. Shah at his fundraiser at the Take Medicine Back meeting February 9, 2024 in Pa...
Physician legislator and creator of 'assistant physician' role in Missouri discusses steps to improve physician shortages
January 22, 2024 13:00 - 25 minutes - 17.8 MBThere is no doubt that America is facing a physician shortage, due in large part to a lack of residency positions, the mandatory 1-3 years that medical school graduates must complete to receive a license to practice medicine. Today we are talking about a proposed solution to this problem—a new professional designation for unmatched medical school graduates called the “Assistant Physician” (AP). I am joined by Dr. Keith Frederick, the originator of the first legislation to create the AP rol...
Physicians fight to prevent more patient deaths from 'wellness' treatments at medspas
January 14, 2024 15:00 - 30 minutes - 20.7 MBIn July 2023, 47 year old Jenifer Cleveland, a mother of four, died after receiving treatments at a Texas medispa. We reported on this tragic story in a podcast with plastic surgeon Alina Sholar (https://www.buzzsprout.com/1475923/13329411-when-wellness-turns-deadly-patient-dies-during-npp-medspa-visit.mp3?download=true). Today, we are discussing the aftermath of this case and efforts by Texas physicians to ensure that no more patients die from ‘wellness’ treatments. Dr. Mary Kelly Green i...
NP malpractice settlements on the rise, especially for NP-owned practices
January 01, 2024 11:00 - 36 minutes - 25.1 MBMalpractice insurance company CNA, along with Nurses Service Organization (NSO) has been providing malpractice coverage for nurse practitioners across the country in a variety of practice settings for the last 30 years. The organization released its first report on NP malpractice claims in 2005, and recently released its 5th report analyzing data between 2017 and 2022. Dr. Kevin Zhang joins me to discuss the findings of this report including: Increase in average total claims for NPs Highe...
Wisconsin NP legislator makes unprofessional comments during testimony on vetoed bill
December 11, 2023 10:00 - 21 minutes - 14.6 MBNurse practitioner and Wisconsin Senator Rachael Cabral-Guevara jokes about 'missing' lobbyist Mark Grapentine's IV... and using the largest bore needle to try again. Bill co-sponsor Rep. Barbara Dittrich responds by pulling her name off the legislation. Get the books! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438 PhysiciansForPatientProtection.org
The Medical Ethics of IV hydration ‘bars’
November 27, 2023 08:00 - 28 minutes - 19.7 MBThere has been a dramatic rise in the number of clinics offering intravenous infusions of fluids and vitamins to treat an array of conditions and for a supposed wellness benefit. But do these treatments actually work? To discuss the risks and benefits of IV infusions outside of a traditional medical setting I am joined by nephrologist Dr. Christin Giordano. Get the new book! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438 PhysiciansForPatientProtection.org
Esteemed physician organization American College of Cardiology selects nurse as new president
November 13, 2023 10:00 - 32 minutes - 22.6 MBInterventional cardiologist Dan Sraow, MD, FACC discusses the election of a nurse rather than a physician to lead the American College of Cardiology (ACC), as well as the risks of non-physicians performing cardiac interventions. PhysiciansForPatientProtection.org
Louisiana doctors succeed at passing graduate physician bill
October 30, 2023 09:00 - 23 minutes - 15.9 MBThere is no doubt that America is facing a physician shortage, due in large part to a lack of residency positions, the mandatory 1-3 years that medical school graduates must complete to receive a license to practice medicine. To alleviate this shortage, some states have a new professional designation for unmatched medical school graduates called 'assistant physician' or 'graduate physician.' Representatives for Louisiana Physicians for Patients discuss their role in passing legislation to...
Louisiana physicians hire lobbyist and defeat NP independence bill
October 16, 2023 04:00 - 27 minutes - 18.8 MBLouisiana physicians discuss their successful effort to block scope of practice expansion in the state. PhysiciansForPatientProtection.org
Bioethicist weighs in on use of the term 'doctor' by nonphysicians
October 02, 2023 08:00 - 30 minutes - 17.8 MBIn 2023, three nurse practitioners sued the state of California for the right to call themselves 'doctors' in a clinical setting. Bioethicist Arthur L. Caplan, PhD, discusses the ethics of titles in healthcare. Dr. Caplan's article - https://www.medscape.com/viewarticle/994536 Get the book Patients at Risk and Imposter Doctors! PhysiciansForPatientProtection.org
Patient asks for OB physician during pregnancy and delivery, told 'no'
September 18, 2023 04:00 - 22 minutes - 15.5 MBAt 39 years old, Hasina Hafiz wanted a physician to oversee her pregnancy and delivery. However, the only clinic in the area that accepted her insurance refused, allowing only CNM/ WHNP care. Retired OB/GYN John Lafferty, MD discusses complications that can occur during pregnancy and delivery, and why team-based care should always be led by a physician. PhysiciansForPatientProtection.org
Noncompete contract restricts rural patient access to physician care
September 04, 2023 04:00 - 32 minutes - 22.3 MBJacqui O'Kane, DO was fulfilling the promise of Family Medicine, providing expert physician care to rural residents of Georgia. Burned out from overwork and support staff challenges, she decided to leave hospital employment. But instead of allowing her to open her own direct primary care practice, the hospital enforced a 50-mile radius noncompete contract, limiting patient access to care. Listen in on our discussion of noncompete contracts and why some physicians are leaving employed practi...
Physician discusses why she will no longer train or supervise NPPs
August 21, 2023 09:00 - 35 minutes - 24.1 MBSara O'Heron, MD discusses changes in the education and training of NPs and PAs over her 35-year career. Learn more at PatientsAtRisk.com Get the new book, Imposter Doctors, available in paperback, eBook and Audible: https://www.amazon.com/Imposter-Doctors-Patients-at-Risk-ebook/dp/B0C4J3P3Z1/ PhysiciansForPatientProtection.org
When 'wellness' turns deadly: Patient dies during NPP medspa visit
August 03, 2023 13:00 - 31 minutes - 21.8 MBPlastic surgeon Alina Sholar, MD discusses the risks and dangers associated with non-physician supervised medspa medical procedures. Get the new book! https://www.amazon.com/Imposter-Doctors-Patients-at-Risk/dp/1627344438/ Join PPP: PhysiciansForPatientProtection.org PhysiciansForPatientProtection.org
Ensuring a fair physician employment contract
July 17, 2023 12:00 - 33 minutes - 23.1 MBEmployment attorney Dennis Hursh, Esq advises physicians on best practices for a fair employment contract. Mr. Hursh is the owner of Physicians Agreements Health Law and the author of The Final Hurdle: A Physician's Guide to Negotiating a Fair Employment Agreement https://www.amazon.com/Final-Hurdle-Physicians-Negotiating-Employment-ebook/dp/B07R596D28/ Contact him at https://pahealthlaw.com/ Get the new book, Imposter Doctors, a sequel to Patients at Risk. https://www.amazon.com/Imposter...
Original study shows impact of NPPs on Emergency physician residents
June 14, 2023 16:00 - 33 minutes - 22.8 MBLead author Andrew W. Phillips, MD, MEd, joins me to discuss the brand new study 'Effects of Non-physician Practitioners on Emergency Medicine Physician Resident Education,' the first study to evaluate the impact of NPPs on EM resident physicians. Permalink https://escholarship.org/uc/item/9g14r2jx Journal Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 24(3) ISSN 1936-900X Authors Phillips, Andrew W Sites, Jeremy P Quenzer, Faith C et al. Publica...
New Book - IMPOSTER DOCTORS - Now On Sale!
June 01, 2023 09:00 - 21 minutes - 14.8 MBHear details about the new book, Imposter Doctors: Patients at Risk, available NOW at Amazon and Barnes and Noble. PhysiciansForPatientProtection.org
Opening your own practice
May 07, 2023 20:00 - 32 minutes - 22.4 MBCan't find a job that doesn't require you to supervise non-physician practitioners? It's time to consider a return to self-ownership! Psychiatrist Dr. Rashida Gray discusses her journey and encourages physicians to take back control of medicine by opening their own practices. Learn more about Dr. Gray at her website: GrayMDPsychiatry.com Join us: PhysiciansforPatientProtection.org PhysiciansForPatientProtection.org
Innocent EKG findings lead to unnecessary ER visit: Why physician training matters
April 17, 2023 09:00 - 17 minutes - 10.4 MBEmergency physician Andrew Wilson, MD, discusses a case in which a routine work physical at an Urgent Care resulted in an unnecessary ER visit for a patient. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164 PhysiciansForPatientProtection.org
Healing the healers: The Physician Support Line
March 20, 2023 23:00 - 27 minutes - 19.2 MBLast week was Match week, and while thousands will celebrate matching into residency, 2,500 medical school grads will face an uncertain future due to a shortage of residency positions. If you know someone who might need help through this difficult time, the Physician Support Line is a free, confidential, and anonymous resource. Dr. Mona Masood, psychiatrist and founder of the Physician Support Line, discusses the importance of help for doctors. Physician Support Line - 1 (888) 409-0141 ...
Utah physician on hiring unmatched medical graduates (associate physicians)
February 11, 2023 12:00 - 28 minutes - 14.1 MBNurse practitioner and physician assistant use are often justified because of a shortage of physicians, especially in underserved areas. One major cause of the physician shortage is a lack of residency positions, the required minimum training that must be completed after medical school to be licensed as a physician. Every year, thousands of aspiring physicians cannot complete that training because of a lack of funding for more residency positions. While physician advocacy groups are lobbyi...
Psychiatrist explains dangers of NP-staffed mental telehealth platforms
January 16, 2023 11:00 - 27 minutes - 13.8 MBThe COVID19 pandemic created both challenges and opportunities in the healthcare sector. One major winner: telehealth startup companies offering ‘virtual’ medical care, including psychiatric care. But instead of hiring physicians, these companies hire nurse practitioners to care for some of the most complex and vulnerable patients in our nation. These companies got an even bigger boost when the U.S. Drug Enforcement Agency relaxed requirements for the prescribing of controlled substances d...
Vicarious liability: Family physicians discuss getting sued due to association with NPs
December 19, 2022 11:00 - 24 minutes - 12 MBNurse practitioner and physician assistant advocates often assure physicians that they face little liability or risk when performing supervision, insisting that NPs and PAs are liable for their own errors. But case law examples demonstrate this to be false. If state law requires physician supervision or collaboration, the physician may be held vicariously liable in the event of negligence, even if they were not consulted by the nonphysician about the patient’s care. Today we are talking wit...
Lack of informed consent: Patient nearly dies after CRNA mishap
November 28, 2022 10:00 - 26 minutes - 12.4 MBImagine this scenario: You are rolled into an operating room in a surgical center for an outpatient elective procedure. But when you wake up; you’re in an emergency department, and you learn that you nearly died from anesthesia complications. Even worse, you find out that your anesthesia was provided not by an anesthesiologist, but by a nurse anesthetist. Paul Ambruster discusses his near-death experience after receiving anesthesia from a CRNA without anesthesiologist supervision. This is a...
Training matters: small town ER doc makes limb-saving diagnosis missed by urgent care NP
October 24, 2022 17:00 - 28 minutes - 14 MBPhysicians train for at least 15,000 hours before we are permitted to practice independently, and one of the reasons is that it takes a long time and a lot of patient volume to be exposed to the many different presentations of disease processes to learn how to recognize true emergencies that need immediate interventions. Today’s guest brings us a perfect example of the importance of this training. Karen Wilson Saintsing DVM is a veterinarian who nearly lost her arm after a nurse practition...
Will an NP/PA perform your next colonoscopy? Part 2
September 06, 2022 11:00 - 23 minutes - 11.3 MBIncreasingly, nurse practitioners and physician assistants are being asked to step into the role of physicians. While surgeons and procedural doctors have been fairly insulated from this phenomenon, the tide is beginning to turn. Today we are going to explore the phenomenon of NPs and PAs performing colonoscopies, screening tests for colon cancer. Colorectal surgeon Amer Alame MD discusses the flaws in a study that claims to show that PAs can safely perform colonoscopies. Fejleh MP, Shen ...
Will an NP or PA perform your next colonoscopy?
August 22, 2022 09:00 - 28 minutes - 13.3 MBIncreasingly, nurse practitioners and physician assistants are being asked to step into the role of physicians. While surgeons and procedural doctors have been fairly insulated from this phenomenon, the tide is beginning to turn. Today we are going to explore the phenomenon of NPs and PAs performing colonoscopies, screening tests for colon cancer. Colorectal surgeon Amer Alame MD discusses the flaws in a 2020 Johns Hopkins study advocating for the use of NPs to perform colonoscopies. Ri...
Physician, Own Thyself: Taking Back Professional Control
July 18, 2022 09:00 - 32 minutes - 16.1 MBTired of being owned by corporations, but don't want to open your own practice? Stephanie Freeman, MD, a critical care physician and entrepreneur, teaches physicians how to become self-employed through contract work and locums. Learn more at DrStephanieICU.com http://www.freelocumstraining.com for free online locums training. National Association of Locums and Independent Physicians http://www.na-lip.com PhysiciansForPatientProtection.org
Nursing research leaders: NPs should not work alone in the ER
July 05, 2022 09:00 - 28 minutes - 13.2 MBIn Jan 2022, the Journal of Nursing Regulation published an article entitled: Analysis of Nurse Practitioners’ Educational Preparation, Credentialing, and Scope of Practice in U.S. Emergency Departments The summary: “Due to the variability in educational preparation, NPs should not perform independent unsupervised care in the ED regardless of state law or hospital regulations.” This unequivocal statement contradicts the rhetoric of NP leadership which insists that NPs should be allowed...
Point of view: Let NPs and PAs practice independently - but hold them to the same standard as a physician
June 20, 2022 04:00 - 34 minutes - 16.8 MBAttorney and emergency medicine physician William P. Sullivan believes that nonphysician practitioners should practice independently, but be held to the same medical standard as physicians since NP/PA leaders argue that there is "no difference in the practices and outcomes between physicians and advanced practice providers." Dr. Sullivan joins us to discuss his article on this issue - https://sullivanlegal.us/nurse-practitioner-and-physician-assistant-standard-of-care/ Get the book! https...
The headlines don't always match the data: an example of egregious methodology in NP literature
June 06, 2022 09:00 - 33 minutes - 16.9 MBIn several previous podcasts, you have heard us refer to research studies that claim to show that nurse practitioner care is just as good or better than that provided by physicians. We’ve shown that in many of these cases, the study authors are using flawed methodology or failing to disclose important information, like nurse practitioners working under physician supervision. Today we invite you to attend Patients at Risk’s first “Journal Club” session as we dissect a study that claims to ...
The secret to hiring and retaining good doctors (and why hospital administrators don't want to hear it)
May 23, 2022 09:00 - 35 minutes - 17.4 MBDouglas Farrago MD discusses why '9 out of 10 administrators' absolutely hate his new book, The Hospital Guide to Physician Retention: Why Creating A Physician-Friendly Environment Is Critical For Your Organization’s Success. Dr. Farrago has been fighting to improve the state of medicine for decades, authoring books on direct care and pointing out the fallacies in health care at his blog, AuthenticMedicine.com. His newest book, The Hospital Guide to Physician Retention is focused on improv...
Women physicians on scope of practice (part 2)
May 09, 2022 11:00 - 19 minutes - 10.3 MBSonal Patel MD and Jou Jou Hanna MD discuss the difficult choices that women make to become physicians, and why that training matters. PhysiciansForPatientProtection.org
No shortcuts in medicine: why women physicians are fired up about scope of practice (Part 1)
April 25, 2022 11:00 - 33 minutes - 16.1 MBOne topic that gets women physicians fired up like no other is a discussion of gender issues in medicine. While medical school classes are currently made up of about 50% women, women physicians are still a significant minority in medical practice today, and women doctors face serious inequities due to their gender. One of the biggest challenges that women must face is the decision of if or when to have children, because of the intense and lengthy educational training process that doctors mus...
Is it time for an NP/PA 'Flexner Report?' Part 2
April 11, 2022 11:00 - 20 minutes - 10.9 MBPart 2 of our discussion with John Lafferty MD regarding the need for Flexner-style reform for NP and PA programs. Dr. Lafferty describes his experiences training PA students. Get the book! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Thanks to our sponsor: Old Pueblo Anesthesia (OPA) is a physician-owned and operated practice that has served the southern Arizona community for over 40 years. They are committed to delivering anesthetic care exclusive...
Is it time for an NP/PA Flexner Report? Part 1
April 04, 2022 11:00 - 23 minutes - 10.9 MBMany of our podcasts have focused on concerns about the deterioration of nurse practitioner training, with an increase in for-profit schools that compete fiercely for student tuition dollars. These programs often boast 100% acceptance rates -in other words, anyone who applies is accepted. Students who attend programs like these complain about sub-par education including open-book tests that leave graduates inadequately prepared to care for patients. The rise of these diploma mills has led ...
Equal pay for 'equal' work: Inside the NP fight to be paid the same as physicians
March 28, 2022 10:00 - 32 minutes - 16 MBOne of the strategic goals of the American Association of Nurse Practitioners listed on their website (now behind a paywall) is for nurse practitioners to achieve pay parity: to be paid the same as physicians. Oregon became the first state to require that insurance companies pay nurse practitioners the same as physicians and now proposed legislation would do the same in Washington state. To discuss the implications of pay parity in Washington and elsewhere, we are also joined by the past pr...
Bob Pegritz
March 14, 2022 09:00 - 33 minutes - 15.9 MBFormer PA and author of 'Hospital Confidential' discusses midlevel malpractice risk
March 14, 2022 09:00 - 35 minutes - 16.6 MBAs nonphysician practitioners increasingly provide more patient care, experts note a commensurate increase in medical malpractice claims. Today we welcome medicolegal adviser Bob Pegritz, the co-author of ‘Hospital Confidential,’ an expose of medical malpractice cases. As Bob wrote me, "I have worked in the medical/legal community for 32 years. Before that, I was a surgical PA. As a medical/legal consultant, I have seen a trend over the past 5 years of more PAs crossing my desk for merit re...
Is this the end of the full-spectrum Family Physician? Discussing proposed ACGME changes to Family Medicine residency training
February 28, 2022 18:00 - 35 minutes - 17.1 MBAs our listeners already know by now, to be licensed to practice medicine, physicians in most states must complete a minimum of three years of postgraduate medical education, called residency training. Each specialty offers its own residency program, but all must follow specific, standardized criteria created by the ACGME—the American College of Graduate Medical Education. If programs fail to meet these criteria, they will not be credentialed by the ACGME, and graduates will not be licensed ...
Who will read your next x-ray? The replacement of Radiologists (Part 2)
February 14, 2022 16:00 - 33 minutes - 23.2 MBAlmost every field of medicine today involves some type of nonphysician practitioner, whose role was originally created to help physicians see patients more efficiently. The specialty of radiology is no exception, and radiologists often work with NPs, PAs, and another type of extender called a radiology assistant (RA). In part 2, I am joined by two radiologists to discuss the use of nonphysicians in radiology and concerns that an increased push for these extenders may negatively impact pat...
Who will be reading your next x-ray? The replacement of radiologists by 'radiology assistants' (Part 1)
January 28, 2022 22:00 - 33 minutes - 17 MBAlmost every field of medicine today involves some type of nonphysician practitioner, whose role was originally created to help physicians see patients more efficiently. The specialty of radiology is no exception, and radiologists often work with NPs, PAs, and another type of extender called a radiology assistant (RA). Today I am joined by two radiologists to discuss the use of nonphysicians in radiology and concerns that an increased push for these extenders may negatively impact patient c...
Responding to EM:RAP and the use of NPPs in the ER
January 17, 2022 00:00 - 39 minutes - 19.2 MBA few months ago, EM:RAP, a well-known and respected EM CME provider hosted a discussion about nonphysician practitioners in the emergency room. Many physicians who listened felt was one-sided and glossed over concerns about independent practice by NPs and PAs. Dr. Steve Carroll, an EM physician and the host of the podcast EM Basics, was so concerned that he reached out to the program to ask for a more even discussion. To their credit, the program allowed him come on to discuss some of the...
Exposing mistruths in the AANP's rebuttal to PPP - Part 2
January 03, 2022 14:00 - 32 minutes - 15 MBIn part 2 of our discussion, Dr. Alyson Maloy and Dr. Phil Shaffer break down the mistruths in AANP president April Kapu's article, 'Full practice authority for nurse practitioners needed to address physician shortage.' Get the book, now available on Audible! https://www.amazon.com/Patients-Risk-Practitioner-Physician-Healthcare/dp/1627343164/ Watch the video on our YouTube channel: https://youtu.be/EDXn7RAomTM Article links: Original article - https://www.medicaleconomics.com/view/cov...
Is PPP a 'fringe' group? Responding to the AANP's accusations in Medical Economics
December 20, 2021 14:00 - 23 minutes - 11.1 MBOn September 29, 2021, the journal Medical Economics published an interview with Dr. Alyson Maloy entitled “Covid exacerbates physician shortage.” In the article, Dr. Maloy discussed the effects of covid19 including a push to increase practice authority for nurse practitioners. A week later, Medical Economics posted a rebuttal written by April Kapu, the president of the AANP, called “Full practice authority for nurse practitioners needed to address physician shortage,” arguing that NPs were...