Episode 18 – Physician Leader and Author Warns the Public of a Dangerous Trend

Niran Al-Agba, MD co-authored the book, Patients at Risk—The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, which unearths the confluence of events allowing poorly trained practitioners to diagnose and treat patients.

Dr. Al-Agba, who has a nurse practitioner in her own practice, believes NPs and PAs can provide high quality care.  In her book she states, “The NP and PA roles were created to provide complementary care with a physician carefully supervising and collaborating on complex patients. This model works well.”

The death of straight-A student and college athlete, Alexus Ochoa-Dockins, motivated Dr. Al-Agba. The healthcare trends that endanger patients are all visible in the tragedy that unfolded in an ED staffed solely by an unqualified NP. Elements fueling the problem:

  • Profit-oriented leaders of healthcare systems trade physician salaries for lower non-physician salaries
  • Private equity companies buy up EDs, anesthesiology services, etc., to “streamline” purely for investor profit  
  • Diploma mills churn out thousands of unprepared, unqualified and unsuspecting NPs
  • Disparity in training and in repercussions for patient harm—NPs attain independent practice authority but sidestep being held to medical standards of care
  • A full-on PR machine, American Association of NPs, drives an influential campaign state-by-state
  • Studies of supervised NP/PAs are used to support efficacy of independent NP/PAs
  • Physicians. Not paying attention and not wanting to get tarred with the “turf war” claim. (Guilty as charged.)

Dr. Al-Agba and I discuss themes beyond the book: her pediatric practice, a writing passion, business acumen that started very young, and her long-term physician partner, her dad, who died in 2017.

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Meet Niran Al-Agba, MD:

Dr. Niran Al-Agba is a third generation primary care physician and board-certified pediatrician.  Born and raised in Bremerton, Washington, she graduated from Michigan State University and went on to receive her M.D. at the University of Washington in 1999. After finishing her pediatric residency at the University of Colorado School of Medicine/Denver Children’s Hospital she went home to Kitsap County in Washington. She joined her father in his longstanding pediatric practice in the small town of Silverdale. Father and daughter were business partners for 16 years until the elder Dr. Al-Agba, a beloved pediatrician and community father figure, died in 2017.

Dr. Al-Agba, a prolific writer, is an op-ed columnist for the Kitsap Sun Newspaper, an avid and opinionated blogger, and has been published in the Seattle Times, USA Today, and Fortune Magazine.  Her recently published book, Patients at Risk—The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, was written to educate patients so they can advocate for themselves.  She and her co-author, Rebekah Bernard, M.D., have the Patients at Risk Podcast where they interview guests about patient safety and independent practice authority for non-physicians.

Dr. Al-Agba is a wife, mother of four amazing children, and she plays tennis in her spare (?!) time.

Resources: 

Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcareby Niran Al-Agba and Rebekah Bernard

Patients at Risk Podcast:  https://open.spotify.com/show/4OPVvQVTy5nqNA68ulJWBN?si=hzBse9gWQJOVLsWoyroBgA

Physicians For Patient Protection: https://www.physiciansforpatientprotection.org/
Families sound alarm on medical transparency after the deaths of their children
Silverdale Pediatrics

Website: https://www.niranalagba.com/
Email: niranalagba@gmail.com
Facebook: https://www.facebook.com/niran.alagba
Twitter: https://twitter.com/silverdalepeds
LinkedIn: https://www.linkedin.com/in/niran-al-agba-md-faap-51771a141/

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