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Island Sailor

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Terrifyingly true!

Overall
5 out of 5 stars
Performance
4 out of 5 stars
Story
5 out of 5 stars

Reviewed: 05-31-22

I am an emergency physician with 37 years of experience. This book is spot-on correct. Properly supervised in real time, PA’s and NP’s can and do serve as safe, effective care extenders. When working without active, appropriate supervision, PA’s and NP’s often get into situations where they either don’t understand the patient’s problem and how to treat it, or they don’t even know there’s a problem to begin with. The book’s main shortcoming is that it fails to address the economic forces at work strongly enough. PA’s and NP’s salaries are often less than half of what a fully trained, experienced physician gets paid, but organizations utilizing the mid levels can still bill for 85%-100% of what they bill for physician services. Simply put, it’s the same revenue for half the cost. And since administrators are virtually never personally liable for harms their systems cause patients, liability insurance premiums and loss payouts are viewed as simply a cost of doing business, which reduces avoidable patient suffering and death to nothing more than entries on a balance sheet. This is an important book that should influence every healthcare policy maker in this country, but unfortunately, I am certain it will be vilified as arrogant, inaccurate, sensationalized, and misleading by every professional organization whose members seek to get their hands further into the cookie jar. I admire Dr. Al-Agba and Dr. Bernard for being brave enough to publish it.

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