Robert Duprey MD

Robert is a 2nd career physician (MD); a combat Veteran with the US Army; a former psychiatric nurse practitioner; an independent researcher; a medical writer; and now having passed USMLE Steps 1, 2CK, 2CS, and 3, is a residency applicant.

Race Car Model: Nurse Practitioners Fight for More Freedom

“It’s like having a driver’s license but then making it illegal for you to drive unless you have a permission slip from someone in your neighborhood,” she said. (1)”             But drawing reference to this driver’s license comparison, we could say also that having a license doesn’t automatically mean you’re qualified to operate a race car.…

I want you: But Not Your Kids, Familes, or Pets…….. (TRICARE families report worse access to care than commercially insured, uninsured)

“Families who are covered through TRICARE report worse access to healthcare than people with private plans—and even the uninsured, according to a new study (1).” Alright, alright, maybe adding the pets to the title was pushing it, but it’s meant to be sarcastic anyway. Deplorable, despicable, unthinkable. But the title isn’t exactly the whole picture…

Doctor Shortage: Short Doctors

This article (1) is not about short doctors under 5’10”, it’s about a shortage of primary care physicians (PCP). Sources indicate: “The United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply, according to new data published today by the AAMC…

I Want My Slice of the Pie: Rationing of Health Care in the United States, An Inevitable Consequence of Increasing Health Care Costs

The bottom line up front (BLUF): “Following the passage of the Affordable Care Act (ACA), much of the national discussion was focused on expansion of coverage and value in health care, but new concerns about rationing of care are emerging.” And who do you think this is going to affect? That’s right, the have not’s. In a recent…

Dangerous Road Ahead

More than 1 in 10 patients are harmed in the course of their medical care…………..and half of those injuries are preventable.  And there she was, by the time she reached the inpatient geriatric psychiatry inpatient ward in serotonin syndrome delirium, Ms. X was on Lexapro, Prozac, Effexor, Risperidone, Ingrezza, Austedo and Trazodone according to medication…

A Two Headed Dragon: Two Tier Healthcare (Primary Care Appointments for Medicaid Beneficiaries With Advanced Practitioners)

Primary care practices may be relying on advanced practitioners (APs) to accommodate new Medicaid beneficiaries following the passage of the Affordable Care Act, according to a study published in the July/August issue of the Annals of Family Medicine (1).             …….and this sets up a two-tiered healthcare system. One for the haves and the other rooted in Medicaid for…

Who Farted: Stigma Stinks (Diagnostic Clarity Needed to Distinguish Physician Burnout & Depression)

“Erroneously labeling a physician’s distress as burnout may prevent or delay appropriate treatment of MDD, a serious and sometimes life-threatening mental disorder,(1)”             This particular article then goes on to describe overlapping symptoms and clinical features between burnout and major depressive disorder, lack of diagnostic clarity on burnout, and stigma associated with having depression.Burnout is a syndrome defined…

“I’m Leaving On a Jet Plane………..”. Bring Narcan

Is there a Doctor onboard?  Those dreaded words. Here’s what you get to look forward to? “Delta Air Lines has announced it will begin carrying a drug used to reverse opioid overdoses on every plane after a passenger reportedly died on a flight earlier this month.” Now an extension of the opiate epidemic, overdoses on board…

Safe Staffing Levels…… What?? Are You Mad?

 I support this one. This is one nursing issue I can get behind. “A memo in support of the bill states that safe staffing reduces adverse patient outcomes, citing research funded by the federal Agency for Healthcare Research and Quality. The data, the memo states, have shown hospitals with lower nurse staffing levels have higher…

Let’s get Ready to Rumble………… Main Event: AMA, AAEM and AAEM/RSA vs AANP

On July 8th, 2019, the American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA), along with the the American Academy of Emergency Medicine (AAEM), sent an open letter (1) to the AMA: “Where is the Public Campaign Advocating for Physicians?”  The overarching concerns were: (a) the recent advertising by nurse practitioners advocating for their independent…