In her latest book, Rebekah Bernard continues to cater to individuals who hold negative opinions toward nurse practitioners and physician assistants. This includes undergraduate pre-med students, medical students, resident physicians, attending physicians, and those who strongly advocate for "patient safety." Her approach in this book is more aggressive than in her previous work.
She is helping to perpetuate a movement through her work that, on the surface, says it aims to protect patients: which, in truth, is noble. However, beneath the surface, you find animosity, hatred, and prejudice that will, if left unchecked, endanger patient outcomes.
Why? Because ultimately, the message is to:
1. Not supervise NPs/PAs
2. Not work with them
3. Not take referrals from them
4. Scour the internet for moments they make a mistake and use it as anecdotal evidence to generalize.
5. Create a hostile work environment
6. Paternalistically dictate what autonomous professions can and cannot do.
7. Maintain physician hegemony over healthcare
8. Abolish the NP profession (there is a special place in Bernard's heart for the NPs)
There is also an apparent and notable obsession with providing anecdotal evidence to demean/broad-stroke views on professions that are boots on the ground, overwhelmingly doing much more beneficence than maleficence. The content primarily centers around denigrating NPs or PAs as second-rate compared to others. The language used to convey the message may be carefully worded and refined, but the tone is far from pleasant.
Healthcare is available in numerous settings, and unfortunately, some doctors, such as Bernard, only concentrate on emergency cases. Although having well-trained physicians available during emergencies is crucial, what about other essential healthcare environments that are not emergent?
There is, here, a pressing cultural issue that needs urgent attention. It's concerning that so many are participative and actively contributing to a harmful and hostile environment that impacts everyone involved. We must acknowledge the significant role that physicians play in this hierarchy and their considerable power, and how a movement like Bernard's can have detrimental effects on the healthcare team.
Dear reader, it is crucial to stay alert and analyze any evidence. Please be careful of anecdotal evidence and consider the level of empirical evidence. It is essential to be mindful of confirmation bias, selection bias, and the abundance of peer-reviewed evidence that may counter many of Bernard's positions. If a movement promotes prejudice, demonization, harassment, or ostracizes certain groups, it is necessary to question whether or not it is fulfilling its intended purpose.
After reading her original book and now this gem, I reflect more than ever that no profession is immune to human error, avarice, malpractice, and other imperfections. Nonetheless, as you read through the pages, please remember that as NPs and PAs, we remain dedicated to being at the forefront of delivering healthcare services. Our mission is to save lives, relieve suffering, provide care to the vulnerable during their most difficult moments, and improve access to healthcare across the United States.
