Is there an emergency physician in the house?

Consider this scenario: You are having a medical emergency. An ambulance takes you to the nearest emergency department, where you are met by a nurse practitioner (NP) or physician assistant (PA), who may or may not have extra training in emergency care. You ask for a physician, but there are none in the department, or even in the hospital.  In fact, there isn’t even a physician available by telephone to guide the NP or PA in your care. 

In the first episode of Physicians Taking Back Medicine, host Rebekah Bernard, MD, discusses this important topic, with insights from fellow physicians Deborah Fletcher, MD, and Mercy Hylton, MD.

Music Credits

Medical Education by Art Media - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction to the Podcast (00:00:07)
Dr. Rebecca Bernard introduces the podcast and its focus on inspiring stories from physicians.
Meet the Guests (00:00:37)
Dr. Debbie Fletcher and Dr. Mercy Hilton share their backgrounds in emergency medicine.
Replacement of Physicians (00:00:53)
Discussion on the alarming trend of replacing physicians with non-physician practitioners in emergency departments.
Impact of Management Changes (00:01:15)
Dr. Fletcher recounts her experience of being replaced by a nurse practitioner due to management decisions.
Concerns During the Pandemic (00:02:28)
Dr. Hilton discusses the replacement of pediatricians with nurse practitioners during fluctuating emergency department volumes.
Patient Care and Supervision Issues (00:03:01)
Concerns about inadequate supervision and care for patients by non-physician practitioners.
Observations of Mismanagement (00:03:51)
Dr. Hilton shares experiences of patient mismanagement and safety concerns in emergency care.
Mismanagement in Emergency Departments (00:05:28)
Dr. Fletcher agrees on the mismanagement issues observed, including overconfidence among non-physician practitioners.
Study on Nurse Practitioners (00:06:36)
Dr. Hilton discusses a concerning study on the educational preparation of nurse practitioners in emergency departments.
Alarm on Educational Standards (00:08:34)
Discussion on the alarming findings regarding nurse practitioners' training and its implications for patient safety.
Workforce Study Initiative (00:08:43)
Dr. Fletcher initiates a workforce study to assess physician staffing in emergency departments.
Survey Findings on Physician Staffing (00:09:30)
Dr. Fletcher reveals alarming statistics about emergency departments lacking 24/7 physician staffing.
Access to Physician Communication (00:11:51)
Findings on the lack of two-way communication between non-physician staff and physicians in emergency departments.
Legislative Changes in Indiana (00:14:06)
Dr. Hilton shares her advocacy efforts leading to Indiana's law requiring physician presence in emergency departments.
Impact of the Alexis Ochoa Case (00:15:14)
Discussion of the tragic case that motivated Dr. Hilton's advocacy for patient safety in emergency care.
Legislation Journey (00:16:13)
Dr. Hilton details the process of getting legislation passed to ensure physician presence in emergency departments.
Legislative Advocacy (00:17:22)
Dr. Hilton discusses gathering data to support the need for physician staffing legislation.
Truth in Advertising for Emergency Departments (00:18:48)
Discussion on the importance of transparency in advertising emergency departments' staffing levels to patients.
Closing Remarks (00:20:09)
Dr. Rebecca Bernard thanks the guests for their advocacy work and concludes the episode.