SB181 Going To Nevada Assembly

On May 18, 2015, in Uncategorized, by admin

Political contributions have taken priority over patient well-being and safety!  No cost savings for Nevadans just lining of the pockets of contributors, Crony Capitalism at the expense of patients.  SB181 was voted down 9 to 6 on Friday but some arm twisting happened by the Republican leadership who reopened it and did a re-vote resulting in passage 8 to 7.

You can observe the committee Work Session video at:
For SB181 footage play at the following times: 00:21:50 and again at 01:41:26

So this is not the end of SB181 which is still alive and must be voted down in the Assembly Floor now. To follow is the message to go to our members on how they can help us protect the most vulnerable poor, pregnant women, children and elderly.

We must reach out to the assembly and try to convince them to vote NO on SB181.  We need a communication tree:  reach out to ten people and then they need to reach out to ten people and so on, and so on…..

Dr. Teijeiro says the bill will go to the floor MondayTuesday or Wednesday….Please reach out to friends, family to voice their concerns to the Assembly on the lists below….WE HAVE NO TIME TO WASTE!!!

First email and call your own Assemblyman or Assemblywoman.  Identify them by clicking on this link and entering your street address and zip code and clicking on your “AD.”  It works best with a desktop computer:

When you identify your legislator, find them on the list below and use the links to email them AND CALL THE NUMBER.  Talk to whoever answers or leave a voicemail after hours.  Identify yourself as a member of their district and tell them why this bill is bad:

1. MAINTAIN OUR QUALITY OF CARE:  You and your loved ones do not want to be left in the operating room with a 23 year old anesthesia assistant with only TWO years of training keeping you alive.
2. NO SHORTAGE:  If you identify yourself as an anesthesiologist, let them know NV has plenty of anesthesiologists available.  The so-called shortage and surplus of Medicaid patients is a smokescreen.  This bill is heavily funded and pushed by hospitals and others who intend to replace anesthesiologists and profit from this dangerous form of cheap labor. How often can doctors go spend days at the legislature? Rarely, but he doctors who stand to financially benefit have taken the time to personally go to Carson City to speak to the legislators and if there was such a shortage then how could they take so much time outside of the operating room.



[email protected]
401 South Carson Street
Room 3156
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3105
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4122
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4115
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4112
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4102
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3123
Carson CityNV 89701-4747

THIS IS THE LIST OF MEMBERS WE NEED TO WORK ON.  Their position is unknown….

[email protected]
401 South Carson Street
Room 4110
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3129
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3105
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3130
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4111
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3124
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4121
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3131
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3134
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3125
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4105
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3159
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4104
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3119
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4114
Carson CityNV 89701-4747

The following are the ones that we can convince or may vote AGAINST THE BILL, but we must reach out to them so they can voice our concerns with authoritative numbers.

[email protected]
401 South Carson Street
Room 4123
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3160
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4107
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4113
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3140
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 4118
Carson CityNV 89701-4747

[email protected]
401 South Carson Street
Room 3158
Carson CityNV 89701-4747

DON’T BOTHER with these.  They are in FAVOR and will not budge or flipped on Friday in the committee vote.
Paul Anderson
Derek Armstrong
John Hambrick
Ira Hansen
Pat Hickey
Marilyn Kirkpatrick
Randy Kirner
Erven Nelson-FLIPPER
Phillip O’Neill
James Ohrenschall

Stephen Silberkraus-FLIPPER
Lynn Stewart
James Oscarson


Guys & Gals,

We do not want to lower the safety of our most vulnerable surgery patients. Please see this important development, a letter from the Nevada Osteopathic Board, on SB181 not necessarily viewed or voiced to the Assembly Commerce & Labor at the hearing last Wednesday.  We must get this out to the public.  I would appreciate you spreading this far and wide.  Use it in your correspondence with the committee members listed below, they need to know there are huge wrinkles in passing this bill.

Attached are important exhibits submitted during the hearing which none of us were informed about.  ACI and the big group up north are the ones who want this bill for obvious reasons.

  • The behavior of crazy proceduralists will be able to browbeat Anesthesiologist Assistants (AAs) into endangering patients lives
  • Unfortunately for the rest of us, this proposed law will displace anesthesiologists 4 times more often than CRNAs.
  • In a state declared emergency, Anesthesiologist Assistants (AAs) can practice without ANY supervision on very challenging patients.
  • Board Certified and Board Eligible anesthesiologists can supervise 4 AAs in separate surgical rooms.

As you realize if SB181 passes the Assembly, Nevada will change it’s standard of quality care from the best to the worst and so will the entire western states.  These AAs have been trying for about 5 years to get into Utah but the surgeons and Utahans have effectively blocked them there.  Most surgeons I have spoken with have no idea this is even being considered, the proponents of this bill (the greedy anesthesiologists and corporate hospitals) have done this under the cloak of secrecy.  The surgeons can’t believe that after years of hearing us inform them how much safer it is to select your anesthesiologist instead of being stuck with hospital controlled anesthesia providers, that some rogue anesthesiologists would want to lower the standard of care to their patients by using lower trained assistant in their ORs!

They claim there is an anesthesiologists shortage (there isn’t), that no one wants to come to Nevada, but the job offers by these guys was below national average so of course they didn’t get any valid candidates. They say they are offering ACT model jobs to CRNAs up north but this is reported as false by CRNAs (one who’s husband testified last Wednesday) who have asked for possible positions and been told there are none available.  The American Society of Anesthesiologists (ASA) is unbelievable because they quote 52,000 members but don’t bother to differentiate between anesthesiologist members, residents, CRNAs, AAs, PhDs, or any other non-anesthesiologist members.  The endorsement of SB181 by the ASA is like the endorsement of Obamacare by the American Medical Association (AMA). 

The testimonies are very deceptive and we can clearly change the outcome if we expose the facts by our numerous outcries. The letter from the former NV Medicaid Administrator, Charles Duarte, who deceased reimbursement by 43% to anesthesiologists but only 5% to hospitals in 2010, and is now a bureaucrat somewhere else, is especially offensive since he helped create the problems he complains of today.

We had a very good showing in opposition at the hearing and you can still voice opposition by: 

  1. Going to the website at: Please see attached screen shots of website Home & Share Your Opinion page so that you click on the link and select or type in SB181 (highlighted in yellow) to share your opinion “Against” this bill.  Tell everyone you know to log on and select “Against” and leave a comment if they wish. Type in their name, home street address (in red marked areas) so the assembly member knows his/her constituents are against this bill.  Entering your Email and other information is optional.
  2. You can also call or email the committee members by clicking on the imbedded links for each member below:
Randy Kirner Chairman
Victoria Seaman Vice-Chairman   
Paul Anderson 
John Ellison
Michele Fiore
Ira Hansen
Erven T. Nelson
P.K. O’Neill

Stephen H. Silberkraus
Irene Bustamante Adams
Maggie Carlton
Marilyn K. Kirkpatrick
Dina Neal
James Ohrenschall  

Note Red names are Republican, Blue names are Democrat and the two bold names are co-sponsors of the bill who may have been deceived by the proponents.  We can stop this if everyone speaks up and opposes this bill.  This is not a partisan issue, this is a Nevada issue! If we remain silent the legislators will not understand the serious problems this law will create and none of the legislators know anesthesia or medical issues!  The legislators know one thing, they wish to either do the right thing or get re-elected and public outcry is the thing that works stronger than any lobbyist or campaign contributions. 

“All it takes for evil to triumph is good men to do nothing.” – Edmund Burke


Voice Your Opposition to Nevada SB 181

On April 29, 2015, in Uncategorized, by admin

AAPS Nevada Members and Friends,

Please read the below note from Nevada Anesthesiologist, Annette Teijeiro, MD, and take action today!

Would you want to pay the same amount you pay now for your own anesthesiologist in your surgery room but get 1/4 of an anesthesiologist because you share time with 3 other asleep patients?  Heaven forbid there is a problem in two of the four rooms at the same time.  Who will get saved and who will be ignored?

The anesthesiologists shortages are fabrications or artificially created by administrative red-tape and hostile environment created by hospital administrations.

There is more to this but if SB 181 passes our lives in Nevada will change and so will the entire western states.  Anesthesiologist Assistants (AAs) have been trying for 5 years to get into Utah but the surgeons have effectively blocked them there.  Most surgeons I have spoken with have no idea this is even being considered.  The surgeons can’t believe that after years of hearing how much safer anesthesiologists are that these anesthesiologists would want an even lower trained assistant in our ORs!

They claim there is an anesthesiologists shortage and that no one wants to come to Nevada.  But the job offers are below national average so of course they didn’t get any valid candidates.  The ASA is unbelievable because they quote 52,000 members but don’t bother to differentiate between anesthesiologist members, residents, CRNAs, AAs, PhDs, or any other non-anesthesiologist members.  The ASA is like the AMA or the AARP who endorsed Obamacare.The testimonies are very deceptive and we can clearly change this if we show up in numbers. The letter from the former Director of NV Medicaid, Charles Duarte, who deceased anesthesiologists’ reimbursement by 43% in 2010 and is now a bureaucrat somewhere else & is especially offensive since he helped create some of our problems. Mr. Duarte purposely lowered all NV Medicaid reimbursement to prepare for the Obamacare Medicaid Expansion which almost quadrupled the numbers of Medicaid patients and has really made treating Medicaid patients financially unsound. The NV Medicaid Expansion is straining our healthcare delivery system, will cost us higher taxes this legislative session and potentially cause doctors to leave Nevada rather than face bankruptcy.

ACI (which Dean Polce, DO is a member of) and the big group up north are the ones who seem to want this bill for obvious reasons.

We need patients, family, friends, surgeons, anesthesiologists, and anyone you can get to attend TODAY’S hearing to simply state or sign-in on the record to be “Against” this bill.

Where: Grant Sawyer Building, 4th floor, 555 E. Washington Blvd., Room 4401, Las Vegas Nevada, this is on the northeast corner of Las Vegas Blvd. & Washington across from Cashman Field.

When: Hearing starts at 1:30pm TODAY!

What: Assembly Commerce & Labor Committee Hearing on SB181

If you are stuck in the office or simply can’t rearrange your day to make it, you can still voice opposition.

To share your opposition to this bill CLICK HERE and select or type in SB181.  Tell everyone you know to log on. Type in their name, home street address so the assembly member knows his/her constituents are against this bill.  Entering Email and other information is optional. Click “Submit” once you have selected “Against.”  Placing a comment is optional.

You can also call or email the committee members by clicking on the imbedded links below:

Randy Kirner Chairman   

Victoria Seaman Vice-Chairman   

Note: Red names are Republican, Blue names are Democrat and the two bold names are co-sponsors of the bill.  We can stop this if everyone speaks up and opposes this bill.  If we remain silent the legislators will not understand the serious problems this law will create for Nevadans. 


Obamacare should remind us we are not ‘subjects’

On December 27, 2013, in oped, by admin

Sonoran News has an interesting article about people fighting back against Obamacare and this Administration. This article has been recommended by:

Robert Odell, MD
AAPS Nevada Chapter, Member
Nevada Healthcare Professionals Coalition, Coordinator

Guest Editorial | December 24, 2013 | Sonoran News

Obamacare should remind us we are not ‘subjects,’ we are people

The unveiling of the dictatorial debacle that is Obamacare absolutely flabbergasts me. It is stunning on so many levels, but the most shocking aspect of it for me is watching millions of free Americans stand idly by while this man, his minions in Congress and his cheerleaders in the press systematically dismantle our Constitution, steal our money, and crush our freedoms.

The President, Nancy Pelosi and Harry Reid (with no small help from Justice John Roberts) take away our health care, and we allow it. They take away our insurance, and we allow it. They take away our doctors, and we allow it. They charge us thousands of dollars more a year, and we allow it. They make legal products illegal, and we allow it. They cripple our businesses, and we allow it. They announce by fiat that we must ignore our most deeply held beliefs – and we allow it.

Where is your spine, America?

Yes, I know people are complaining. I read the news on the Internet. I read blogs. I have a Twitter feed. So what? People in the Soviet Union complained. People in Cuba complain. People in China complain (quietly). Complaining isn’t the same thing as doing anything about it. In fact, much of the complaining that we hear sounds like resignation: Wow. This sucks. Oh well, this is the way things are. Too bad.

Perhaps you need reminding of a few important facts. Here goes:

1. The President is not a king. Barack Obama does not behave like a President, an elected official, someone who realizes he works for us. He behaves like a king, a dictator – someone who believes his own pronouncements have the force of law, and who thinks he can dispense with the law’s enforcement when he deigns to do so. And those of us who object? How dare we? Racists!

And while he moves steadily “forward” with his plans to “fundamentally transform” the greatest country in human history, he distracts people with cheap, meaningless trivialities, like “free birth control pills!” (In fact, let’s face it: this administration’s odd obsession with sex in general – Birth control! Abortion! Sterilization! Gay guys who play basketball! – is just plain weird. Since when did the leader of the free world care so much about how people have sex, who they have it with, and what meds they use when they have it? Does he have nothing more important to concern himself with?)

2. It isn’t just a failed software program; it is a failed philosophy. People are marveling that was such a spectacular failure. Well, if one is only interested in it as a product launch, I’ve explained some of the reasons for that here. But the larger point is that it isn’t a software failure, or even a product failure; it is a philosophy failure.

I have said this before: Obama is not a centrist; he is a central planner. And this – all of it: the disastrous computer program, the hundreds of millions of dollars wasted, the lies, the manipulation of public opinion, the theft of the public’s money and property, and freedom (read insurance, and premiums, and doctors) – IS what central planning looks like.

The central premise of central planning is that a handful of wunderkinds with your best interests at heart (yeah, right) know better than you what’s good for you. The failure of such a premise and the misery it causes have been clear from the dawn of humanity. Kings and congressmen, dictators and Dear Leaders, potentates, princes and presidents can all fall prey to the same imperial impulses: “we know what is good for ‘the people.’”

And they are always wrong.

There is a reason the only times communism has really been tried have been after wars, revolutions, or coups d’état. You have to have complete chaos for people to be willing to accept the garbage that centralized planning produces. Take the Soviet Union, for example. After two wars, famine, and the collapse of the Romanov dynasty, why wouldn’t people wait in line for hours to buy size 10 shoes? Or settle for the gray matter that passed for meat in the grocery stores?

But communism’s watered-down cousin, socialism, isn’t much better. Ask the Venezuelans who cannot get toilet paper. Toilet paper. ¡Viva la Revolución!

Contrary to what so many who believe in a “living Constitution” say, the Founding Fathers absolutely understood this. That is why the Constitution was set up to limit government power. (Memo to the President: the drafters of the Constitution deliberately didn’t say “what government had to do on your behalf.”) They understood that was the path to folly, fear, and famine.)

3. Obama is deceitful. Just as the collapse of the computer program should not surprise anyone, neither should we be shocked the President lied about his healthcare plan. Have any of you been paying attention over the past few years? Obama has made no secret of his motivations or his methods. The philosophies which inspire him espouse deceit and other vicious tactics. (Don’t take my word for it: read Saul Alinsky.) Obama infamously told reporter Richard Wolffe, “You know, I actually believe my own bullshit.” He has refused to be forthcoming about his past (where are his academic records?). His own pastor, Rev. Jeremiah Wright, told author Ed Klein, Obama said to him, “You know what your problem is? You have to tell the truth.”

Did Obama lie when he said dozens of times, “If you like your plan, you can keep it. Period!”? Of course he did. That’s what he does.

4. The media is responsible. And had the media been doing their jobs, we would have known a lot of this much, much earlier.

The press is charged with the sacred responsibility of protecting the people from the excesses of government. Our press has been complicit, incompetent, or corrupt. Had they vetted this man in 2008, as they would have a Republican candidate, we would have known far more about him than we do, even now. Had they pressed for more details about Obamacare, Congress’ feet would have been held to the fire. Had they done their jobs about Eric Holder, Fast and Furious, Benghazi, the IRS scandal, NSA spying – or any of the other myriad betrayals of the public trust this administration has committed, Obama would likely have lost his 2012 reelection campaign. (A fact even The Washington Post has tacitly acknowledged. Well done, fellas! Happy now?)

Instead, they turned a blind eye, even when they knew he was lying, abusing power, disregarding the limits of the Constitution. It was only when he began to spy on them, and when the lies were so blatant the lowest of low-information voters could figure it out they realized they had to report on it. (Even in the face of blatant, deliberate and repeated lies, The New York Times has the audacity to tell us the President “misspoke.”) They have betrayed us, abandoned us, and deceived us.

5. Ted Cruz was right. So was Sarah Palin. The computer program is a disaster. The insurance exchanges are a disaster. What’s left? The healthcare system itself. And this, of necessity, will be a disaster, too.

Millions of people have lost their individual insurance plans. In 2015, millions more will lose their employer-provided coverage (a fact which the Obama administration also knew, and admitted elsewhere).

The exorbitant additional costs Obamacare has foisted on unsuspecting Americans are all part of a plan of wealth confiscation and redistribution. That is bad enough. But it will not end there.

When the numbers of people into the system and the corresponding demand for care vastly exceed the cost projections (and they will, make no mistake), then the rationing will start. Not only choice at that point, but quality and care itself will go down the tubes. And then will come the decisions made by the Independent Payment Advisory Board about what care will be covered (read “paid for”) and what will not.

That’s just a death panel, put politely. In fact, progressives are already greasing the wheels for acceptance of that miserable reality as well. They’re spreading the lie it will be about the ability of the dying to refuse unwanted or unhelpful care. Don’t fall for that one, either. It will be about the deaths that inevitably result from decisions made by people other than the patients, their families, and their physicians. (Perhaps it’s helpful to think of their assurances this way: “If you like your end-of-life care, you can keep your end-of-life-care.”)

6. We are not SUBJECTS. (or, Nice Try, the Tea Party Isn’t Going Away). We have tolerated these incursions into our lives and livelihoods too long already. There is no end to the insatiable demand “progressives” have to remake us in their image. Today it is our insurance, our businesses, our doctors, our health care. Tomorrow some new crusade will be announced that enables them to take over other aspects of our formerly free lives.

I will say it again: WE ARE NOT SUBJECTS. Not only is the Tea Party right on the fiscal issues, but it appears they are more relevant than ever. We fought a war once to prove we did not want to be the subjects of a king, and the Boston Tea Party was just a taste of the larger conflict to come. If some people missed that lesson in history class, we can give them a refresher.

The 2014 elections are a good place to start. Call your representative, your senator, your candidate and tell them: “We are not subjects. You work for us. And if the word “REPEAL” isn’t front and center in your campaign, we won’t vote for you. Period.”

Laura Hollis is an attorney and teaches entrepreneurship and business law at the University of Notre Dame. She resides in Indiana with her husband and two children.


Now is the most dangerous time in the legislative session.

Much mischief happens this last weekend.


One joint resolution has a strong chance of passing setting the payment for emergency room charges in the hands of the Nevada Legislature.  It was introduced May 21, 2013 and is under the radar.  Can you say, DANGER WILL ROBINSON!  Today it is the hospitals; tomorrow it will be other businesses.  Do we want the state government setting payments for whatever they define as a right?  Emergency plumbing services, emergency air conditioning repair, emergency housing, emergency legal defense, you name it and they will put it into the mix.  AJR9 does not need the governor’s signature but anyone who knows the following legislators or live in their districts must contact them immediately.

For AJR9 contact everyone but definitely the ones listed below:

Name (Party) District email contact link

Majority Leader Senator Mo Denis-D (2) [email protected]

Senator Justin Jones-D (9) [email protected]

Senator Joyce Woodhouse-D (5) [email protected]us

Senator Michael Roberson-R (20) [email protected]us

Senator Aaron D. Ford-D (11) [email protected]

Senator David Parks-D (7) [email protected]

Senator Mark Manendo-D (21) [email protected]

Speaker of Assembly Marilyn Kirkpatrick-D (1) [email protected]

Assemblyman Jason Frierson-D (8) [email protected]

Assemblywoman Marylyn Dondaro-Loop-D (5) [email protected]

Assemblywoman Ellen Spiegel-D (20) [email protected]

Assemblyman Andrew Eisen-D (21) [email protected]

Assemblyman Andrew Martin-D (9) [email protected]

Assemblywoman Teresa BenitezThompson-D(27) [email protected]


If unsure of your Districts go to:

Roster for Assembly is:

Roster for Senate is:

Here is the link for the text of the joint resolution: AJR9



We will have to work hard to get some of these passed proposed laws vetoed by our governor.  He needs our votes to win re-election so let’s share our displeasure and hold everyone accountable at the ballot box!

There is an extremely dangerous law that has passed both chambers (pushed by Speaker Marilyn Kirkpatrick-D & Assemblywoman Maggie Carlton-D) and heads to the governor next.  We need him to veto AB170 and it is not clear if he will.  And although Nurse Practitioners are a valuable asset to a healthcare team this law will change this for the worse.  It is a first in the nation, a complete independent practice Advanced Practice Nurse (APN) license.  Although several states have special circumstances where Nurse Practitioners can prescribe certain lower risk medications and assist in rural areas with some autonomy, no state gives the Nursing Board carte blanche in defining any area of practice, and anywhere that they want, no restrictions.  There were a couple of amendments but none of these amendments truly require collaboration with a physician (no supervision at all).  Yes, the APN can simply open an office after a year of nurse practice and begin seeing patients.

Please note that collaboration agreements with physicians are not moneymakers for the physician.  It is my understanding that a physician cannot bill for collaboration to an insurance company.  In fact for the time spent in collaborative duties, the physician would make more money seeing patients of his own and not performing collaborative monitoring of the APN charts.  Truly not attractive from a medical liability or remunerative vehicle.

Furthermore, this will greatly decrease physicians wanting to practice in Nevada’s shortage specialties such as Primary Care because we will be a beacon to every APN in the country who wants to hang up a sign and begin practicing medicine.  The authors of this proposed law never allowed or attempted to create any oversight, limitation, or safety net to insure public safety.  Here is a fact, the majority of APN’s practice in major metropolitan areas in Nevada.  They removed the prohibition to practice outside of the APN practicing where they are not qualified but an amendment requires these APN’s to be insured but who wants the need to sue in the first place?  Shouldn’t we avoid the potential of danger before the life-threatening event if possible?

Why go to college for four years and fulfill all the premed required courses, four years of medical school and three years minimum of residence (minimum of 11 years) when you can get a four year nursing degree, APN for three years, no residency (7 years) and begin an independent office practice just 2,000 hours (a full time job is 2,080 hours a year) later in Nevada.

Which is more cost effective? Which one would you like at your bedside?  The new healthcare law (aka Obamacare) encourages this type of patient “access” to care.  In fact, unlike most legislation this proposed law takes effect July 1, 2013!  Most routine stuff will be okay but cross your fingers that it is routine stuff because if it is not chances are it could be missed because the APN’s simply don’t have the training for the rare complex problems.

The link for the text of the bill is: AB170 as passed by our Nevada Legislators, pay particular attention to what is being removed in red from Nevada law, like page 4 (Section 6) and 22 (Section 37) below.

Sec. 6. NRS 632.237 is hereby amended to read as follows:

(b) If authorized pursuant to NRS 639.2351 [,] and subject to the limitations set forth in subsection 3, prescribe controlled substances, poisons, dangerous drugs and devices . [,
pursuant to a protocol approved by a collaborating physician. A protocol must not include and an advanced practitioner of nursing shall not engage in any diagnosis, treatment or other conduct which the advanced practitioner of nursing is not qualified to perform.]

Sec. 37. NRS 454.695 is hereby amended to read as follows:

454.695 [1.] An advanced [practitioner of nursing] practice registered nurse may prescribe poisons, dangerous drugs and devices for legitimate medical purposes in accordance with [:

(a) The certificates] the certificate he or she holds from the Board and the license issued by the State Board of Nursing . [; and

(b) The protocol which is approved by the State Board of Nursing.

2. For the purposes of this section, “protocol” means the written agreement between a physician and an advanced practitioner of nursing which sets forth matters including the:

(a) Patients which the advanced practitioner of nursing may serve;

(b) Specific poisons, dangerous drugs and devices which the advanced practitioner of nursing may prescribe; and

(c) Conditions under which the advanced practitioner of nursing must directly refer the patient to the physician.]

Please share your thoughts because I am very concerned for Nevadans.  Contact the governor and share your concerns. He can send a strong message to the legislature to work out a safer alternative by a veto for this potentially life threatening change for the most vulnerable.

His office telephone number is: (775) 684-5670

Link to Nevada Governor website is:

Link to his campaign website is:

Link to his Facebook is:

Link to his Pinterest is:


Dr. Annette Teijeiro


By: Annette Teijeiro MD – AAPS Nevada Chapter Coordinator
Former Candidate for Nevada State Senate

Annette Teijeiro, M.D.

It is interesting that most businesses favor government work because it usually pays well and once you have friendly legislators (usually through lobbying efforts/political contributions) who support you, the contracts keep coming your way. Unlike for hospitals, in our medical practice, the payment for healthcare services rendered to people on our government healthcare plans is the complete opposite. Medicaid patients are usually the most demanding, least compliant, the most litigious, the most labor intensive in workforce costs, heck the regulatory red tape is exhausting, and yet the lowest reimbursed. Medicare & TriCare have been heading down this path as well. Now the private health insurance plans are beginning with PPACA. I am sure Halliburton would not work under these conditions but doctors and nurses do.

By the way, all of this is happening along with increasing requirements for recertification by hospitals, health insurance networks, and state licensing boards in all practice areas since the late 1990’s which costs patients healthcare workforce time (less face to face hands-on time), directly thousands of dollars in new taxes, and indirectly thousands of dollars in wasteful unnecessary mediocre care. The worse part is it takes away time we could spend on patient care because of the weeks of preparation courses, time spent logging your patient procedure/treatment logs, and taking the actual exam. And, since we all have this incredible amount of free time on our hands (sarcasm noted), we also will spend our vacation and family time jumping through this unending mass of regulatory hoops. None of this has been proven to improve patient care but most of this will certainly take away from patient care.

Interestingly, the lawyers do not have to do this, once they pass their state bar exam they are free to practice in almost any type of area of the law they choose and this can change whenever they freely decide to do so. They are only required to take Continuing Legal Education to maintain their license. This would be the equivalent of receiving your Medical Degree and then taking Continuing Medical Education to maintain your license but being able to practice any area of medicine you felt comfortable in. Unfortunately for doctors, the legislatures are composed of many lawyers, very few doctors, and our academicians lobby in favor of increasing their power over and collecting money from the private practice doctor at every turn. Please understand that this is a massively profitable business for the certification boards, academic institutions, and all at the expense of patients’ access to affordable care.

We need to stop this insanity before patients die! American trained quality experienced doctors are dwindling in numbers. About 25% of doctors are over the age of 55, many are turning to VIP/concierge practices, and some will retire early once the new healthcare law is fully implemented. There has been a noticeable change in the new doctors coming out of training in the last decade with less altruistic dedication, more expectation of a salaried predictable hours type positions & benefit packages, and less overall hands-on experience. Those trained prior to the 21st century were the best and the brightest of their time so they will do well in many other areas once they leave healthcare. Once they leave medical practice these very regulations will make it impossible to get them back. We must act now, time is short, 2014 is around the corner!

Our federal and state governments are both accelerating this healthcare disaster at logarithmic rates. The government is making promises that it cannot keep by their own massive regulatory fiat. This is why making acceptance of Medicaid and Medicare mandatory along with the aforementioned requirements for state medical licensing will further escalate the disintegration of quality healthcare access. The Nevada State Legislature starts February 4, 2013 and the legislators begin orientation just before that in Carson City.

We the People can stop this insanity by educating the silent majority and organizing massive demonstrations of a diverse group of people. We need to speak now or forever hold our peace as we watch America disintegrate into a 2nd world and then a 3rd world country within our lifetime! Please join us now, we need everyone, the young, old, blue-collar & white-collar workers, retired, military personnel & veterans, rich, middle class & poor, every race or religion, etc… We are fighting for our LIVES now!


Health Care Forum, Friday September 14, 2012

On September 1, 2012, in Events, by admin




Dr. Annette Teijeiro
What is the Patient Protection and Affordable Care Act?

Dr. Robert Odell
How PPACA will affect the Quality (Technology) & Accessibility
(Rationing) of Care for Seniors

Dr. Andrew Zak
The Personal Impact of Health Care Reform

Dr. Annabel Barber
Director, Lions HealthFirst Foundation

Assemblyman Richard McArthur (AD-4)
Legislative Process for Bills

moderated by
Dwight Mazzone

followed by
A Question & Answer Session

Reception with refreshments served from 5:00 – 5:45 PM
Friday, September 14th, 2012 (Doors Open at 2:30 PM)

Clark County Library (in the Main Theater)
1401 E. Flamingo Rd., Las Vegas, NV 89119

Free Admission | Seating is Limited | RSVP is Required   702.706.PLUS (7587) or [email protected]


Health Care Forum – April 30, 2012

On April 25, 2012, in Events, by admin



Monday, April 30th 5:00 – 9:00 P.M.

DesertVistaCommunity CenterinSun CitySummerlin

10360 Sun City Blvd(89134)

This Will Truly Be A Very Interesting Evening



Special Guest Moderator, Andy Matthews of Nevada Policy Research Institute

5:00 – 6:00 Private Reception and Fundraiser for the Candidates (optional)

Registration with Food and Drinks and Time to Mingle

6:00 – 7:15 Speakers on Healthcare Topics ( * Starts Promptly @ 6:00 p.m.)

  • HR 1409 Fair Negotiating Law for Doctors Andrew L. Zak, M.D.
  • Supreme Court Hearings (Mark Hutchison *)
  • The Case for “Universal Health Insurance Coverage”
  • The Case for HR 3000, Republican Alternative Annette Teijeiro, M.D. (candidate NV Senate)
  • Nevada State Legislative Issues Larry Matheis

7:15 – 7:30 Break

7:30 – 8:00 Keynote Address        Danny Tarkanian

8:00 – 9:00 Panel (Bipartisan) Discussion         Questions & Answers

Invited candidates:         Danny Tarkanian (U.S. Congress CD4)

Andy Eisen, M.D. (NevadaAssembly 21)

Annette Teijeiro, M.D. (NevadaStateSenate 5)

Mark Hutchison (NevadaStateSenate 6)


Support Annette Teijeiro, M.D.

On April 19, 2012, in Uncategorized, by admin

Two Events Saturday April 21

Las Vegas Physician and Coordinator of the AAPS Nevada Chapter, Annette Teijeiro, MD is running for the Nevada State Senate (District 5)!

This Saturday there are two opportunities for you to show your support for her campaign.

The first one is an opportunity to walk with Dr. Teijeiro in the Henderson Heritage Parade.  Volunteers will distribute candy, flyers, and get a t-shirt if there are any left on a first come first serve basis.  The parade this Saturday (April 21, 2012) starts at 10:00 am on Waters St. in downtown Henderson.  If people want to show support and walk in the parade they need to be there by 9:00 am at Water St. & Ocean Ave. and we will be #54 in the parade.  The fun is not only to walk in the parade which runs from 10:00 am to 12:00 pm, but there are activities in the downtown are to celebrate the 59th anniversary of Henderson afterwards.

Second, is a fundraiser in Las Vegas also on Saturday (April 21,2012) from 4:00 to 7:00 pm. RSVP required. Please find more information at


Las Vegas Workshop, Briefing, and Dinner

On January 19, 2012, in Uncategorized, by admin

January 20, 2012

DATE: Friday, January 20, 2012
WHEN: 12:50pm to 5:30pm – Workshop
6pm to 8:30pm – Reception, Briefing & Dinner
LOCATION: Orleans Hotel
4500 West Tropicana Avenue
Las Vegas, NV 89103
GROUP RATE: $79/night (Until 12/20)
Click Here to Make Hotel Reservation Online & enter code A2APC01 or call (800) 675-3267 and mention AAPS
COST: Workshop (includes dinner):
$99 AAPS member
$149 non-member,
$49 Office staff w/ Doctor
Residents, Medical Students FREE
Dinner Only: $30/person

Continue reading »


Looking for something?

Use the form below to search the site:

Still not finding what you're looking for? Drop a comment on a post or contact us so we can
take care of it!

Visit our friends!

A few highly recommended friends...