Patients at Risk

The Rise of the Nurse Practitioner and Physician Assistant in Healthcare
by Niran Al-Agba, M.D. and Rebekah Bernard, M.D.


Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare exposes a vast conspiracy of political maneuvering and corporate greed that has led to the replacement of qualified medical professionals by lesser trained practitioners. As corporations seek to save money and government agencies aim to increase constituent access, minimum qualifications for the guardians of our nation's healthcare continue to decline--with deadly consequences. This is a story that has not yet been told, and one that has dangerous repercussions for all Americans.

With the rate of nurse practitioner and physician assistant graduates exceeding that of physician graduates, if you are not already being treated by a non-physician, chances are, you soon will be. While advocates for these professions insist that research shows that they can provide the same care as physicians, patients do not know the whole truth: that there are no credible scientific studies to support the safety and efficacy of non-physicians practicing without physician supervision.

Written by two physicians who have witnessed the decline of medical expertise over the last twenty years, this data-driven book interweaves heart-rending true patient stories with hard data, showing how patients have been sacrificed for profit by the substitution of non-physician practitioners. Adding a dimension neglected by modern healthcare critiques such as An American Sickness, this book provides a roadmap for patients to protect themselves from medical harm.


This is a deep dive into a troubling trend in US healthcare and a must-read for anyone with an interest in healthcare policy and patient advocacy.
Agarwal, Rita, MD, FAAP, FASA (2020-Dec-10) Read complete review at California Society of Anesthesiologists

Listen to the authors' podcast at

Al-Agba and Bernard tell a frightening story that insiders know all too well. As mega corporations push for efficiency and tout consumer focused retail services, American healthcare is being dumbed down to the point of no return. It's a story that many media outlets are missing and one that puts you and your family's health at real risk.
--John Irvine, Deductible Media

Laced with actual patient cases, the book�s data and patterns of large corporations replacing physicians with non-physician practitioners, despite the vast difference in training is enlightening and astounding. The authors' extensively researched book methodically lays out the problems of our changing medical care landscape and solutions to ensure quality care.
--Marilyn M. Singleton, MD, JD

A masterful job of bringing to light a rapidly growing issue of what should be great concern to all of us: the proliferation of non-physician practitioners that work predominantly inside algorithms rather than applying years of training, clinical knowledge, and experience. Instead of a patient-first mentality, we are increasingly met with the sad statement of Profits Over Patients, echoed by hospitals and health insurance companies.
--John M. Chamberlain, MHA, LFACHE, Board Chairman, Citizen Health

A must read for patients attempting to navigate today�s healthcare marketplace.
--Brian Wilhelmi MD, JD, FASA

NewsNation interview (2020 Dec 17th)"Families sound alarm on medical transparency after deaths of their children"

CSPAN "Washington Journal" Interview on 2020-May-02 Dr. Rebekah Bernard on Primary Health Care Access and COVID-19 Pandemic

CSPAN "Washington Journal" Interview on 2020-May-02 Dr. Rebekah Bernard on Primary Health Care Access and COVID-19 Pandemic

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About the Author

Dr. Al-Agba earned her medical degree at the University of Washington in 1999 and completed pediatric residency at the University of Colorado School of Medicine/Denver Children�s Hospital in 2002. She is a board-certified pediatrician in private practice in Silverdale, Washington.

Dr. Bernard received her medical degree from the University of Miami in 1999 and completed her residency in family medicine at the Florida Hospital in Orlando in 2002. She is a family physician in private practice in Fort Myers, Florida.


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