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Friday, March 24, 2023
Mr. Glitterati
  • Automotive
    4 Common Mistakes To Avoid With Car Restorations

    4 Common Mistakes To Avoid With Car Restorations

    Signs That It Might Be Time To Get a New Car

    Signs That It Might Be Time To Get a New Car

    Mercedes-Benz Charging Network

    Mercedes-Benz to Launch Global Branded High-Power Charging Network in North America

    Ways To Surprise Your Partner Who Loves Cars

    Ways To Surprise Your Partner Who Loves Cars

    5 Important Tips for Every New Jeep Owner

    5 Important Tips for Every New Jeep Owner

    The Best Ways To Increase the Value of Your Car

    The Best Ways To Increase the Value of Your Car

    Why Jeeps Are Awesome for Off-Roading Adventures

    Why Jeeps Are Awesome for Off-Roading Adventures

    What To Know Before Purchasing Your First Motorcycle

    What To Know Before Purchasing Your First Motorcycle

    How To Ensure Proper Motorcycle Maintenance

    How To Ensure Proper Motorcycle Maintenance

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    • Mercedes-Benz
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  • Business
    Fulfilling Side Hustles for Good Money in 2023

    Fulfilling Side Hustles for Good Money in 2023

    5 Tips on How To Run Your First Charity Event

    5 Tips on How To Run Your First Charity Event

    4 Ways To Prepare Yourself for a Big Promotion

    4 Ways To Prepare Yourself for a Big Promotion

    Tips for Setting Effective Goals for Your Business

    Tips for Setting Effective Goals for Your Business

    How To Host a Music Festival During Colder Months

    How To Host a Music Festival During Colder Months

    Tips for Designing an Effective Beverage Label

    Tips for Designing an Effective Beverage Label

    Delta now accepting flight attendant applications

    Delta now Accepting Flight Attendant Applications

    Common Mistakes That Every Manager Makes

    Common Mistakes That Every Manager Makes

    Important Safety Features in Commercial Buildings

    Important Safety Features in Commercial Buildings

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    • Fashion
      Essential Tips for Planning a Great Fashion Show

      Essential Tips for Planning a Great Fashion Show

      Signs That Your Tuxedo Doesn’t Fit Right

      Signs That Your Tuxedo Doesn’t Fit Right

      Make a Bold Style Statement With These Wide-Leg Pants

      Make a Bold Style Statement With These Wide-Leg Pants

      Power Your Winter Workouts With The Best Zip Hoodies for Men

      Power Your Winter Workouts With The Best Zip Hoodies for Men

      The Ultimate Watch Buying Guide

      The Ultimate Watch Buying Guide

      Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

      Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

      Our 7 Favorite Field Jackets for Tackling Fall Weather

      Our 7 Favorite Field Jackets for Tackling Fall Weather

      The Best Leather Jackets for Guys – No Matter Your Budget

      The Best Leather Jackets for Guys – No Matter Your Budget

      Campus-Ready Backpacks for Storing *All* the Books

      Campus-Ready Backpacks for Storing *All* the Books

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      • Food & Drink
        Cheese Tortellini in Creamy Marinara

        Cheese Tortellini in Creamy Marinara

        Unusual Products That Come From Animals and Their Uses

        Unusual Products That Come From Animals and Their Uses

        Tips for Creating a Homemade Wine Cellar

        Tips for Creating a Homemade Wine Cellar

        How the wine you choose can help you have an eco-friendly home

        How the Wine You Choose Can Help You have an Eco-Friendly Home

        Rum and Cola Holiday Ham

        Special Centerpieces for Holiday Celebrations

        ChefsGiving 2020

        This Holiday Season, How about Cooking for a Cause?

        Iced Cold Moscow Mule cocktail with lime and pomegranate

        Holiday Spirits: The Cranberry Smash Moscow Mule

        The Most Beautiful Liquor Bottles in the World

        The Most Beautiful Liquor Bottles in the World

        Tao Group Virtual Chef Experience

        Entertain Your Guests Virtually This Fall ?

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        • Health
          When College Athletes Kill Themselves, Healing the Team Becomes the Next Goal

          When College Athletes Kill Themselves, Healing the Team Becomes the Next Goal

          The Policy, and Politics, of Medicare Advantage

          The Policy, and Politics, of Medicare Advantage

          Sen. Sanders Shows Fire, but Seeks Modest Goals, in His Debut Drug Hearing as Health Chair

          Sen. Sanders Shows Fire, but Seeks Modest Goals, in His Debut Drug Hearing as Health Chair

          Being ‘Socially Frail’ Comes With Health Risks for Older Adults

          Being ‘Socially Frail’ Comes With Health Risks for Older Adults

          Fresh Produce Is an Increasingly Popular Prescription for Chronically Ill Patients

          Fresh Produce Is an Increasingly Popular Prescription for Chronically Ill Patients

          End of Covid Emergency Will Usher in Changes Across the US Health System

          End of Covid Emergency Will Usher in Changes Across the US Health System

          Prescription for Housing? California Wants Medicaid to Cover 6 Months of Rent

          Prescription for Housing? California Wants Medicaid to Cover 6 Months of Rent

          Mental Health Care by Video Fills Gaps in Rural Nursing Homes

          Mental Health Care by Video Fills Gaps in Rural Nursing Homes

          Mobile Clinics Got Rolling in the Pandemic. A New Law Will Help Them Cast a Wider Safety Net.

          Mobile Clinics Got Rolling in the Pandemic. A New Law Will Help Them Cast a Wider Safety Net.

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          • Lifestyle

            Sacrifice States: the US Nuclear Sponge

            woman with gun near thief at night in parking lot

            Why it’s Important to know Your 2nd Amendment Rights

            Tips for Growing a Fuller and Healthier Beard

            Tips for Growing a Fuller and Healthier Beard

            Fulfilling Side Hustles for Good Money in 2023

            Fulfilling Side Hustles for Good Money in 2023

            5 Tips on How To Run Your First Charity Event

            5 Tips on How To Run Your First Charity Event

            Essential Home Defense Gear for Gun Owners

            Essential Home Defense Gear for Gun Owners

            Lake Mead Nevada

            The Ramifications of Lake Mead Drying Up

            Different Types of Lucrative Collectibles To Invest In

            Different Types of Lucrative Collectibles To Invest In

            Long, Lush, Lovely: Styling & Care Tips for Long-Haired Men

            Long, Lush, Lovely: Styling & Care Tips for Long-Haired Men

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            • Politics
              Collapsed Silicon Valley Bank enlisted ‘revolving door’ lobbyists to push its policy agenda in Washington

              Collapsed Silicon Valley Bank enlisted ‘revolving door’ lobbyists to push its policy agenda in Washington

              Candidates spend a record amount of campaign funds on childcare in 2022 midterms

              Candidates spend a record amount of campaign funds on childcare in 2022 midterms

              March Madness 2023: Annual K Street College Classic bracket features biggest federal lobbying spenders in higher education

              March Madness 2023: Annual K Street College Classic bracket features biggest federal lobbying spenders in higher education

              ‘Pop-up’ super PACs poured millions into high-stakes congressional races without disclosing their donors ahead of the 2022 general election

              ‘Pop-up’ super PACs poured millions into high-stakes congressional races without disclosing their donors ahead of the 2022 general election

              Sunshine Week: Shining a light on money in politics

              Sunshine Week: Shining a light on money in politics

              Wisconsin’s high-stakes, high-spending Supreme Court elections

              Wisconsin’s high-stakes, high-spending Supreme Court elections

              Armed Services Committee members received $5.8 million from defense sector during 2022 election cycle

              Armed Services Committee members received $5.8 million from defense sector during 2022 election cycle

              Senate Banking Committee presses Federal Reserve chair on capital requirements following big bank lobbying blitz

              Senate Banking Committee presses Federal Reserve chair on capital requirements following big bank lobbying blitz

              New federal indictment sheds light on former FTX CEO Sam Bankman-Fried’s alleged straw donor scheme

              New federal indictment sheds light on former FTX CEO Sam Bankman-Fried’s alleged straw donor scheme

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              • Real Estate
                How To Make Your Rental Property More Eco-Friendly

                How To Make Your Rental Property More Eco-Friendly

                Things To Consider Before Investing in Real Estate Overseas

                Things To Consider Before Investing in Real Estate Overseas

                Incredible Areas in Florida To Buy a Vacation Home

                Incredible Areas in Florida To Buy a Vacation Home

                Helpful Home Staging Tips for Virtual Tours

                Helpful Home Staging Tips for Virtual Tours

                Ways To Decorate and Design a Lake House

                Ways To Decorate and Design a Lake House

                Challenges To Managing a Rental Property

                Challenges To Managing a Rental Property

                The Best Landlord: How To Show Tenants You Care

                The Best Landlord: How To Show Tenants You Care

                The Best Locations To Invest in a Second Home

                The Best Locations To Invest in a Second Home

                How a Nice Garden Can Impress Buyers

                How a Nice Garden Can Impress Buyers

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                • Automotive
                  4 Common Mistakes To Avoid With Car Restorations

                  4 Common Mistakes To Avoid With Car Restorations

                  Signs That It Might Be Time To Get a New Car

                  Signs That It Might Be Time To Get a New Car

                  Mercedes-Benz Charging Network

                  Mercedes-Benz to Launch Global Branded High-Power Charging Network in North America

                  Ways To Surprise Your Partner Who Loves Cars

                  Ways To Surprise Your Partner Who Loves Cars

                  5 Important Tips for Every New Jeep Owner

                  5 Important Tips for Every New Jeep Owner

                  The Best Ways To Increase the Value of Your Car

                  The Best Ways To Increase the Value of Your Car

                  Why Jeeps Are Awesome for Off-Roading Adventures

                  Why Jeeps Are Awesome for Off-Roading Adventures

                  What To Know Before Purchasing Your First Motorcycle

                  What To Know Before Purchasing Your First Motorcycle

                  How To Ensure Proper Motorcycle Maintenance

                  How To Ensure Proper Motorcycle Maintenance

                  Trending Tags

                  • Mercedes-Benz
                  • Mustang
                • Business
                  Fulfilling Side Hustles for Good Money in 2023

                  Fulfilling Side Hustles for Good Money in 2023

                  5 Tips on How To Run Your First Charity Event

                  5 Tips on How To Run Your First Charity Event

                  4 Ways To Prepare Yourself for a Big Promotion

                  4 Ways To Prepare Yourself for a Big Promotion

                  Tips for Setting Effective Goals for Your Business

                  Tips for Setting Effective Goals for Your Business

                  How To Host a Music Festival During Colder Months

                  How To Host a Music Festival During Colder Months

                  Tips for Designing an Effective Beverage Label

                  Tips for Designing an Effective Beverage Label

                  Delta now accepting flight attendant applications

                  Delta now Accepting Flight Attendant Applications

                  Common Mistakes That Every Manager Makes

                  Common Mistakes That Every Manager Makes

                  Important Safety Features in Commercial Buildings

                  Important Safety Features in Commercial Buildings

                  Trending Tags

                  • Fashion
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                    Essential Tips for Planning a Great Fashion Show

                    Signs That Your Tuxedo Doesn’t Fit Right

                    Signs That Your Tuxedo Doesn’t Fit Right

                    Make a Bold Style Statement With These Wide-Leg Pants

                    Make a Bold Style Statement With These Wide-Leg Pants

                    Power Your Winter Workouts With The Best Zip Hoodies for Men

                    Power Your Winter Workouts With The Best Zip Hoodies for Men

                    The Ultimate Watch Buying Guide

                    The Ultimate Watch Buying Guide

                    Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

                    Outdoor Enthusiasts, Take Note: These Watches Are as Tough as You

                    Our 7 Favorite Field Jackets for Tackling Fall Weather

                    Our 7 Favorite Field Jackets for Tackling Fall Weather

                    The Best Leather Jackets for Guys – No Matter Your Budget

                    The Best Leather Jackets for Guys – No Matter Your Budget

                    Campus-Ready Backpacks for Storing *All* the Books

                    Campus-Ready Backpacks for Storing *All* the Books

                    Trending Tags

                    • Food & Drink
                      Cheese Tortellini in Creamy Marinara

                      Cheese Tortellini in Creamy Marinara

                      Unusual Products That Come From Animals and Their Uses

                      Unusual Products That Come From Animals and Their Uses

                      Tips for Creating a Homemade Wine Cellar

                      Tips for Creating a Homemade Wine Cellar

                      How the wine you choose can help you have an eco-friendly home

                      How the Wine You Choose Can Help You have an Eco-Friendly Home

                      Rum and Cola Holiday Ham

                      Special Centerpieces for Holiday Celebrations

                      ChefsGiving 2020

                      This Holiday Season, How about Cooking for a Cause?

                      Iced Cold Moscow Mule cocktail with lime and pomegranate

                      Holiday Spirits: The Cranberry Smash Moscow Mule

                      The Most Beautiful Liquor Bottles in the World

                      The Most Beautiful Liquor Bottles in the World

                      Tao Group Virtual Chef Experience

                      Entertain Your Guests Virtually This Fall ?

                      Trending Tags

                      • Health
                        When College Athletes Kill Themselves, Healing the Team Becomes the Next Goal

                        When College Athletes Kill Themselves, Healing the Team Becomes the Next Goal

                        The Policy, and Politics, of Medicare Advantage

                        The Policy, and Politics, of Medicare Advantage

                        Sen. Sanders Shows Fire, but Seeks Modest Goals, in His Debut Drug Hearing as Health Chair

                        Sen. Sanders Shows Fire, but Seeks Modest Goals, in His Debut Drug Hearing as Health Chair

                        Being ‘Socially Frail’ Comes With Health Risks for Older Adults

                        Being ‘Socially Frail’ Comes With Health Risks for Older Adults

                        Fresh Produce Is an Increasingly Popular Prescription for Chronically Ill Patients

                        Fresh Produce Is an Increasingly Popular Prescription for Chronically Ill Patients

                        End of Covid Emergency Will Usher in Changes Across the US Health System

                        End of Covid Emergency Will Usher in Changes Across the US Health System

                        Prescription for Housing? California Wants Medicaid to Cover 6 Months of Rent

                        Prescription for Housing? California Wants Medicaid to Cover 6 Months of Rent

                        Mental Health Care by Video Fills Gaps in Rural Nursing Homes

                        Mental Health Care by Video Fills Gaps in Rural Nursing Homes

                        Mobile Clinics Got Rolling in the Pandemic. A New Law Will Help Them Cast a Wider Safety Net.

                        Mobile Clinics Got Rolling in the Pandemic. A New Law Will Help Them Cast a Wider Safety Net.

                        Trending Tags

                        • Lifestyle

                          Sacrifice States: the US Nuclear Sponge

                          woman with gun near thief at night in parking lot

                          Why it’s Important to know Your 2nd Amendment Rights

                          Tips for Growing a Fuller and Healthier Beard

                          Tips for Growing a Fuller and Healthier Beard

                          Fulfilling Side Hustles for Good Money in 2023

                          Fulfilling Side Hustles for Good Money in 2023

                          5 Tips on How To Run Your First Charity Event

                          5 Tips on How To Run Your First Charity Event

                          Essential Home Defense Gear for Gun Owners

                          Essential Home Defense Gear for Gun Owners

                          Lake Mead Nevada

                          The Ramifications of Lake Mead Drying Up

                          Different Types of Lucrative Collectibles To Invest In

                          Different Types of Lucrative Collectibles To Invest In

                          Long, Lush, Lovely: Styling & Care Tips for Long-Haired Men

                          Long, Lush, Lovely: Styling & Care Tips for Long-Haired Men

                          Trending Tags

                          • Politics
                            Collapsed Silicon Valley Bank enlisted ‘revolving door’ lobbyists to push its policy agenda in Washington

                            Collapsed Silicon Valley Bank enlisted ‘revolving door’ lobbyists to push its policy agenda in Washington

                            Candidates spend a record amount of campaign funds on childcare in 2022 midterms

                            Candidates spend a record amount of campaign funds on childcare in 2022 midterms

                            March Madness 2023: Annual K Street College Classic bracket features biggest federal lobbying spenders in higher education

                            March Madness 2023: Annual K Street College Classic bracket features biggest federal lobbying spenders in higher education

                            ‘Pop-up’ super PACs poured millions into high-stakes congressional races without disclosing their donors ahead of the 2022 general election

                            ‘Pop-up’ super PACs poured millions into high-stakes congressional races without disclosing their donors ahead of the 2022 general election

                            Sunshine Week: Shining a light on money in politics

                            Sunshine Week: Shining a light on money in politics

                            Wisconsin’s high-stakes, high-spending Supreme Court elections

                            Wisconsin’s high-stakes, high-spending Supreme Court elections

                            Armed Services Committee members received $5.8 million from defense sector during 2022 election cycle

                            Armed Services Committee members received $5.8 million from defense sector during 2022 election cycle

                            Senate Banking Committee presses Federal Reserve chair on capital requirements following big bank lobbying blitz

                            Senate Banking Committee presses Federal Reserve chair on capital requirements following big bank lobbying blitz

                            New federal indictment sheds light on former FTX CEO Sam Bankman-Fried’s alleged straw donor scheme

                            New federal indictment sheds light on former FTX CEO Sam Bankman-Fried’s alleged straw donor scheme

                            Trending Tags

                            • Real Estate
                              How To Make Your Rental Property More Eco-Friendly

                              How To Make Your Rental Property More Eco-Friendly

                              Things To Consider Before Investing in Real Estate Overseas

                              Things To Consider Before Investing in Real Estate Overseas

                              Incredible Areas in Florida To Buy a Vacation Home

                              Incredible Areas in Florida To Buy a Vacation Home

                              Helpful Home Staging Tips for Virtual Tours

                              Helpful Home Staging Tips for Virtual Tours

                              Ways To Decorate and Design a Lake House

                              Ways To Decorate and Design a Lake House

                              Challenges To Managing a Rental Property

                              Challenges To Managing a Rental Property

                              The Best Landlord: How To Show Tenants You Care

                              The Best Landlord: How To Show Tenants You Care

                              The Best Locations To Invest in a Second Home

                              The Best Locations To Invest in a Second Home

                              How a Nice Garden Can Impress Buyers

                              How a Nice Garden Can Impress Buyers

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                              Readers and Tweeters Urgently Plea for a Proper ‘Role’ Call in the ER

                              by Staff Writer
                              February 27, 2023
                              in Health
                              Readers and Tweeters Urgently Plea for a Proper ‘Role’ Call in the ER
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                              Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.

                              How Physician Assistants and Nurse Practitioners Enhance Health Care

                              The story of one patient’s ER experience does not at all capture the complexities of an emergency department serving the needs of a stochastic patient population.

                              Given the reach of KHN, it is disappointing to read stories that inch closer to tabloid-level reporting (“Doctors Are Disappearing From Emergency Rooms as Hospitals Look to Cut Costs,” Feb. 13).

                              Having spent most of my career working in and operationalizing emergency departments, I can assure you that there are plenty of opportunities to optimize the delivery of care and reduce unnecessary waste and cost while maintaining excellent outcomes. The salient point that you make “it’s all about the money” is too simplistic given the complexities.

                              Advanced practice providers (APPs) collectively describe nurse practitioners (NPs), physician assistants (PAs), certified registered nurse anesthetists (CRNAs), and certified nurse midwives (CNMs). The term “midlevel practitioner” is outdated.

                              The archaic paternalistic approach to health care has long been overdue for change. Post-pandemic, it is critical to pivot from “the way it has always been done,” and that includes embracing new models of care.

                              Physicians and APPs provide excellent care to their patients and operate with different scopes of practice, training, and licensure. Therefore, most of us find working together in team-based models to be highly effective in ensuring that patients see the right care provider for the right health problem.

                              I found this reporting to be superficial and even offensive to nurse practitioners, like myself, who provide just as high quality care to patients as our physician colleagues.

                              I welcome the opportunity for dialogue about the value of nurse practitioners and physician assistants.

                              — Cindi Warburton, Spokane, Washington

                              Idiot corporate vermin strikes again, decides that this makes perfect sense, because if there is one job unnecessary in a hospital emergency room then it would have to be doctor https://t.co/qdcZcPqAef

                              — Mark Williams (@TalkerMark) February 16, 2023

                              — Mark Williams, Sacramento, California

                              I heard your NPR-partnered story on emergency rooms being managed by private equity and using fewer doctors and more nurse practitioners and physician assistants as midlevel practitioners.

                              But I prefer midlevel practitioners and medical residents, if their skills are relevant to me. They tend to be more careful in telling me what I should know and in entering records.

                              The professionally senior doctors (by years of experience and specialty, but I don’t know about board certification) tend to use record-keeping to support higher insurance reimbursement and then they don’t seem to believe what anyone else writes in the records, or don’t bother looking. Furthermore, they’re less likely to tell me what circumstances should prompt me to seek out a doctor or an ER, but if anything goes so wrong or becomes so advanced that I need even more care, they’re happy to provide it.

                              Doctors often categorically object to nurse practitioners, and state regulations reflect that.

                              — Nick Levinson, Brooklyn, New York

                              Yeah- there definitely needs to be our vision of the alternative healthcare system, otherwise, this will continue until you have a probe for your mouth, and one for your rectum just like in #Idiocracy. https://t.co/uX2KYbpD0V

                              — Dr. Lynn Fynn-derella🐭 (@Fynnderella1) February 17, 2023

                              The recent KHN article “Doctors Are Disappearing From Emergency Rooms as Hospitals Look to Cut Costs” failed to address a critical consideration in the complexities of health care delivery today: the challenge of providing care to patients when they need it at a time when demand for care is on the rise, and the health care workforce is experiencing staggering levels of decline.

                              Today, 99 million Americans lack adequate access to primary care. By 2026, there will be a shortage of up to 3.2 million health care workers. As a physician associate/physician assistant for more than 20 years, I am kept up at night because of this perfect storm on the horizon — worried for my patients and their ability to access the care they need. Timely access to a trusted and qualified health care provider is never more pressing than during an emergency, when patients are at their most vulnerable, and delay in care can be a matter of life or death.

                              There is no easy answer to this impending workforce crisis, but one thing is clear: We can meet patient needs only if every member of today’s health care team is respected for the contributions they bring and can practice to the fullest extent of their education and training.

                              The fact is, without PAs, patients’ access to care would suffer. PAs account for more than 500 million patient visits each year. For many patients, PAs serve as primary care providers. And in some communities, PAs are the only health care providers. Let’s not lose sight of the countless stories we have all read in the media about community hospitals and clinics closing.

                              This article failed to take into account any research that shows the value and quality of PA-delivered care. For example, a 2021 study published by PLOS ONE looked at 39 studies across North America, Europe, and Africa between 1977 and 2021. In 33 of the 39 studies, researchers found care provided by a PA was comparable or better than care delivered by a physician. In 74% of the studies, resource and labor costs were lower when care was delivered by a PA versus a physician.

                              The quality of PA-delivered care can also be seen when looking at the ratio of liability claims. The ratio of claims to PAs averaged one claim for every 550 PAs. Compare this to the physician ratio, which averaged 1 claim for every 80 physicians.

                              Hiring PAs to practice in emergency medicine is not about “replacing” physicians, nor does it diminish the quality of care. Utilizing PAs in emergency medicine is about equipping health care teams with a wide range of highly educated and trained clinicians who can work together to ensure patients get the safe, high-quality care they need.

                              Let us stay focused on the reason why PAs, nurse practitioners, and physicians went into medicine in the first place: to care for people! Patient-centered, team-based care is about every single one of us contributing our knowledge, experience, and expertise to ensure the best outcomes for patients.

                              — Jennifer M. Orozco, American Academy of Physician Associates president and board chair, Chicago

                              What could possibly go wrong when you take doctors out of the ED? Well if the effects of other private equity-owned healthcare organizations are a bellwether then nothing good…https://t.co/vhoPQRQTxD

                              — Whitney Schmucker- MPH, MBA (@WhitSchmucky) February 13, 2023

                              — Whitney Schmucker, New York City

                              KHN should not be using the term “midlevel providers.” It’s a derogatory term used by doctors to belittle advanced practice providers (nurse practitioners and physician associates).

                              — Danielle Franklin, Minneapolis

                              .⁦@_Eric_Reinhart⁩, ⁦@donberwick⁩,⁦@suhas_gondi⁩ and ⁦@sanjaykishore31⁩ have talked about greed in American medicine. A case in point. Doctors Are Disappearing From Emergency Rooms as Hospitals Look to Cut Costs – Kaiser Health News https://t.co/QlqdPmssU8

                              — Gregg Gonsalves (@gregggonsalves) February 13, 2023

                              — Gregg Gonsalves, New Haven, Connecticut

                              Nurse practitioners are essential providers in our nation’s current and future health care system. In an effort to highlight concerns related to health facility ownership models, the recent article “Doctors Are Disappearing From Emergency Rooms as Hospitals Look to Cut Costs” incorrectly represents the care provided by NPs in emergency rooms.

                              In fact, a recent study examining advanced practice providers (APPs), including NPs, in the ER found increasing APP coverage had no impact on flow, safety, or patient experiences in the emergency department. Additional research concluded that after controlling for patient severity and complexity, APPs diagnostic testing and hospitalization rates did not differ from physicians in patients presenting to the emergency department with chest and abdominal pain.

                              Prepared at the master’s or doctoral level, NPs provide primary, acute, chronic, and specialty care to patients of all ages and backgrounds. NPs practice in nearly every health care setting including hospitals, clinics, Veterans Health Administration and Indian Health Service facilities, emergency rooms, urgent care sites, private physician or NP practices, skilled nursing facilities and nursing facilities, schools, colleges and universities, retail clinics, public health departments, nurse-managed clinics, homeless clinics, and home health care settings. Collectively, NPs deliver high-quality care in more than 1 billion patient visits each year.

                              Grounded in 50 years of research and evidence-based practice, NPs deliver high-quality care, consistent with their physician counterparts. Results from a study of over 800,000 patients at 530 Veterans Affairs facilities found that patients assigned to NP primary care providers were less likely to utilize additional services, had no difference in costs, and experienced similar chronic disease management compared with physician-assigned patients. Furthermore, a comprehensive summary of studies examining NP quality of care from the American Enterprise Institute underscores the benefits of NP-led care.

                              Today, NPs represent 355,000 solutions to our nation’s health care needs. Patients deserve access to these high-quality health care providers wherever they seek care.

                              — April N. Kapu, president of the American Association of Nurse Practitioners, Austin, Texas

                              If you like seeing an actual doctor when you go to the hospital now is the time to speak up! https://t.co/417fm2JKsg

                              — Sarabeth Broder-Fingert MD, MPH (@sbroderfingert) February 14, 2023

                              — Dr. Sarabeth Broder-Fingert, Boston

                              Ophthalmologists and Optometrists Aren’t Interchangeable

                              Increasing Americans’ access to care is critical. However, loosening the scope of practice for certain types of care can be counterproductive and potentially risky for patients (“Montana Considers Allowing Physician Assistants to Practice Independently,” Feb.10).

                              A small handful of states, for example, have loosened scope-of-practice laws for laser eye surgery, which, if done incorrectly, could lead to serious complications that can damage a person’s vision. Over the course of their medical school education, internships, and residencies, ophthalmologists must complete thousands of hours of training before being allowed to perform laser eye surgeries on their own.

                              Unfortunately, some states permit optometrists, who are not medical doctors, to perform laser eye surgeries as long as they complete a 16- to 32-hour course. As one might expect, the likelihood of a patient needing additional surgery is significantly higher — more than double — when initial surgeries are performed by an optometrist instead of an ophthalmologist. It is little wonder, then, why states like California have successfully blocked efforts to loosen the scope of practice for laser eye surgery.

                              Despite the potential risks, and no evidence of documented access issues, the Department of Veterans Affairs updated its community care guidelines last year to allow optometrists in this small number of states to perform laser eye surgery on veterans in community care settings. Worse still, the VA is developing its National Standards of Practice, which many fear would let optometrists in VA facilities nationwide perform laser eye surgery on America’s veterans. To defend our veterans and prevent them from suffering adverse outcomes, it is critical for the VA to maintain patient protections that ensure only medical doctors with the requisite education and training can perform invasive eye surgeries.

                              Ophthalmologists and optometrists both play important roles in a patient’s collaborative care team, but their duties and skill sets are not interchangeable. Loosening the scope of practice for laser eye surgeries will not serve patients well. Our veterans defended us; now the VA must protect them.

                              — Dr. Daniel J. Briceland, president of the American Academy of Ophthalmology, Sun City West, Arizona

                              More competition is the answer to much of what ails the U.S. healthcare system. https://t.co/uc168WUdFS

                              — David Johnson (@4sighthealth_) February 20, 2023

                              — David Johnson, Chicago

                              We were disappointed that the article by Keely Larson about Montana’s consideration of a change in physician assistant regulation failed to note that the vast majority of research on the quality of care provided by physician assistants and nurse practitioners demonstrates that they have similar quality of care to physicians when practicing in their area of expertise. There are numerous literature reviews published in peer-reviewed journals on this topic, which should have been noted in the story. The author selected a single working paper that focuses on quality of care in emergency departments in a single health system (the Department of Veterans Affairs) that is not representative of the settings in which most physician assistants and nurse practitioners work. The individual cited, Dr. Yiqun Chen, extrapolated her working paper to the entire profession of physician assistants (who were not included in her study), which is a significant overreach.

                              We are accustomed to KHN stories being well researched and balanced. This story missed the mark and does not reflect well on the quality KHN aims to achieve.

                              — Joanne Spetz, Janet Coffman, and Ulrike Muench, the University of California-San Francisco

                              Since the pandemic, we have lost 300k workers in nursing homes, putting patients at risk. We need more young people to go into nursing and need to adjust immigration laws to allow foreign trained nurses to legally seek employment in the USA.Read more: https://t.co/j67QFxKO9v

                              — Dr. Mehmet Oz (@DrOz) February 4, 2023

                              — Dr. Mehmet Oz, Bryn Athyn, Pennsylvania

                              At the Crux of Nursing Home Staffing Crunch: Compensation

                              I doubt it is possible to staff nursing facilities with qualified and caring staff when the compensation is quite poor and the work environment is very challenging (“Wave of Rural Nursing Home Closures Grows Amid Staffing Crunch,” Jan. 25). It is more a system problem than a staffing problem and will not get “fixed” without some serious changes.

                              — Dr. Jack Page, Durham, North Carolina

                              “Microgrants” — small amounts of funding typically given to community organizations — are a great way to increase reach of public health departments and increase vaccine uptake, as seen in this example of immigrant communities in Colorado.https://t.co/PxpD23qZpY

                              — Benjy Renton (@bhrenton) February 14, 2023

                              — Benjy Renton, Washington, D.C.

                              Participating in the Mental Illness Stigma

                              I wonder what is behind the pressure to persuade us to say there is a stigma to mental health issues (“Public Health Agencies Turn to Locals to Extend Reach Into Immigrant Communities,” Feb. 10)? I wonder why we so easily comply?

                              — Harold A. Maio, retired mental health editor, Fort Myers, Florida

                              #Rural #Seniors Benefit From #Pandemic-Driven Remote Fitness Boom | Kaiser #Health News https://t.co/s3U5fJDEXT

                              — Andrzej Klimczuk (@AndrzejKlimczuk) February 3, 2023

                              — Andrzej Klimczuk, Bialystok, Poland

                              Remote Fitness Must Not Replace the Value of Physical Therapy

                              If we’ve learned anything in recent years, it’s how vital technology is in allowing us to stay connected virtually, especially when it comes to health care. However, the online world cannot safely and adequately replace everything.

                              The recent article “Rural Seniors Benefit From Pandemic-Driven Remote Fitness Boom” (Jan.17) details how many older Americans living in rural areas rely on virtual fitness classes to remain physically active. While this is an important and effective option for some seniors, remote fitness classes cannot and should not replace clinically directed physical therapy.

                              Physical therapy helps patients remain strong and independent by managing pain, preventing injury, and improving mobility, flexibility, and balance under the supervision of a professionally trained physical therapist. It’s especially important at a time when senior deaths from falls are on the rise. Evidence shows that when seniors underwent an exercise intervention from a trained health care professional, it lowered their risk of a fall by 31%.

                              Not only is it effective in rehabilitating patients, but it is also an affordable, lower-cost alternative to invasive surgeries and pharmacological treatments, saving our health care system millions. And now, with the emergence of remote therapeutic monitoring, physical therapists can more easily reach patients in rural communities to ensure they are reaching their clinical goals through safe, at-home therapy exercises.

                              Physical therapists undergo years of education and training to provide the best, safest care for their patients. And while I applaud seniors for embracing online fitness classes and staying active, I also encourage them to recognize when clinically supervised physical therapy is needed to protect their safety and health.

                              — Nikesh Patel, executive director of the Alliance for Physical Therapy Quality and Innovation (APTQI), Washington, D.C.

                              The last volley before the storm comes ashore. RADV awaits.https://t.co/oaryjjRA8N

                              — Eric Weinhandl (@eric_weinhandl) January 27, 2023

                              — Eric Weinhandl, Victoria, Minnesota

                              Tallying Bad Pennies

                              “Did Your Health Plan Rip Off Medicare?” (Jan. 27) was a highly misleading article. On a per-enrollee per-year basis, over- and under-payments amounted to literally pennies. If you must pile on, focus on the few bad apples.

                              — Jon M. Kingsdale, Boston

                              Unbelievable. This exact same thing is happening to me right now. After an emergency c-section at 29 weeks, followed by 7 weeks in the NICU, I have spent the last 6 months fighting over the bill. https://t.co/t4O69C8v6V

                              — Inger BurnettZeigler (@ibzpsychphd) February 2, 2023

                              — Inger Burnett-Zeigler, Chicago

                              How Much Did They Know and When Did They Know It?

                              Great story by Harris Meyer about Prentice and Lurie hospitals (“A Baby Spent 36 Days in an In-Network NICU. Why Did the Hospital Next Door Send a Bill?” Jan. 30). I was practicing as an anesthesiologist in Illinois in 2011 when the bill became law banning out-of-network balance billing for hospital-based docs. Of course we knew about the advent of the law: We had to enter into contracts to be in network, contracts that materially reduced all our doctors’ incomes!

                              It is impossible for me to believe that a professional operating a billing service in 2020 for Ann & Robert H. Lurie Children’s Hospital of Chicago didn’t know about this 2011 law. I don’t believe them for a moment.

                              Thanks for the great article.

                              — Ron Meyer, Wilmette, Illinois

                              #covid19 First and foremost – have a plan for when you test positive. And if older or have preexisting conditions, get Paxlovid (unless contraindicated). Older adults represent nearly 90% of U.S. deaths from covid-19 in recent mont…https://t.co/Dip9rzgEY0 https://t.co/SLZho2p3TK

                              — Regina Phelps 🇺🇦 (@ReginaPhelps) January 18, 2023

                              — Regina Phelps, San Francisco

                              Leaving a Bad Taste in My Mouth

                              In every article I’ve read about Paxlovid, including yours (“What Older Americans Need to Know About Taking Paxlovid,” Dec. 18), not one mentions the horrible metallic taste these pills have. I was prescribed Paxlovid after contracting covid-19. I’m 71 years old. It’s beyond my reasoning that in this day and age a pharmaceutical manufacturer can’t put a neutral coating on the pills. This awful taste stays with you day and night for the five days of use. I even had a friend who had to stop taking them as she was losing sleep over the horrible taste. My reference to friends is: “It’s like sucking on a wrench.” I’m sure this issue isn’t confined to us seniors, but it would be nice to read some recognition of a problem with this medication.

                              By the way, my workaround, which definitely helps but is hardly a solution, is to swallow the pills down with a swig of cranberry juice.

                              — Don Dugan, Brookfield, Wisconsin

                              In North Carolina, more people are training to support patients through an abortion – In the months since Roe v. Wade was overturned, training groups in North Carolina say they’ve seen an uptick in interest from people wanting to work as abortion doulas.… https://t.co/NMJR2df1Ol

                              — Olav Mitchell Underdal (@omunderdal) December 19, 2022

                              — Olav Mitchell Underdal, Irvine, California

                              Admiration for Abortion Doulas

                              I admire and respect individuals willing to provide aid and comfort to others who are going through either the traditional birth process or a hard decision to end a pregnancy (“In North Carolina, More People Are Training to Support Patients Through an Abortion,” Jan. 5). Kudos to news groups for increasing awareness of individuals and organizations providing valuable services for their fellow citizens.

                              — Michael Walker, Black Mountain, North Carolina

                              When someone learns they’re pregnant, they should have access to #MaternalHealth services. After all, healthy babies start with healthy pregnancies. This personal account from @K_Hought shares why we must remain dedicated to improving care for everyone. https://t.co/n1JkPlIJ6O

                              — Darrell Gray, II, MD, MPH, FACG (@DMGrayMD) January 20, 2023

                              — Dr. Darrell Gray II, Owings Mills, Maryland

                              Thinking Outside the Traditional Medicine Box

                              Katheryn Houghton missed out on sharing info on traditional methods, especially acupuncture (“Why People Who Experience Severe Nausea During Pregnancy Often Go Untreated,” Jan. 13). Also ginger, as in ginger tea, and peppermint. Peppermint oil (sniffed) or tea. I am an advocate for people with cancer.

                              — Ann Fonfa, founder of the Annie Appleseed Project, Delray Beach, Florida

                              Nausea is common in the first trimester but some women experience symptoms that linger and require medical attention, but often go untreated. @K_Hought reports on asepct of #pregnancy too often ignored. #WomensHealth https://t.co/zYEu0G6bHC via @khnews

                              — Catherine Arnst (@cathyarnst) January 16, 2023

                              — Catherine Arnst, New York City

                              A Cartoon Blooper?

                              The “Gender reveal?” political cartoon (Feb. 14) was confusing, unfunny, and inaccurate. How is this “political”? (It isn’t.) What makes gender reveals funny? (They’re not.) Most importantly, such reveals — an anachronistic cultural tradition that should be done away with anyway — are “sex reveals,” not “gender reveals.” (Biological sex is based on anatomy at birth, while gender is self-determined later in life and is fluid over time.) Even sex reveals are problematic, as they assume two biological sexes. (Some estimates indicate nearly 2% of individuals are born intersex, with their sexual anatomy not fitting into categories of either female or male.)

                              With anti-trans and anti-drag queen legislation being proposed and codified seemingly daily, now is not the time to poke fun at, nor inaccurately represent, the construct of gender. (It’s never the time.)

                              — Steff Du Bois, licensed clinical psychologist, Chicago

                              NEW: The KHN Health Minute this week looks at how the end of the public health emergency will affect pricing for covid tests and treatments, and issues a warning about kids getting into marijuana edibles. https://t.co/5iP5gQLcVB

                              — Kaiser Health News (@KHNews) February 21, 2023

                              Keeping Marijuana Candy Away From Children

                              As an emergency room doctor, I was disappointed by the recent “KHN Health Minute” story trivializing a growing public health risk by suggesting parents “lock up their marijuana gummies” to avoid poisoning their children (“Listen to the Latest ‘KHN Health Minute,’” Feb. 16).

                              For background on why I, and other doctors, are concerned, I encourage you to read “Marijuana Candy: Poisoning and Lack of Protection for Children.”

                              — Dr. Roneet Lev, San Diego

                              An excellent discussion, led by @jrovner, of the repercussions in #healthcare from the current political maneuvering in DC. Practice leaders feel in limbo, unsure how to plan. The potential impact on patients is worse, if they lose access to local care. https://t.co/YcW2bX9vhA

                              — Halee Fischer-Wright (@DrHalee) February 9, 2023

                              — Halee Fischer-Wright, Denver

                              A Suggestion for Extra-Credit Reading

                              In response to the recent “What the Health?” podcast episode “As US Bumps Against Debt Ceiling, Medicare Becomes a Bargaining Chip” (Jan. 19), please have Julie Rovner read Stephanie Kelton’s book “The Deficit Myth.” She needs to understand why taxes pay for nothing. I consider Kelton’s book the most important on economics and how government budgets and financing work in the modern world.

                              — Mark Schaffer, Las Vegas

                              From investing in nursing schools to continuing the support of visa waivers for #clinicians in medically underserved areas, Congress needs to act & fix the ongoing workforce shortage in #healthcare. I REALLY want to believe both parties can hash this out…https://t.co/zvIEjSrrvl

                              — Iqbal Atcha RPh, MBA, SPHR, RACR (@IqbalAtcha1) February 21, 2023

                              — Iqbal Atcha, Hanover Park, Illinois

                              Investing in ‘Practice-Ready’ Nurses to Bolster Workforce

                              The Connecticut Center for Nursing Workforce Inc. has created a best-practice plan to address these issues (“Senators Say Health Worker Shortages Ripe for Bipartisan Compromise,” Feb. 17). As nursing is the largest health care workforce role and a critical infrastructure within the state, nurses are a significant contributor to the fiscal, physical, and mental health of Connecticut, and a profession that can provide economic stability to its workers and families. Over 10,000 qualified nursing students were denied admission to registered nursing programs in 2021 due to full-time and part-time faculty shortages, lack of student clinical placements, and capacity of capstone experiences in specialty areas.

                              To produce “practice-ready” nurses, investment needs to be made in increasing the number of nursing faculty lines, both full-time (classroom) and part-time (clinical) experiences, simulation capacity and expertise, operations staff, and transition to practice resources.

                              Today, this is more challenging than ever, due to the impact of covid-19 on our nursing workforce, the natural attrition of our older nurses, early departure of new nurses causing a severe nursing shortage in the state, and the cost of “travel” nurses that is crippling the budgets of our health care facilities and not sustainable over the long term.

                              Nursing schools are competing for the same nursing human capital as our practice settings yet offer 30% less compensation for faculty roles as compared to clinical practice roles.

                              As a solution, it is critical to:

                              1. Engage nursing schools to identify the demand for full-time and part-time faculty lines and staff.
                              2. Develop a nurse faculty marketing campaign for associate, baccalaureate, accelerated registered nurse programs, and master’s degree in nursing programs for both full-time and part-time roles.
                              3. Capitalize on the expertise of clinical nurses for the role of part-time clinical nurse faculty.
                              4. Engage health care facilities to determine current nurse vacancies, future staffing needs, and onboarding/“transition to practice” gaps to best inform educational institutions as to the programs needed to be continued, expanded, or dissolved; thereby, maximizing education capacity, resources, faculty, and staff.

                              — Marcia Proto, executive director for the Connecticut Center for Nursing Workforce Inc., North Haven, Connecticut

                              Compromise?? https://t.co/IRUYV0xsFM

                              — R.J, Connelly III, CELA, Connelly Law Offices, Ltd (@rjc3esq) February 24, 2023

                              — RJ Connelly III, Pawtucket, Rhode Island

                              Missing Pieces in the Covid Data Puzzle

                              It is misinformation to state that covid-19 deaths were counted when the opposite was true, and deaths were underreported due to political reasons, and reasons of expediency (“FDA Experts Are Still Puzzled Over Who Should Get Which Covid Shots and When,”) Jan. 27. For example, my father-in-law tested positive for covid before entering the hospital, and then repeatedly tested positive for covid while in the hospital so that he could not be released, and he died in the hospital, and covid was not listed as a cause of death on his death certificate. I have reason to believe that my own father died of covid in May 2020, during an election year, and covid was not listed as a cause of death on his death certificate. These men were not merely statistics, but left behind families who are still in turmoil and grief.

                              In public, people should wear masks all the time regardless of vaccination status, but, at the same time, be updated on vaccinations and boosters, and, at the same time, socially distance, and, at the same time, wash hands frequently and thoroughly. While all these measures should be taken simultaneously, everyone wearing masks is the easiest way to monitor compliance, and eliminates problems in determining someone else’s vaccination status, or determining whether the efficacy of their vaccines may have waned, or in determining whether they tested positive for covid, and failed to quarantine.

                              When, previously, the science was that vaccines and booster efficacy waned after three to six months, it should not be touted now to get the vaccine or booster only once a year.

                              The goal post should never have been moved to merely keeping people out of the hospital, but the goal should be to prevent people contracting covid, and to eradicate this scourge once and for all.

                              — Edward H. Bonacci Jr., Apex, North Carolina

                              KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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                              This story can be republished for free (details).

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