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Physicians must continue to oversee nurse practitioners in Pennsylvania | PennLive letters

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Physicians must continue to oversee nurse practitioners in Pennsylvania |  PennLive letters


In a recent article, “House measure would allow NPs to practice independently,” nurse practitioners continue to push for legislation on independent practice without physician oversight.

The Pennsylvania Medical Society (PAMED) vigorously supports and advocates for physician-led, team-based care whether by direct supervision or written collaborative agreement of all non-physician practitioners and acknowledges nurse practitioners as a vital member of that team. The collaborative agreement ensures access to a physician in a patient’s care; acting as a safety net for any case beyond the training of a non-physician practitioner.

The article mentions the laws of other states in a continued effort to say expanding non-physician roles will expand access to care. But research from the American Medical Association mapped out locations of primary care physicians and nurse practitioners in rural, western states and showed they tend to practice in the same areas of the state as physicians, regardless of scope of practice laws.

Studies continue to show that scope of practice expansion for all non-physician providers can lead to safety concerns, increased health care costs and an increase in unnecessary testing.

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There is no need to expand scope of practice laws only to put the patients of Pennsylvania at risk. As established in their collaborative agreement, CRNPs can already diagnose, prescribe and treat illnesses. Nothing in current law limits patient access to CRNPs.

Patient care is most effective when delivered through health care teams, a cadre of non-physician roles with physician oversight. We will continue to fight for quality patient care in Pennsylvania.

F. Wilson Jackson, III, MD, president of the Pennsylvania Medical Society.



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Pennsylvania

Books and coffee? Both shine at Pressed in Erie, Pennsylvania

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Books and coffee? Both shine at Pressed in Erie, Pennsylvania


Independent bookstores are the heartbeats of their communities. They provide culture and community, generate local jobs and sales tax revenue, promote literacy and education, champion and center diverse and new authors, connect readers to books in a personal and authentic way, and actively support the right to read and access to books in their communities.

Each week we profile an independent bookstore, sharing what makes each one special and getting their expert and unique book recommendations.

This week we have Pressed in Erie, Pennsylvania!

What’s your store’s story?

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Founded in Erie, Pennsylvania in 2018, our goal is to encourage others to step away from their device and enjoy the feel, smell, and look of a book, paired with a comforting coffee. We love it when customers take their time checking out what’s new (or old!), and have a lovely time reconnecting with their senses as they explore the books and gifts in our shop.

What makes your independent bookstore unique?

Customers love the vibe in our store. It’s modern and upbeat, but with good old-fashioned books in the spotlight! They’re encouraged to take their coffee or warm drink (from our full-service coffee shop) and explore. 

We’re known for a curated but wide variety of reading genres, along with fun literary gifts (staff take real pleasure in hearing customers laugh out loud as they peruse the store), as well as our large kids’ area, with our famous reading tree. We’re proud to do our part to make Erie a vibrant and interesting city, something more than just a cluster of big-box stores.

What’s your favorite section in your store?

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My favorite section is the front, where all the best displays are and where we greet our customers. But a close second is the kids’ room — the reading tree and the moss-covered cobblestone look of the carpet are so inviting!

Why is shopping at local, independent bookstores important?

People vote for what they want in their community with their dollars. If they like having indie bookstores in their town, they simply must spend money there. Spending money elsewhere is exactly like submitting a vote for the indie to close. As long as people understand what they’re doing when they choose not to shop local, I have no problem with it. But if people want that local shop to stay, because it adds value and personality to their town and because they enjoy shopping there, they have to be okay with spending a few extra dollars on a book there. That’s the bottom line. 

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Check out these books recommended from Pressed owner, Tracey Bowes:

  • “Z: A Novel of Zelda Fitzgerald” by Therese Anne Fowler. It’s a page turner, well-written, entertaining and informative, and often hasn’t yet been read. 
  • “We Should All Be Feminists” by Chimamanda Ngozi Adichie
  • “The Women” by Kristin Hannah
  • “The Fury” by Alex Michaelides



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Criminal charges for climate pollution? Some argue a Pa. law would apply

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Criminal charges for climate pollution? Some argue a Pa. law would apply


While Braman agrees it would be difficult to take on as a prosecutor, he said that could change as more young people move into positions of influence.

“As the catastrophes escalate and as young people who face their entire future in an environment dominated by increasing climate harms, [and] start to join the jury pool, start to become prosecutors, start to become judges and start to become shareholders, I think that the writing’s on the wall,” Braman said, “and I hope that everybody, including everyone inside fossil fuel companies, starts to pay attention to that.”

But Weber said prosecutors would still have to convince a judge or jury to convict beyond a reasonable doubt.

Fossil fuel companies have permits to conduct their business, essentially government permission to do what they are doing, another way for the company to defend itself in court.

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If the companies are charged and convicted of risking or causing a catastrophe, the fines are in the range of $15,000 to $25,000 per count, Weber said.

“Is that going to deter a multimillion dollar company? Is that going to interfere with the operation of their business and the money that they’re making? I don’t think so,” Weber said. “I mean, did Energy Transfer go out of business by that criminal prosecution?”

“Maybe you put the CEO in jail,” Weber said. “And do you think that the other fossil fuel companies are going to say, ‘That guy went to jail, so we shouldn’t do what we’re doing anymore’? No, they’re going to do what drug dealers do. Drug dealers say, ‘Well, that guy got caught for drug dealing because he’s stupid. We’re not stupid.’”

 ‘Win by losing’

Environmental attorney Rich Raiders said there are a lot of questions with the strategy, but says the article does serve an important purpose.

“The idea behind these articles isn’t necessarily to come to an answer, but to get people to start thinking about how to address a question. And in that respect, it does that and it does it well,” Raiders said.

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Raiders represented homeowners who sued Energy Transfer over the Mariner East pipeline construction. He said a case like this would be a battle of the experts, but there are fundamental questions the article does not address about whether the charges would stick.

“What do you have to show responsible for climate change to meet the definition of a catastrophe?” Raiders said. “What is that level of threshold that you have to show before you can write a complaint that actually can survive objections? And how do you prove that it was the fossil fuel emissions caused by the marketing aspects of these companies to get you far enough that you can meet this definition? We don’t know.”

Raiders said the goal of this type of prosecution could be to get a large settlement, similar to what happened with the tobacco companies settlement or a previously proposed Sackler family settlement over opioids.

In that case, it makes sense to bring a case where you “win by losing.”

“And maybe that’s what a case like this does. It’s not necessarily to win the case, but it’s to move the needle,” Raiders said.

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For example, he said it could get the legislature to take action. But it also requires someone willing to lose.

“I think this is an interesting discussion in the long term for how to get people to think about the problem,” Raiders said. “And as a thought piece it does have some merit. But will you see something like that filed in the next 12 months? No, not anytime soon.”

Braman, one of the co-authors of the piece, is more optimistic.

“We desperately need some kind of solution that will allow the public to hold these massive corporate criminal actors accountable and have them really address the harms that they’re generating,” he said.

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Cash reward offered for information leading to Pennsylvania cold case homicide resolution

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Cash reward offered for information leading to Pennsylvania cold case homicide resolution


LEBANON COUNTY, Pa. (WHTM) — A cash reward is being offered for anyone who has information surrounding a 2021 cold case homicide in Lebanon County.

The $2,000 reward is for anyone who has information that can solve the case of the death of 35-year-old Zachary Lauderman, according to State Police.

Lauderman was found dead with two gunshot wounds to his head in his home, located along Ulsh lane in Bethel Township Sept. 10 just before 3 p.m., according to Troopers.

Anyone who knows something is asked to contact PSP Tips at 1-800-4PA-TIPS (8477), or they can go online to submit a tip by clicking here.

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