Taz Profile picture
Emergency Physician/Army Vet/Patient-Physician Advocate/Model/Opinionated Citizen/Hippie chick; opinions expressed are mine and mine alone, thank you very much.
Nadine Roumaya Profile picture WPR MD🩺🧠💗 Profile picture 2 added to My Authors
30 Apr
A FYI for followers: State insurance commissioners are consumer advocates. They deal with insurance fraud as well as health, homeowners, life, flood, etc. companies which tend to be obstructive when it is time to pay the piper. Health insurance is the worst. This is MedTwitter,
2)so I will focus on the health insurance scumbags. If you and your doctor determine that your health insurance company is denying a claim or refusing to honor a medication and instead is telling your doctor how to practice medicine, you as a consumer can contact your state
3)insurance commissioner and file a complaint against your insurance company as well as the medical director or physician who denied your claim. You can ask the insurance company for the name and medical license number of the physician to provide to the commissioner. Many times,
Read 7 tweets
29 Apr
I'm asking all TX physicians, as well as the citizens of TX, to please support Betty's Law. This law "would require healthcare workers providing direct patient care and practicing in freestanding ERs and urgent care clinics to wear a photo identification change.org/p/greg-abbott-…
2)badge." The law was introduced by the parents of Betty Wattenbarger, after their 7 y/o autistic little girl was misdiagnosed by a pediatric nurse practitioner(PNP), sent home and died from complications related to sepsis/pneumonia. The PNP did not identify herself as a Nurse
3)Practitioner nor did she have a badge that was visible-so the parents thought she was a physician. Similar laws do indeed exist on the books; however, the associated consequences don't. Violation of Betty's Law may lead to the medical facility being sepsis.org/faces/betty-wa…***
Read 9 tweets
26 Apr
A perfect example of physicians being left out of the conversation when it involves healthcare. These fools are intent on making docs obsolete in the provision of rural health care. Invisible. By intent. No doctor on this list. innovation.cms.gov/innovation-mod…
2)Health insurance executives are well-represented. Right at the top. Now take a look at the "hospital representatives". Not one f***ing physician anywhere. One RN. One CRNP. No physician. Let me reiterate for those in the back...HOSPITAL REPRESENTATION, health.pa.gov/topics/Health-…
3)WITHOUT PHYSICIAN REPRESENTATION. This is how non-medical entities control the narrative of health care. So for the docs who keep yapping that this "is the way medicine is going" have relinquished their position in the driver's seat. I'm not one of those docs. Medicine is our
Read 8 tweets
25 Apr
The attached commentary is from Reddit(reddit.com/r/Residency/co…). I will be the first to admit that medicine would not be going into the toilet w/o the assistance of irresponsible or lax physicians expediting the process. This MS1 documents their experience with seeing a
2)"Rheumatology NP" in a clinic "supervised" from a distance by a Rheumatologist. NP diagnosed the student with scleroderma--who knows how or why. Fortunately, the MS1 had a fabulous PC physician who advocated for them and found the student an actual Rheumatologist who diagnosed
3)and treated the student accordingly. Knowing that there is no actual ACCREDITED NP curriculum for rheumatology that exists, I decided to see if there was anything that could pass for rheumatology NP "education" and lo and behold, there was. An online curriculum(of course)
Read 16 tweets
14 Apr
So this is the response from Envision's CEO to the hubbub that occurred a couple of weeks ago regarding their dismissal of anesthesiologists from WRMC in Wisconsin. It reads as one would expect..I'll leave it at that. He states that "physicians" were not replaced by CRNAs. No one
2)claimed that--I will be more specific and reiterate ANESTHESIOLOGISTS were terminated from WRMC and replaced. And they were not replaced by air. How do I know? Look at the original letter that states they are going to a "100% CRNA model". If they were using CRNAs in this model
3)before, then why was it necessary to make the announcement in the first place? In addition, a lead CRNA will be managing anesthesia services. Not an anesthesiologist. Also note in the letter the statement, "An Envision anesthesiologist will be on staff at this hospital and will
Read 12 tweets
12 Apr
Welp, EM docs, it's happening...With CMGs opening their own EM residencies, the proliferation of NPP "residencies" and "fellowships" and ignoring the warning by the American Academy of Emergency Physicians(AAEM) in 2016 about the threat of an oversupply of EPs, we finally did it.
2)Created a glut. We already knew compensation was dropping. We witnessed all the EPs being terminated in favor of NPPs who were perceived as saving costs and increasing revenue. IMO, the CMGs developed their own programs for two reasons:
-To control physicians whom they would
3)would train to prioritize metrics and thus increase revenue(thereby engaging in the illegal practice of medicine).
-They needed medical licenses for liability purposes so as not to incur full ownership of NPP malpractice/negligence that would occur because of our failure to
Read 9 tweets
6 Apr
Most of you who follow me know that I use Twitter to educate and inform. My thread regarding the firing of anesthesiologists at Watertown Regional Medical Center was published in Medscape. There were at least three other Twitter posts on the same topic--apparently mine resonated.
2)The irony is I was actually condemning corporate medicine. The WRMC/Envision decision was not in the best interest of the public. I think corporations should stay the hell out of medicine. Nevertheless, over-sensitive CRNAs and virtue-signaling docs deduced that I was
3)criticizing CRNA practice. I happen to believe that the safest model of practice if one cannot have a 100% anesthesiologist model, is a model in which CRNAs are supervised by anesthesiologists. In addition, I take issue with any CRNAs who claim to practice EXACTLY as
Read 12 tweets
4 Apr
@CNotlof Thank you for your sentiments, greatly appreciated. Before I answer your question, allow me to give you the perspective from which my opinion arises. I am a descendant of people who were lynched, blinded, mutilated, etc. for daring to learn to read and write. But they learned
@CNotlof 2)anyway. One of the greatest orators of all time, and a former slave, Frederick Douglass, believed that the ability to read and write was the first step to freedom. That history enabled me to be where I am today. I was able to expound on my literacy skills to become what I
@CNotlof 3)chose, which was a physician. I began lecturing on the value of education while still in college. I never took my education for granted, I viewed it as a gift provided by those who came before. My parents sacrificed a great deal to move us into a neighborhood where Blacks were
Read 10 tweets
2 Apr
There is a misperception that Physicians for Patient Protection(PPP) only advocates for or opposes scope creep issues related to NPs/PAs. Nope. We oppose anyone attempting to practice medicine w/o a license. Attached is info on pending or active legislation in almost every state ImageImageImage
2)regarding CRNAs, CNMs, naturopaths, , pharmacists, optometrists, psychologists, etc. It's exhausting. We do this because we have to. Because it is in the best interest of the public. We inform the public so they also know and can protect themselves against people practicing ImageImage
3)beyond their scope. An informed patient is an empowered patient. We don't have lobbyists, who are incredibly expensive, so we do the legwork ourselves. We volunteer our time willingly--it is essential to our mission, which is to protect patients and the integrity of the
Read 5 tweets
22 Mar
For the love of God Texas legislators, please stop giving everyone the right to practice medicine and/or surgery UNSUPERVISED. NPs, CNMs, CRNAs, PAs, Optometrists...How many damaged patients will it take? How many? Give me a number. So we know. authenticmedicine.com/2020/05/what-k…
Read 4 tweets
20 Mar
Tweet Peeps, most of you who know me know that I am a wordsmith. Not quite as exceptional as @OTirmizi, but close. One of my biggest pet peeves is word manipulation. Spinning. Why? Because in some instances, it is intentionally used to deceive. When it deceives the public, I get
2)enraged. So let me demonstrate an example of a hospital's ad to provide consult services for Endocrinology, specifically, diabetes. So the "specialists" in the ad are two NPs. Deceitful act #1: One NP is described as a "board-certified NP who specializes in care for
2)endocrine diseases..." The implication is that he/she is a specialist in diseases of the endocrine system, with a particular focus in DM. His/her memberships includes the American Association of Clinical Endocrinologists(-ology)--lending false credibility to his/her being an
Read 17 tweets
4 Mar
Physician colleagues in Texas(and elsewhere), I ask that you please sign this petition for the Wattenbarger family to support them in persuading legislators to pass Betty's Law. This is especially important in light of a proposed bill, HB 2029, which
2)would allow NPs to practice medicine unsupervised. Physicians for Patient Protection(PPP) is vigorously opposing this bill because they don't wish to see any more preventable cases like Betty's. PPP was contacted by the Wattenbarger family when they read about the organization
3)in a news story concerning a NP-run hormone clinic. A community physician, @amytownsendmd, a board member of PPP, was able to get the clinic shut down after two patients died and a child was mismanaged. In both cases, NPs misrepresented themselves and "supervision" was lax.
Read 8 tweets
27 Feb
Peeps, Texas is next on the chopping block for FPA. NPs are at it again, trying to pass legislation(HB 2029) so they can practice unsupervised. If there was ever a time to stand up against, this is it. Physicians from all over, write letters or call Texas
2)legislators. NPs in this forum who oppose FPA, this is your time to put your money where your mouth is. It is not enough to say you don't support it then sit back on your laurels. Write/call the legislators and let them know. I have listed their contact info. Klick is a lost Image
3)cause--she is the sponsor of the bill. I encourage the public who don't support nurses practicing medicine unsupervised to contact these house members as well. MS legislators had the good sense to recognize that they needed to get more information before passing a bill that
Read 14 tweets
21 Jan
FYI CALIFORNIA PHYSICIANS: As most of you may know, AB 890, the bill sponsored by a nutwad dentist who thinks that NPs and physicians are the same, was passed into law on 9/29/20. As is typical with FPA, the plan on how that law will be executed is disorganized. Oversight by a
2)BON who is not only under investigation for falsifying documents, but who also voted against the bill and wanted no part of supervision but were forced, a weak "advisory" committee to the BON which has no enforcement powers whatsoever, a "transition to practice", provided NPs
3)have 3 years of FT "equivalent" work in good standing, (although this requirement can be modified if they have a DNP degree), etc. The legislature made their intent clear: "2837.100. It is the intent of the Legislature that the requirements under this article shall not be an
Read 13 tweets
18 Jan
I want those of you reading this to understand the significance of this request. Physicians are being asked to function as nurses after some "training". Not NPs who are actually RNs. Not CRNAs who are actually CC RNs. Not LVNs. Not EMTs or paramedics. Physicians. Nursing is
2)not an entry-level position, it requires skill. Expertise. Physicians are not trained to be nurses, although there are a few who were nurses prior to becoming physicians. So exactly what training will be provided since it takes a minimum of 2 years to become an RN(AA degree)?
3)That is, real nurses, not the entry-level degree RNs who don't actually work as RNs. So nursing must be pretty easy if anyone can be trained to do it. Why not contact the ANA or the AANP to ask them to put out the word to their membership and request assistance from actual
Read 13 tweets
16 Jan
thehill.com/opinion/health… Here we go again. This time it is the American Academy of Physician Assistants(AAPA)using the pandemic to push their agenda of Optimal Team Practice aka OTP aka practicing medicine w/o a medical license. Same old broken record of "outdated regulations",
2)designed to protect the public, preventing them from practicing at the "top of their license", which to date, remains undefined. Same old tired a**"studies" that show equivalent or better outcomes than the physicians who train them. Studies that anyone with common sense can
3)review and see how poorly done they are. Same old rhetoric of claiming to want "collaborative" practice while their actions say otherwise. All under the guise of helping fill the physician gap when we have much better options such as unmatched U.S., IMG and FMG graduates.
Read 11 tweets
31 Dec 20
LONG TWEET. The WGN report by Rich McHugh set off a firestorm. The American Association of Nurse Practitioners(AANP) is on the defensive, claiming it disparaged NPs. Doesn't matter that WGN's anchorman clearly stated it was about transparency in health care, which all HCPs should
2)support. Nope, they had to resort to the predictable victimhood role and gaslighting to which we all have become accustomed. No comment about the parents and the fact that they were lied to, didn't even register on their radar. What became apparent after that story is that Full
3)Practice Authority(FPA) aka: "independent" practice aka: practicing medicine w/o a medical license should never have been an option in the U.S., because it represents two-tiered care. Now the AANP has set out to prove they are being discredited because physicians had the
Read 17 tweets
18 Dec 20
@RichMcHugh It is apparent throughout this thread that the NPs who claim "bashing" are following their usual bullying modus operandi to get the reporter to STFU. It's a f***ing broken record. Investigative reporter with an exceptional pedigree(blew the Harvey Weinstein scandal wide open)
@RichMcHugh 2)reports on families who are complaining about lack of transparency and misrepresentation in healthcare, taking their choice to request someone with a higher level of training. And now have dead children. NPs immediately threaten the station for making THEM look bad and claiming
@RichMcHugh 3)feigned victimhood. All this despite the fact that the anchor compliments NPs and acknowledges their contribution to the pandemic. They ignore all that s**t because being the "victim" is imperative in their attempt to destroy the credibility of this reporter who gave a voice to
Read 10 tweets
27 Oct 20
This is why medicine is going into the toilet. FNP takes a liposuction course provided by two Ob/Gyns specializing in cosmetic gynecology. NP is from AZ, a state where NPs can practice "independently". Course is in NJ. FNP "specialty" is an O/P curriculum in primary care-the SOP Image
2)DOES NOT include surgery. There is no NP program or curriculum that exists for liposuction and fat transfer. This is basically a 2-day course/seminar. But since these docs teaching the course most likely don't know or care about NP SOP and the FNP has no oversight in Arizona, Image
3)what's to prevent her from practicing surgery w/o a license at her own medspa(renewedmedicalhealth.com)? Not a damn thing. She may claim she is "certified" because of the form she receives for the course/seminar. Who is the certification body? The International Society of
Read 10 tweets
30 Sep 20
So AB 890 was signed into law by our CA governor, unfortunately. Some may feel as if it is a win, I do not. To clarify, nothing was preventing NPs from caring for the underserved...nothing. The lack of logic to their claims that physicians never work rural/underserved areas but
2)somehow prevented them from doing so did not register with legislators. The thing when one talks BS is you have to remember the lie. It's tough. They have been given license by our legislators to practice medicine w/o a medical license. The irony is the only nursing body to
3)oppose AB 890 was the CA BON who has now been forced to supervise what they did not want nor are equipped to supervise. So a fake-a** "advisory committee" made up of 4 NPs, 2 token physicians and one community member. No idea how members will be selected but I can guarantee you
Read 10 tweets
26 Sep 20
@DocStrange_1 @GallaherCaren "However, our national organizations strongly oppose the view that emergency care is solely “physician-led” or that physicians should dictate education and practice standards for advanced practice registered nurses (APRNs). APRNs undertake rigorous preparation through their
@DocStrange_1 @GallaherCaren 2)education and clinical training through nationally accredited graduate programs, as well as pass national board certification exams. APRNs practice in accordance with the scope of practice determined by national standards and state law." I have no qualms in stating that there
@DocStrange_1 @GallaherCaren 3)is no emergency nurse practitioner(ENP) curriculum that can compare to the training required to become an emergency physician. Not even remotely close. If the AANP does not want physicians to dictate education or practice standards, then don't ask us to precept. Don't apply to
Read 13 tweets