We have all been there. We have a potentially serious injury or health concern and go to the emergency department for treatment. When we’re there, though, we don’t see a doctor. A doctor is not available. We can only see a nurse practitioner or a physician’s assistant. These mid-level practitioners may be ok to prescribe medicine for the flu or for pain, but they are notoriously bad at diagnosing and treating serious medical conditions. Why? Because they do not have the same education, training, and experience as a doctor. So why are hospitals throughout Arizona, including in Phoenix and Tucson, relying on nurse practitioners and physicians’ assistants so much? The answer, of course, is profit.
CNN ran an article recently on this horrible business decision. And, to be clear, that is all this is. A business decision. It does not create a safer environment for patients. It does not increase the level of care patients receive. There is absolutely no benefit to the patient at all. The article discusses a patient, Natasha Valle, who presented to Tennova Healthcare, a hospital in Tennessee. She was pregnant and was bleeding, which scared her. She went to the emergency department and was sent home. She returned 3 more times to the ER over the next 3 days. She did not see a doctor until the last visit. Of course, it was the doctor who diagnosed the miscarriage. The nurse practitioners and the physicians’ assistants all missed it.
17 months before this ordeal, the Tennova hospital system outsourced all of its emergency departments to American Physician Partners. While the word “physician” is in the name, it is purely a staffing company. Unsurprisingly, the company is owned by private equity investors. What do they care about? Profit. According to the article, “the company employs fewer doctors in its ERs as one its cost-saving initiatives to increase earnings.” This is not just an allegation from a journalist. THe statement is found in a confidential company document obtained by news outlets. The company is literally putting profits over safety.
What is even more troubling is that these steps are being taken as studies show the increasing dangers of the emergency department. A study published last month in the New England Journal of Medicine found that 1 in 18 emergency department patients are misdiagnosed. That is a huge number, and it is only going up. Why is that number increasing? Because hospital systems continue to prioritize dollars and staff cheaper providers instead of trained doctors. If you go into any Banner Hospital or Honor Health hospital you are likely to find exactly the same thing: No doctor will see you until you are admitted into the hospital.
Until hospitals put patient safety as their top priority, misdiagnosis and malpractice rates will continue to rise at unprecedented rates.