Written by
Natalie Newman, M.D., Emergency Room Physician

THE TRUTH BEHIND NPS REPLACING PHYSICIANS

“Concerning Trends in Primary Care Physician Demand and Compensation” was the title of the article, and “Merritt Hawkins report shows skyrocketing demand for nurse practitioners while the demand for family physicians dropped” was the subtitle. This sobering article (authored by Dr. Seger Morris) summarizes the fact that physicians ARE INDEED being replaced by non-physician providers.

“Nurse practitioners (NPs) topped the list of Merritt Hawkins’ most requested search engagements for the first time, underscoring the accelerating demand for these professionals. In 27 previous years, the top position has always been held by physicians.”

I submit that the demand is not due to patient requests or necessity, but corporate medicine (backed by private equity) preferentially seeking out and hiring cheaper NPs for positions for which they may not be fully or appropriately qualified….all to save costs and increase profits.

In an article titled “How to Discourage a Doctor,”² author Dr. Richard Gunderman further clarifies more reasons why demand may have increased, because the corporate practice of medicine (CPOM) has a specific agenda.

The pandemic conveniently provided the CPOM with an “Eureka” moment, delivering an unexpected opportunity for them to remove physicians from the medical landscape without drawing much attention. Who would question the quality of care for anyone when so many patients with COVID were dying? A great smokescreen for hiding substandard care in other areas.

Additionally, COVID led to a financial boon for the CPOM that has persisted for two years, to their delight. It is also my opinion that the significant majority of patients do not demand NPs, as the marketing campaign, “We Choose NPs” by the American Association of Nurse Practitioners (AANP) would have you believe. Patient choice is almost completely removed in today’s healthcare scenario. Patients are forced, by the corporate practice of medicine and insurance companies, to take what is given to them while they are gouged financially. Being charged the same price they would pay if they had seen an actual physician rather than a facsimile purported to be “equivalent.” Common sense dictates that when given a choice, laypeople will choose physicians, especially if they are being charged the same for the service.

Primary care physicians (Family Medicine, Internal Medicine, and Pediatrics) have the most difficult job in medicine because they manage the entire body and all of its systems. When damage is done to children, it is even more reprehensible. Children are not little adults, and they are not always “easy”.

These con artists do their utmost to convince everyone else that NPP (non-physician provider) practice is “just as good” care as provided by physicians.

Bulls**t.

If it were, they would also use NPPs to provide primary care to their own families and/or children. The majority of them don’t. Their hypocrisy is lost on them. This is the s**t that occurs when ego overrides common sense, when gluttony is prioritized over safety, when one aspires to be a parasitic “Pimp or Ho”² rather than a healthcare professional or executive with integrity.

Bottom line: Primary care physicians are irreplaceable.

As with all businesses, when medicine became corporatized, the expectation was to ensure that profits would be plentiful. The Cartel and Pimps needed it to “rain Benjamins.” The higher the net yield, the happier the shareholders. It was never about the quality of care or healthcare at all. Although unintentional, the “Future of Nursing” campaign, of which Full Practice Authority (FPA) is an integral part, aligned nicely with the goals of the business of medicine. Both entities desired to remove physicians from their natural leadership position in the medical hierarchy.

For Pete’s sake, there was ready money to be had. For NPs seeking pay parity and equivalence by professional misappropriation (aka identity theft), physicians were obstructive. In the way. For the corporate practice of medicine, physicians’ pesky ethics not only obstructed their greedy pursuance of financial gain, but they were also just too damn expensive. The CPOM had no desire to pay for expertise; their wish was to simply increase the profit margin by any means necessary.

So physicians had to go. And go they have. Family Medicine Physicians. Internists. Pediatricians. Anesthesiologists. Hospitalists. Dermatologists. Psychiatrists. Emergency Medicine physicians.

Replaced by substandard replicas which were NEVER DESIGNED to be substitutes for physicians. They forced a round peg into a square hole and then proceeded to convince the public that the pieces fit by promoting dishonest propaganda and false advertising. Lying comes easily to charlatans. For them, a moral compass is nonexistent.

One of the consequences of unsupervised (or poorly supervised) NPP practice is that malpractice claims and payouts are increasing, for NPs in particular and the physicians and hospital systems for which they work. One such case is the tragic story of Alexus Ochoa. The attorneys acting on behalf of her family sued the hospital and the ED medical director for permitting an unqualified NP to work, unsupervised, in an ED where supervision was required.

Malpractice: Can’t Fake It ‘til You Make It

An episode of the podcast “Patients At Risk” features Travis Dunn, one of the attorneys from the law group that is representing the Ochoa family. For the record, the NP was also named as a defendant, BY HER EMPLOYER, and was held accountable as well. ³ It is my contention that the “trend” mentioned in the Merritt Hawkins article is unsustainable.

“Healthcare is neither a right nor a privilege. In a civilized society, it is a necessity. The corporate practice of medicine is directly antithetical to that need and its power must be abrogated.” –N. Newman, MD

Why? Because one cannot “fake it until you make it” in medicine. The art and science of medicine is simply too complex, as is the human body. The deficits in fundamental medical knowledge eventually manifest in poorly managed patients, suffering from medical errors that no physician would make. Can’t sweep humans under a rug, so the damage inevitably becomes visible. I fully expect that much like the housing crash of 2008, this medical bubble will also collapse, with a trail leading directly to the culprits who caused the fiasco.

U.S. “hellcare” is a fragile, unstable, unscrupulous system propagated by rapacity. It is not too big to fail, and when it does, I predict the fall will be catastrophic. To whom will everyone turn to repair the resultant clinical devastation precipitated by the current system? Physicians. That’s who.