In this episode of RadCentral a radiology podcast, we delve into the topic of Scope of Practice Expansion with Monica Deshmukh, MD. Dr. Deshmukh is a practicing radiologist and associate professor working in Los Angeles, California.

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Transcript Episode 1: Scope of Practice Expansion

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00:00:00:05 – 00:00:14:51
Dr. Deshmukh
We are losing the PR battle. Radiologists are losing the PR battle. We are not educating our patients as to what we do.

00:00:14:56 – 00:00:20:15
Laura
Welcome to Red central, a radiology podcast hosted by Excalibur Healthcare. I’m Laura.

00:00:20:18 – 00:01:01:28
Betsy
I’m Betsy. Let’s get right into this episode’s topic. It is about scope of practice expansion. this is a very contentious topic, and the importance of all professionals and their contributions to the delivery of health care can’t be understated. Our intent is to speak objectively and factually, and we have no intention to disparage any contributors. So, another thing we want to cover before we have our interview is we want to tell the audience that we intend to use the acronym NPP, quick acronym to stand for non physician practitioner.

00:01:01:33 – 00:01:35:15
Betsy
So this term can refer to a number of health care professionals. They include physician assistants a nurse practitioners. It can also include certified registered nurse anesthetists. So we will be using NPP as our standard acronym for non Physician Practitioner. Scope of practice. Expansion. What is it? Well, scope of practice expansion gives NPS the ability to perform more services that were previously only in the realm of physicians.

00:01:35:20 – 00:01:50:26
Betsy
So this is something that is accomplished through state legislation where there they are given the ability to perform more tasks and they are legally allowed to do so. So let’s get right to the interview.

00:01:50:31 – 00:02:20:34
Laura
We are delighted to have our guest with us today to share her perspective on the effects of scope of practice expansion. She comes from a long line of radiologists with a vast knowledge of radiology in the private sector, academics, and changes in radiology as we see them today. She is a well-respected physician and distinguished professor in Los Angeles, California, with multiple publications in the RSA Journal of Radio Graphics, Wiley Online Library, and Springer.

00:02:20:34 – 00:02:42:16
Laura
Link and recipient of the Outstanding Clinical Department Award. A lifelong procrastinator, baker, traveler, and hiker. Let’s welcome the Associate Clinical Professor and Vice Chair of the Department of Radiology at a top ranking educational institution in Los Angeles, California. Doctor Monica Deshmukh, welcome.

00:02:42:21 – 00:02:46:06
Dr. Deshmukh
Hello. Thank you so much for having me. I’m very. Thank thanks.

00:02:46:06 – 00:02:54:54
Laura
For coming. Of course. Yeah. So we’re delighted to have you on our show. Is there anything you would like to add to your very impressive resume that I just went through?

00:02:54:57 – 00:03:21:15
Dr. Deshmukh
I mean, no, I think that you said everything perfectly. My mom would be so proud. yes. I grew up with, I grew up around radiology. and so I actually have the unique distinction of seeing how it has changed so much, from the days of fluoroscopy, ultrasound, X-ray to advanced imaging. I, and I’m really excited to share my perspective with you guys.

00:03:21:16 – 00:03:25:17
Laura
Wonderful. Yeah. So that leads me to my next question. Why radiology?

00:03:25:21 – 00:03:55:41
Dr. Deshmukh
Yeah. You know, it’s so funny because like I said, I grew up in and around radiology. I, I genuinely, you know, was very undecided when I attended med school. but after going through all of the rotations and learning about the different fields, I really got very excited about radiology. I was lucky to have some really great mentors, and that’s one of the most important things about medicine is latching on to good mentors.

00:03:55:46 – 00:04:23:13
Dr. Deshmukh
And these, actually predominantly female, physicians, really shaped my worldview and made me excited to practice. radiology is a very, unique field because it’s not what people typically think about when they think of medicine. You know, they think about TV shows, they think about the emergency room and coding patients and traumas. It’s a little more what I like to call cerebral.

00:04:23:18 – 00:04:43:32
Dr. Deshmukh
and that’s something that really attracted me to it. also, I’m very, interested in the role of medicine and technology. Medicine. What do we what is it going to look like in the future? And I think radiology is a perfect field to kind of address those issues. So those are sort of my main instances and my main reasons.

00:04:43:37 – 00:04:48:09
Laura
Yeah. Perfect. So Betsy you want to ticket. Sure.

00:04:48:09 – 00:05:22:01
Betsy
And we have some questions for you. particularly about the topic that this episode is, is about and that is scope of practice expansion. And, I want to start off with a question, have you or your colleagues experienced scope of practice expansion within your own work environment? And can you tell us what that might look like, in your experience, or anecdotes that you’ve, you’ve heard from your radiologist colleagues?

00:05:22:06 – 00:05:34:39
Betsy
We’re particularly interested in the radiology specialty and scope of practice expansion. It’s something that’s happening with, with lots of specialties. We want to talk about radiologists.

00:05:34:49 – 00:06:03:49
Dr. Deshmukh
Absolutely. So we are very blessed. We do work with excellent, nurse practitioners, but those are there mainly in the field of interventional radiology. So our nurse practitioner, she is a part of the team. She works up our patients. She screens the referrals and determines which studies should be worked up, which studies warrant interventional imaging. excuse me, interventional.

00:06:03:54 – 00:06:29:04
Dr. Deshmukh
you know, we should this be seen by the physician? She is an essential part of the service as of right now, we do not have NPS or Pas in the diagnostic realm. however, as I practice in the state of California, there’s been a lot of new laws and one of the most important laws that I think we should discuss is a law called, California Assembly Bill 890.

00:06:29:09 – 00:07:00:33
Dr. Deshmukh
It was just passed in 2023. And this bill allows, nurse practitioners with three years of experience to apply to become independent. Previously to 2023, most NPS had to work under the guidance of a physician, with some notable exceptions like the emergency room, women’s health, etc. so this is expanding it much more globally. So as of today, we are mainly working with entities under physician guidance.

00:07:00:37 – 00:07:11:17
Dr. Deshmukh
But the future is going to be very different. And I think that’s something that we need to focus on and talk about and educate the listeners about. What’s the future going to look like?

00:07:11:22 – 00:07:57:23
Betsy
Sure. is this Bill I the research I’ve done on scope of practice expansion is that these, these additional privileges or additional, correct me if I’m using the right vocabulary. scope of practice. Bills, when passed, typically go into effect either immediately upon passing or there is some kind of additional training requirement set into motion that when the bill passes, they need to they need to be able to get this training to have those extra, expanded scope of practice.

00:07:57:32 – 00:08:04:14
Betsy
So can you explain to me what that particular bill will have when it goes into effect?

00:08:04:19 – 00:08:26:34
Dr. Deshmukh
Absolutely. And one thing I want to say before I delve into that is that for the listeners, all of this is on the ACR website. So if you just Google ACR scope of practice expansion, there’s a tremendous amount of resources. Most of the education that I, I’m receiving about this topic is coming from these resources and the AMA with these bills.

00:08:26:34 – 00:08:56:37
Dr. Deshmukh
Absolutely. There is a minimum requirement of hours at least. This is for my state. So my understanding and I could be off a little bit with the numbers is 3000 hours. is what’s required before you can apply for this new licensure. And it is called an NPS three. Excuse me. It’s called an NP 103. This is a designation which allows an NP to practice without physicians supervision.

00:08:56:42 – 00:09:24:04
Dr. Deshmukh
but a physician needs to be available for consultation. So they need to have access to a physician. There’s a second tier called an NP1 hundred four, which will allow the NP after three years of being a 103, to be completely independent. Okay, so this is where things are going. There’s multiple states that already allow NPS to essentially be independent.

00:09:24:09 – 00:09:59:22
Dr. Deshmukh
But the reason why I’m bringing up this bill is because one of the things that was introduced but was defeated by lobbying by the ACR is allowing NPS to not only order imaging, but perform and interpret imaging that provision was killed and that is very good. So without that provision with 3000 or excuse me, with 3000 hours of experience, an NP could start interpreting images.

00:09:59:27 – 00:10:00:06
Laura
Yeah.

00:10:00:10 – 00:10:13:57
Betsy
Oh yeah. What’s to give us a comparison. what is that look like compared to a radiologists hours of training? what’s the difference?

00:10:14:02 – 00:10:34:27
Dr. Deshmukh
So okay, so for the listener again, this is going to be on the website. A radiologist has to go to medical school for four years. We have to do an internship and we have to do a four year residency. Then a majority of radiologists then do a fellowship, which will vary in size from one year to three years.

00:10:34:31 – 00:11:04:12
Dr. Deshmukh
That is multiple years of training, multiple years of debt. So our experience is vastly different than a nurse practitioner and a PA. Again, I’m not discounting the role. I have a tremendous amount of respect for the nursing field in general, particularly after what we’ve dealt with Covid. These are essential members of the workforce in health care. However, it is very important for physicians to be able to distinguish ourselves from an employee and a PA.

00:11:04:17 – 00:11:33:18
Dr. Deshmukh
And another thing we should discuss is there’s nomenclature changes, you know, coming where, for example, in the state, in Colorado, PA, physicians assistants are called physicians associates. in other states, nurse anesthetists are going to be called doctors of nurse and anesthesia. Like, these changes can be very confusing to our patients. And this is why I tell my residents.

00:11:33:18 – 00:11:59:24
Dr. Deshmukh
And I tell my trainees that we should avoid using the term provider. We are not providers. We’re doctors. I think it’s important that we use appropriate nomenclature to distinguish ourselves. A provider is a generic term. I respect the term provider. That is a term that we use often in my facility. But we’re doctors and I think it’s important to make those distinctions.

00:11:59:29 – 00:12:08:16
Laura
yeah, certainly. Do you think that the change in the nomenclature is intentionally trying to confuse the public, the public?

00:12:08:16 – 00:12:41:03
Dr. Deshmukh
I think that we have to be careful. I don’t think anybody’s trying to mislead, but I do think that it allows interpretation. It expands interpretation. And, I think, you know, for example, if your average patient is not educated as to the different roles of providers versus physicians, they may be confused. And I am, you know, again, I’m not discounting the role of NPS, but I think there has to be a distinction.

00:12:41:07 – 00:12:49:03
Dr. Deshmukh
And I don’t want to use the word confusing, but I think it could, I think that’s the slippery slope. It could go down, to be honest.

00:12:49:08 – 00:13:05:41
Laura
From the public’s perspective, I’m not I mean, I’m very new to medicine in the world of medicine and the nomenclature, as you’ve mentioned. So from the public’s perspective, it would be confusing. I wouldn’t I would not know who a physician’s assistant versus a physician’s associate.

00:13:05:47 – 00:13:30:58
Dr. Deshmukh
Associate. I agree, and I think that, you know, right now we are dealing with global health care and health care worker shortages. We have, in fact, at the RCA, they talked about it as one of the biggest issues affecting radiology today. And we have to be very cognizant of this because right now, I think back to just going to the doctor myself.

00:13:31:03 – 00:13:50:56
Dr. Deshmukh
I was told for my own physician I had to see somebody new because my, primary care doctor, she retired, and they told me to see a new doctor. Had to wait three months, but I could see a PA in a week, and I said, I’ll see you in a week. That’s fine. We had the appointment, and, you know, I respected this person.

00:13:50:56 – 00:14:10:21
Dr. Deshmukh
I really appreciated that I was able to be seen so quickly, but there was a difference function and care. I think that we have to be very careful. These are different. These are apples and oranges and there has to be a maintenance of that of that distinction to the public.

00:14:10:26 – 00:14:29:05
Laura
Right. And so with with the changing as, as it, as it stands for radiology, and the changing roles of the physicians and the NPS and the physician assistants. can we talk about the rise in unnecessary imaging that’s been connected to NPS? Have you seen that in your practice?

00:14:29:06 – 00:14:53:49
Dr. Deshmukh
I have, I work I work pretty extensively with NPS and in the emergency department, and I do a lot of emergency radiology and they are you know, they’re mainly working in triage. So they triaged the patients and they’re ordering imaging. And it’s pretty routine for them to order a significant amount of imaging. Now, would that be, I’m going to train you.

00:14:53:49 – 00:15:20:35
Dr. Deshmukh
I’m in a teaching hospital. Full disclosure. So would that be different from a resident physician? I don’t know, but when in non teaching hospitals, I, I would assume the answer is yes. And some of the data does that that that these providers are increasing health care utilization, increasing advanced test ordering and increasing the number of tests that we are, you know, that need to be provided and need to be performed.

00:15:20:40 – 00:15:44:51
Dr. Deshmukh
If you don’t have a wide, vast array of medical knowledge, you are going to order more tests. I think that’s pretty, you know, self-explanatory. If you don’t really know what’s going on, you have to order more imaging. You have to order more laboratory and more specialized care. a specialist, rather than figure out what’s going on as a physician on your own.

00:15:44:56 – 00:16:05:42
Dr. Deshmukh
And I think that’s something that we will have to grapple with. And maybe that will offset the, sort of explanation for why we are using more and more services, which is cost, right? They cost less. But if they’re ordering more and they’re overall increasing health care expenditures, what is the trade off?

00:16:05:47 – 00:16:20:52
Betsy
Not to mention, I would think that in an emergency department, ordering images because you’re not able to make a quick diagnosis can affect the delivery of care timing wise.

00:16:20:52 – 00:16:45:04
Dr. Deshmukh
Absolutely. I think it would prolong it will prolong your stay. But we also have to remember there is, like I said, a physician shortage. They are dealing with a lot of, you know, we’re dealing with a lot of patients and health care right now. We are seeing that sometimes the demand of patients exceeds the supply of physicians. So again, there is a role for providers like encompass.

00:16:45:09 – 00:17:26:03
Dr. Deshmukh
However, maybe if ordering these imaging studies and then having a physician decide, okay this is appropriate, this is inappropriate may be better utilization of services. That being said actually yeah. Sorry. That being said, you know, we also need to be very careful and mindful that we are not, increasing this workload for physicians because there is a lot of, you know, anecdotal and anecdotal stories out there about, for example, in anesthesia, one physician anesthesiologist is overseeing multiple nursing tests.

00:17:26:07 – 00:17:34:41
Dr. Deshmukh
And how is that safe? So I think it’s a very fine line, and it’s kind of unchartered territory. And so we have to be careful.

00:17:34:46 – 00:17:55:08
Betsy
Can I ask a patient question? Sure. As a, as a layperson, that has the ear of a radiologist, can you tell me what is what is supervision mean when someone is when, when NPS are being supervised by a physician?

00:17:55:08 – 00:17:55:50
Dr. Deshmukh
Sure.

00:17:55:55 – 00:18:21:34
Betsy
What does that look like? And anecdotally, when I’m seen by an NP for for a routine physical or something like that, even if I’m under the understanding that they are being supervised by a physician as the patient, I don’t see that. I don’t see I don’t see where the physician supervision is coming from. Yeah, I don’t know.

00:18:21:34 – 00:18:27:09
Betsy
There’s no it. The definition of supervision is foggy to me.

00:18:27:14 – 00:19:04:19
Dr. Deshmukh
I think that you know, in an ideal world, we’re talking in an ideal world, the physician is developing a relationship, establishing standardized practices, overseeing the NP and the PA with a high degree of oversight in the beginning, for example, when they first start at the clinic and seeing them interact with patients, making sure it’s appropriate and it’s within standard of care, and then I assume in in primary care, I can’t speak for that.

00:19:04:24 – 00:19:39:31
Dr. Deshmukh
then further allowing them to have more autonomy, but at the end of the day, cosigning their notes, cosigning their orders and ultimately taking their liability. Correct. Because, you know, the physician would have ultimate liability over their staff. That’s in an ideal world, I think where things can get slippery is if there’s less supervision because of these increasing number of patients and the, you know, amount that physicians are getting stretched thin.

00:19:39:36 – 00:20:09:56
Dr. Deshmukh
but that would be in an ideal world in radiology. And I’m speaking about interventional here. we are we oversee pretty significantly. There is, the, the NP in our, in our, practice does mostly triage and management lab assessments, making sure the INR and the and the labs are appropriate to do the procedure. She is not doing the actual needle pokes or anything like that.

00:20:10:01 – 00:20:38:55
Dr. Deshmukh
That varies other institutions, they are doing courts, they’re doing Picc lines, they’re doing other types of procedures. And being overseen by a physician. So I think it really varies. But in an ideal world, we want to believe that they are being managed and supervised. In the beginning so that they meet their standard of care, and then the physician is allowing them to do stuff without suit, without sort of like hovering.

00:20:39:00 – 00:20:44:01
Dr. Deshmukh
And then cosigning their notes and cosigning their orders.

00:20:44:06 – 00:20:46:30
Betsy
and the physician is ultimately responsible.

00:20:46:44 – 00:21:05:37
Dr. Deshmukh
For precisely in this. Yes. Wendy and Pas works for them. Correct. Because they need to stick within the guidelines of their standardized procedures. So remember, an npm Pas can independently do things within the scope of their standardized procedures.

00:21:05:42 – 00:21:19:25
Betsy
Okay. so can we, talk about some alternative measures that might be considered to reduce inappropriate scope of practice expansion?

00:21:19:30 – 00:21:50:48
Dr. Deshmukh
This is a tough question because I will be honest, and this is what I want the listeners to know. This is coming okay. Especially in radiology. This is coming. There is two areas where we need to be careful and that is for profit hospital systems. And this is going to be a I think a different topic on the podcast is investor owned practices, correct practices owned by non physicians.

00:21:50:52 – 00:22:16:23
Dr. Deshmukh
Yes. This is where really and I just before we talk about that I kind of just want to talk about the history of this because I think it’s important for people to know. So you know MPs and peers, the the fields were actually created quite long ago in like the 60s or something as, advanced because of, of the increased demand on physicians.

00:22:16:28 – 00:22:40:06
Dr. Deshmukh
it wasn’t really until the 2000 where the scope of what an NP and a PA does truly expanded. And this for a few reasons. Number one, we have to talk about resident work hours. So when the resident work hours changed from residents could basically be abused and work, you know, 100 hours a week and 110 hours a week, that changed.

00:22:40:06 – 00:23:16:36
Dr. Deshmukh
And they were then allowed to and basically residents are not allowed to work 80 hours, more than 80 hours a week. Where is that extra work going to be absorbed? This is where MPs and peers fill that void. That was number one. Number two, I’d like to talk about the ACA, the Affordable Care Act was administered in 2010 and was passed in 2010 to increase health care access, and NPS and PA were realizing at that time, we need to start lobbying our government to allow us to be part of that equation.

00:23:16:40 – 00:23:49:53
Dr. Deshmukh
And then finally, and Covid, Covid is really where these expansions really dramatically increased. for example, the VA, the VA basically, you know, expanded rapidly, expanded the, the scope of practice for NPS and PA during Covid because they had to address the massive demand of patients that they needed to see. And the physicians couldn’t supervise all of these NPS and then, there was executive orders where, all supervision of NPS, was dropped.

00:23:49:53 – 00:24:16:10
Dr. Deshmukh
For example, in New York during the height of Covid. So those were really the areas where this became dramatically increased and lobbying efforts on behalf of NPS and PaaS were really dramatically increased. Luckily, the ACR and the AMA were able to keep up with this, but I think that we are going to start really struggling in the future.

00:24:16:15 – 00:24:53:22
Dr. Deshmukh
And the reason why is because now we have a lot of investor, funded private equity, venture capital and retail, you know, services like big corporations that are moving into medicine and with their, movement into our field will be a dramatic expansion of lobbying efforts to create more positions for non physicians. So I think it’s really important that we realize that this is a this is something that the future is, is very, uncertain.

00:24:53:27 – 00:25:04:57
Dr. Deshmukh
And I’m not trying to scare people. I’m just trying to educate people to the realities of what we face. And yeah.

00:25:05:02 – 00:25:27:54
Betsy
I really appreciate you talking about this, this, I think this is a great topic for a podcast because when I talk about it, at the dinner table or bring it up with my parents or my friends. Yeah, you you can start a conversation with. Do you know what scope of practice expansion is? And they say, no, they don’t know.

00:25:28:08 – 00:25:59:47
Betsy
And then as soon as I explain it to them and kinetic connected to how they’ve experienced going to see their primary care physician or they’ve needed a procedure done as soon as I explain what’s happening. They of course, they immediately have a story to tell. Everyone has experienced this in some way recently, if not multiple times.

00:25:59:47 – 00:26:17:22
Betsy
And it’s I’m a little amazed that that it’s just not it’s just it’s just behind. It’s just behind a, thin wall that people don’t understand. People don’t understand that it is a big issue and and it’s affecting them already.

00:26:17:27 – 00:26:47:26
Dr. Deshmukh
And I think that’s where as physicians, we’re not doing our jobs of education. You’re busy like we have. We are losing the PR battle. Radiologists are losing the PR battle. We are not educating our patients as to what we do. I was, you know, as we had discussed when we, first connected, something like 50% of Americans don’t even know that a radiologist is a doctor.

00:26:47:31 – 00:27:11:12
Dr. Deshmukh
We are not doing enough to educate people about what we do, about what physicians do. We are losing the PR battle, and this is where we, one of the most respected professions in America, is nursing, not physician. And there’s a reason, because I genuinely respect I remember when I was, you know, having my own, you know, having various health care challenges.

00:27:11:16 – 00:27:33:34
Dr. Deshmukh
The role that nurse nurses play is essential. They are so patient facing. There is also a belief that MPs and peers spend more time with you. Physicians are too busy because they’re always writing down notes and they’re always, you know, checking their phone or checking their watch. We need to change patient education so that they trust us more with their care.

00:27:33:43 – 00:27:44:58
Dr. Deshmukh
And then they demand to say, you know what? I want to see the physician. And that’s really where we have to be involved in lobbying, PR legislation.

00:27:45:03 – 00:28:21:30
Betsy
Yes. and that’s something that that we talked about, before we started interviewing you, that it, it is a state by state thing. And there are the you were talking about the ECR. The AMA is also a they have a great website. It’s very public friendly. and you it you can read it and, and there’s a lot of ways for anyone to understand what’s going on and let their legislators know that they’re concerned about still having physicians be part of their care.

00:28:21:30 – 00:28:22:36
Betsy
Absolutely.

00:28:22:40 – 00:28:46:31
Dr. Deshmukh
Absolutely. And to, circle back and address, what you had discussed, how can we prevent this for the future? And I think that there’s a few areas. number one, we have to increase the number of doctors in this country, American doctors, doctors, trainees trained in the United States. again, I’m not discounting, you know, doctors outside of the United States.

00:28:46:31 – 00:29:11:39
Dr. Deshmukh
They’re fantastic. But we need to train more physicians in America. We need to expand the number of medical schools we need to expand, the number of, facilities to deal with this. We need to expand our residency programs. We don’t have the you know, residency is residency programs are funded by the federal government, by Medicare and Medicaid.

00:29:11:43 – 00:29:38:16
Dr. Deshmukh
There are more medical student graduates than there are residencies. We need to expand residency programs. We need to reduce the barriers to medical education. It is very challenging to become a doctor. I don’t know how you I look at some of our medical students and I’m like, wow, you guys are I mean, from just incredible resumes. And I commend them.

00:29:38:16 – 00:29:58:57
Dr. Deshmukh
But does it do we need that? Like, can we make things easier for people? Can we make it so that, hey, I’m an MP and I want to go to medical school? Can we make it so that, you know, maybe people that have been in practice in other fields for a few years can transition and become medical, can become physicians.

00:29:58:57 – 00:30:23:03
Dr. Deshmukh
We have to lower the barrier. That’s number one. Number two, we have to embrace technology as our friend. We can’t be afraid of technology. There is really, really cool stuff out there that’s going to help radiologists become more efficient and faster and more accurate. And we have to embrace that. We can’t run from it. It’s not going anywhere and we don’t want it to replace us.

00:30:23:07 – 00:30:46:44
Dr. Deshmukh
I think that’s what has to happen. It’s essential. And I always, you know, tell my, my students and my residents that we have to be involved. Serve on your professional association at the hospital, go to your tumor boards, be friendly. There’s sometimes a misconception that radiologists are just like trolls living in the basement. We’re not. We’re really nice people.

00:30:46:58 – 00:31:13:18
Dr. Deshmukh
Come visit us. Come see. You know your patient’s imaging I love teams, I love it. This is not a plug, but I love, you know, anything remote I can that’s patient friendly that you know that that protects HIPAA. show them images online and be available. We need to make sure that we are part of the team. Otherwise we will be replaced.

00:31:13:22 – 00:31:14:58
Dr. Deshmukh
That’s how I feel.

00:31:15:03 – 00:31:15:52
Laura
Excellent.

00:31:16:03 – 00:31:31:51
Dr. Deshmukh
Yeah. This I’m very excited about. This is I think it’s just, you know, I think that, you know, that physicians are our are we are losing our legislative battles. We need to be more involved in legislation because there are people that will fill the voids for us if we’re not.

00:31:32:02 – 00:31:57:05
Betsy
I was, I was listening to some other podcasts that were related to scope of practice expansion. We are going to put them in the show notes. There’s some there’s some great information. Yeah, that that can help not just not just people involved, in medicine for their jobs like us, but, but if anyone’s a patient, and I know there are some patients out there, they would want to.

00:31:57:05 – 00:32:08:24
Betsy
They would want to educate themselves on how, how they can advocate for getting seen by physicians. we want we want to help you become more visible.

00:32:08:27 – 00:32:32:29
Dr. Deshmukh
Absolutely. And I also think that, you know, one more thing. Not to keep, referencing it, but there are funds available if you go on websites like the AMA and the ACR, they have, grants that states societies can apply for to lobby against these efforts. So it’s you shouldn’t feel like there’s not resources available to you. You can have those resources.

00:32:32:29 – 00:32:51:24
Dr. Deshmukh
And again, going on the professional society of your hospital and voicing your opinion as to, how you feel about these practices could be very helpful. we again, with the rapid expansion of non physicians and health care, we can’t lose our voice.

00:32:51:28 – 00:33:18:37
Betsy
It is important to mention that this is not an American problem. Being someone who is not that, who is not paying that much attention might dismiss this as an American problem. Scope of practice. Expansion is being implemented in other countries as well. the UK being one of them. And they are not they’re not having it’s not a it’s not good.

00:33:18:46 – 00:33:30:23
Betsy
It’s they’re having problems as well. I won’t I won’t speak directly to the details of their, of their issues. But we will have links in the show notes if anyone’s interested.

00:33:30:23 – 00:34:06:32
Dr. Deshmukh
And I’m glad you brought that up, because the UK is going nuts. I mean, and they’re publishing. That’s the thing. That’s concerning is that they are doing this, change it, making these changes and they’re rapidly, expanding scope of practice for especially in radiology. And, they’re publishing their data and that is where we become, we become vulnerable because we are, we are relying on, you know, we are relying on our stories and our experiences.

00:34:06:32 – 00:34:26:46
Dr. Deshmukh
But when there’s data out there, that’s when legislators who love numbers, they love to crunch data. Show me the data will say, but wait, it’s okay. Because they did 10,000 patients in the UK and everything was fine. And the reality is it’s apples and oranges. Remember, the UK health care system is extremely different from the United States, completely different.

00:34:26:51 – 00:34:47:47
Dr. Deshmukh
And, you know, we need to protect, our patients. And we need to understand that these, these, studies are coming out, and, we don’t want to become the UK. I don’t think our patients want us to become like the UK. And that’s a different topic of conversation, because, you know, we don’t want to get into that.

00:34:47:47 – 00:35:11:03
Dr. Deshmukh
But, I just think that there is a lot of stuff on the pipeline and we need to talk to ourselves. but that means and you’re we could do a lot of PR. Texas did a lot of really great commercials, like the state of Texas, which is very good at this. They’re very good at, at preventing scope of practice creep.

00:35:11:07 – 00:35:25:01
Dr. Deshmukh
They, you know, created a lot of commercials that they would, have out there saying, you know, I want my doctor, I want to be seen by my doctor. And this this is how we educate patients. We show them the difference. I mean, there’s a huge difference.

00:35:25:06 – 00:35:50:44
Betsy
So perhaps we can find a link to one of those spots and upload that in the show notes as well. and perhaps we can end this episode with a little more awareness about scope of practice expansion for the people that want to listen to this podcast and, talk about it over dinner with your friends and find out if if people are aware of it because they certainly experience it.

00:35:50:49 – 00:35:51:43
Dr. Deshmukh
Absolutely.

00:35:51:48 – 00:35:59:06
Laura
Absolutely. thank you so much for thank you. I’ve learned a lot. I’m sure our listeners, I did too learned.

00:35:59:11 – 00:36:22:09
Dr. Deshmukh
I did too. And I feel thank you so much for allowing me to share my viewpoints. and I think this is a really important topic for physicians, non physicians, patients. And I really encourage everybody to go online and check out the resources in their state, the laws that are pending. and I always recommend having a relationship with local legislators, especially if you’re a physician.

00:36:22:13 – 00:36:25:48
Dr. Deshmukh
It’s really important that they know our point of view.

00:36:25:53 – 00:36:27:32
Laura
excellent. Yeah. Thank you so much.

00:36:27:32 – 00:36:29:45
Betsy
Thank you so much. Thanks for all your time.

00:36:29:45 – 00:36:32:58
Dr. Deshmukh
Thank you so much. I appreciate it.

00:36:33:03 – 00:36:34:55
Betsy
Wow. She was great.

00:36:34:55 – 00:36:39:32
Laura
Doctor Deshmukh, it’s amazing what a good conversation we’ve had. I’ve learned so much from her.

00:36:39:32 – 00:36:43:39
Betsy
Yes, yes. what a great first episode. Also.

00:36:43:39 – 00:36:46:40
Laura
And we’re just scratching the surface on scope of practice expansion.

00:36:46:49 – 00:36:48:18
Betsy
There’s a lot of things to talk about.

00:36:48:18 – 00:37:07:39
Laura
Yeah. If you would like to be a guest, if you have anything to contribute on the topic of scope of practice or anything that we’ve talked about today, please sign up to be a guest on Rad Central podcast.com. Listen, like and subscribe wherever you get your podcasts. Rad central is a production of Excalibur Health Care from all of us here.

00:37:07:39 – 00:37:08:29
Laura
Have a great week!

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** The views, opinions, and statements expressed by guests on this RadCentral are solely their own and do not necessarily reflect the views, opinions, or positions of the RadCentral podcast, Excalibur Healthcare, or its hosts. Excalibur Healthcare does not endorse or guarantee the accuracy, completeness, or reliability of any information shared by guests during the episodes. *

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