Imposter Doctors: Patients at Risk

by Rebekah Bernard MD

When you experience a medical emergency, you expect to be treated by a licensed physician with expertise in your condition. What happens when you look up from your hospital gurney to find that the doctor has been replaced by a non-physician practitioner with just a small fraction of the training and experience?

From the co-author of Patients at The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, the first book to warn of the systematic replacement of physicians, comes Imposter Doctors, an even more frightening exposé of patient endangerment at the hands of for-profit corporate entities and healthcare conglomerates.

In the two years since Patients at Risk debuted, the employment of non-physician practitioners has continued to skyrocket. While advocates insist that nurse practitioners and physician assistants are ‘just as good’ as physicians, they are wrong. Despite over fifty years of scientific analysis, there is no conclusive evidence that non-physicians can provide safe and effective medical care without physician oversight. In fact, recent studies have shown the that the replacement of physicians puts patients at risk.

The only cure for today’s healthcare crisis is for patients to become informed about who is providing their care. We must all know the difference in clinician education and training, and demand answers from those who would deprive us of physician-led care.

REVIEWS and WORDS OF PRAISE

This book is well-written, richly researched, and scientifically based. Imposter Doctors explains how scope expansion has been facilitated by the corporatization of American medicine, and exposes the fallacy of NP/PA and physician equivalency. It is a must-read for anyone concerned about our nation’s healthcare system.
--Susan Rudd Bailey, MD, Past President American Medical Association

Another frank and hard-hitting discussion from the author of Patients at Risk. While some will likely dismiss this book as aiming to protect the status quo in healthcare, I sincerely hope it creates important conversations about training, qualifications transparency, and public safety.
--L Allen Dobson Jr, MD, FAAFP, Editor-in-Chief Medical Economics

This follow-up book to Patients at Risk articulates the desperate need for reform to the healthcare system to re-insert physicians as the ultimate decision maker for the sake of patient care. After reading this book, one must ask "will a physician be available to care for me and my family when the need arises?"
--Linda Lambert, FAAMSE

Genres: Medicine

272 pages, Kindle Edition

Published June 1, 2023

Reviews

[Alden Bush · Rating 1 out of 5]

In her latest book, Rebekah Bernard continues to cater to individuals who hold negative opinions toward nurse practitioners and physician assistants. This includes undergraduate pre-med students, medical students, resident physicians, attending physicians, and those who strongly advocate for "patient safety." Her approach in this book is more aggressive than in her previous work.

She is helping to perpetuate a movement through her work that, on the surface, says it aims to protect patients: which, in truth, is noble. However, beneath the surface, you find animosity, hatred, and prejudice that will, if left unchecked, endanger patient outcomes.

Why? Because ultimately, the message is to:
1. Not supervise NPs/PAs
2. Not work with them
3. Not take referrals from them
4. Scour the internet for moments they make a mistake and use it as anecdotal evidence to generalize.
5. Create a hostile work environment
6. Paternalistically dictate what autonomous professions can and cannot do.
7. Maintain physician hegemony over healthcare
8. Abolish the NP profession (there is a special place in Bernard's heart for the NPs)

There is also an apparent and notable obsession with providing anecdotal evidence to demean/broad-stroke views on professions that are boots on the ground, overwhelmingly doing much more beneficence than maleficence. The content primarily centers around denigrating NPs or PAs as second-rate compared to others. The language used to convey the message may be carefully worded and refined, but the tone is far from pleasant.

Healthcare is available in numerous settings, and unfortunately, some doctors, such as Bernard, only concentrate on emergency cases. Although having well-trained physicians available during emergencies is crucial, what about other essential healthcare environments that are not emergent?

There is, here, a pressing cultural issue that needs urgent attention. It's concerning that so many are participative and actively contributing to a harmful and hostile environment that impacts everyone involved. We must acknowledge the significant role that physicians play in this hierarchy and their considerable power, and how a movement like Bernard's can have detrimental effects on the healthcare team.

Dear reader, it is crucial to stay alert and analyze any evidence. Please be careful of anecdotal evidence and think about the level of empirical evidence being presented. It is essential to be mindful of confirmation bias, selection bias, and the abundance of peer-reviewed evidence that may counter many of Bernard's positions. If a movement promotes prejudice, demonization, harassment, or ostracizes certain groups, it is necessary to question whether or not it is fulfilling its intended purpose.

After reading her original book and now this gem, I reflect more than ever that no profession is immune to human error, avarice, malpractice, and other imperfections. Nonetheless, as you read through the pages, please remember that as NPs and PAs, we remain dedicated to being at the forefront of delivering healthcare services. Our mission is to save lives, relieve suffering, provide care to the vulnerable during their most difficult moments, and improve access to healthcare across the United States.

[Anna · Rating 3 out of 5]

I would actually give this book 3.5 stars. I liked it, but I liked Patients at Risk more. Still, the point comes across very well - midlevel practitioners are unqualified to practice independent of physician supervision. It boggles my mind that this is not common sense to our legislators and colleagues. I don’t think I’ve met at APP who wants independent practice. It makes no sense. It’s crazy that a book like this is even necessary.

Imposter Doctors heavily utilizes anecdotes to make its points. It behooves me to point out that anecdotal evidence is not even close to scientific, statistically significant evidence. The book really should’ve emphasized the Hattiesburg Clinic study more. I was very surprised it was only mentioned in the last chapter. This study is really the best proof we have that APP care is subpar when compared to physician care.

Lastly, a message to my physician colleagues. Stop teaching APPs how to do your job. You are only enabling them to one day take your job. Not even surgery is immune.

[cindy Lukasiewicz-cossu]

A MUST READ for anyone concerned about our current health care system !

This book points out the critical point: NP' s and PA' s do NOT have the same EDUCATION and TRAINING as Physicians! The public has the RIGHT to know the difference and they need to be able to make an informed decision as to who is treating them ! Just wondering? How many NP' s and PA' s were NOT accepted to Medical School ? Choosing this direction I stead !

[Connie · Rating 4 out of 5]

A look at how the generalized term "provider" patients who do not understand the depth of training of many practitioners and those who have less training may or may not have oversight or supervision of their practice.

[Kit · Rating 5 out of 5]

A must read.

Patients beware! Poorly trained non physician practitioners (NPs and PAs) are attempting to practice medicine. Learn about this dangerous trend and what needs to be done to stop it.

[Melissa Mendez · Rating 4 out of 5]

This is the companion book to Patients at Risk and expands on the podcast. This should be a wake up call to the American public at why our healthcare is failing.

[Gina Guillotte · Rating 5 out of 5]

This would not be considered a fun read, but it is well written and important.