| Welcome to Bw Reads, our weekend newsletter featuring one great magazine story from Bloomberg Businessweek. Today we’re sharing the fourth installment of The Nurse Will See You Now, a series documenting how the increasing reliance on nurse practitioners is imperiling US patients. In it, Caleb Melby describes a cottage industry of fixers that shows how a broken system can be changed. You can find the whole story online here. If you like what you see, tell your friends! Sign up here. Across the US, nurse practitioner students face the same problem. Like medical doctors, they need to complete clinical rotations to graduate. Unlike doctors, they don’t have access to federal funding to support that training, and their schools often leave them to find their own clinical instructors, known in the industry as preceptors. The stakes are high. For many students, it’s the only time they’ll work with real patients as an NP before entering the workforce. And if they can’t get the hours, their graduation will be delayed. So students beg on Facebook for placements, drop off cookies at front desks for potential preceptors—and, when they find someone who’s willing, often pay the person themselves. For the public, the ramifications are greater. Even some hospital leaders acknowledge there’s so little quality control that patients can’t be sure their NP is properly trained to treat them. Struggling to ensure they’re prepared to handle the duties assigned them, students have few places to find help. Many have turned to Dino Soriano.  Soriano, founder of Clinical Match Me, in his home office in Puerto Rico. Photographer: Erika P. Rodriguez for Bloomberg Businessweek A decade ago, Soriano founded a company called Clinical Match Me to help patch this broken system. For a flat $1,995 fee (paid by the students, financing options available), Clinical Match Me will do the work that their universities often refuse to: finding, scrutinizing and paying clinical instructors. The company advertises a roster of more than 220,000 potential preceptors across all 50 states, and it’s placed students from more than 280 advanced nursing programs. It’s one of the biggest players in the NP matchmaking business. Soriano’s experience has given him a deeper look into the fractured education infrastructure that nursing students face. Increasingly, NPs are taking on roles previously filled by physicians, but their regimen hasn’t kept pace with those growing responsibilities. Soriano, like many within the health-care industry, has concluded that more needs to be done. The clinical hour requirements, for instance, are simply “insufficient to properly train them and prepare them to be safe,” he says. For Soriano these problems are personal. When he couldn’t find a preceptor, his own graduation from Walden University, the for-profit online school that graduates the most advanced nurses, was delayed. As a problem-solver, though, he cuts a somewhat awkward figure. In 2020 he pleaded guilty to one count of conspiracy to commit Medicare fraud after federal prosecutors accused him of receiving compensation for prescribing orthotic equipment for which he falsified testing and examination records. In the charges, prosecutors made clear that Soriano was unaware of the overarching fraud scheme, even as he profited from it. Nevertheless, he pleaded guilty, and multiple states revoked his NP license. He then transferred Clinical Match Me to a new entity with a new owner, for whom he serves in a consulting role. (The chief executive officer says Soriano has “never been a principal in the current company, so his conviction should be irrelevant.”) Clinical Match Me isn’t flawless; some of its clients complain about their placements. But its very existence underscores the extent of the problem posed by NPs’ ever-growing role in US health care. It also points the way toward potential solutions for lawmakers, hospitals, accreditors and the regulators that have failed to properly police the training of the nation’s newest NPs. Keep reading: Desperate Nursing Students Turn to Fixers for Their Clinical Training For the rest of the series: Part 1, The Miseducation of America’s Nurse Practitioners Part 2, What Happens When US Hospitals Go Big on Nurse Practitioners Part 3, In a MedSpa, Your Surgeon May Be a Nurse | 
