Malpractice Costs Will Soar if NPs are Deemed On Par With Physicians

Dear Administrator Verma,

Deeming non-physicians to be essentially equal in training and experience to physicians amounts to a dangerous experiment on American patients. It is improper and unethical for the federal government to be making such decisions regarding the scope of practice of medical professionals.

I have spent over 40 years as a complex litigation specialist. Handling over 35,000 malpractice claims. It seems the law of unintended consequences is at play. Currently the “Captain of the Ship” doctrine limits liability to allied health personnel. It also limits professional and legal liability costs. Placing nurse practitioners and Physician assistants on par will indeed lead to greater claim frequency and increased legal costs. Rates for all providers will increase. In fact underwriters will increase offices with PA’s and NP’s. We could see malpractice costs for internal medicine practices rise from $1-3,000 to $9-12,000 per allied health professional .

We saw the law of unintended consequences occur with EHR and once down that “rabbit hole” there is no return. There is both a patient and physician expense that has not been calculated.

Likewise it is irrational and counterproductive to pay a minimally trained person the same as a highly trained, experienced person. If the reimbursement is the same for poor quality as for good quality, but the poor quality costs less to provide, the entities that degrade quality have a competitive economic advantage. Medicare’s existing price controls are already impeding patient access to high quality care and should not be exacerbated by additional flawed policies that further disregard important differences between practitioners. 

The bottom line is that patients’ lives are at risk. The federal government should follow a policy of “first do no harm.” It violates this principle to impose top-down edicts declaring that non-physicians are qualified to practice medicine. I urge the federal government to reject such policies.

Peter Leone

President, Edge Professional Liability Services https://edgepro.net/

Time to Educate the Public on the Difference Between Physician Extenders and Physicians

NJ Physicians Mark Nemiroff, MD, George Petruncio, MD and IP4PI’s Craig M Wax, DO say the difference matters and believe it is time that the public knows the risks of having non-doctors imply that they have the same qualifications as physicians.

They have introduced Resolution 6-2019 at the Medical Society of New Jersey House of Delegates:

Title: Investigation of the autonomous practice of physician extenders in New Jersey and education of the public regarding the differences between physician extenders and physicians.

Sponsored by: Camden County Medical Society

Whereas, physician assistants (PAs) and nurse practitioners (NPs) in the State of New Jersey must have supervising physicians; and

Whereas, there appear to be PAs and NPs practicing semi-autonomously or autonomously in New Jersey with practice names implying they are “Certified Physicians,” and

Where as, physician extender and mid-level practitioner advertisements appear to fraudulently indicate medical licensure, putting public health at risk, and therefore be it

Resolved, the Medical Society of New Jersey call on the New Jersey licensure and regulatory agencies to investigate the legitimacy, guidelines and regulations pertaining to physician extender advertisements and autonomous practice, and be it further

Resolved, the Medical Society of New Jersey educate the public on the difference in education, ability and licensure requirements of physician extenders versus physicians.

Submitted by:

Dr. Mark Nemiroff, President Camden County Medical Society

Dr. George Petruncio

Dr. Craig M. Wax

I should not be mandated to PAY-to-Practice this great noble profession of Osteopathy.

IP4PI supporter Gina Reghetti, D.O. shares correspondence regarding continued attacks on the osteopathic profession.

Just a note to let you know that I received a letter today from the AOA, dated 1-9-2017 and signed by Jeffrey L. Weaver, O.D., yes, OD, not DO, an Optometrist who is the Vice President, Certifying Board Services, and from Eunice Lee, Associate Vice President, Client and Member Services, informing me that I have until February 1, 2017 to renew membership to keep my AOA board certification active. My board certification is wrongfully time-dated to expire in December 31st, 2022.

My scanner isn’t connecting to my PC wifi so I am unable to email the letter to you currently.

I called Jeffrey L. Weaver, O.D., this morning to confirm that he is not a DO, and I had a conversation with him for more than an hour regarding my views and concerns of the wrong agendas that the AOA has enforced on their doctors, such as re-certifications, and OCCs and membership dues connected to certifications. Continue reading

OMT – Is there an app for that?

I had a student who wanted to create an app for PAs and NPs with counterstrain positioning, codes, and paymehts electronic records and insurance coding send all rolled into one so non-DOs can use and code for OMT(osteopathic manual treatment).

As his teacher, I was more than a little disappointed. This ‘all you gotta do’ attitude and get rich quick off creating an osteopathic app was shallow and disrespectful of Osteopathic practices and I refused to participate. As a D.O., our students get 1000 extra hours of osteopathic principles, practices and treatment experience than our other physician colleagues.  We are in a period where this type activity will increase and trivialize the value of OMT if THIS is what it comes to mean. By sheer volume this over simplified version of OMT could become what they think it IS. This is dangerous and we should issue policy and position statements carefully as a profession.

I knew this type activity was in the works, so I am not surprised, but I am a little dismayed that THIS is what has come to Osteopathy.

Carlisle Holland, D.O.
Holonomic Institute
Sebastopol, California 95472
Holonomics are the Principles of Integrative Medicine