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trof

(54,255 posts)
Tue Jul 28, 2020, 07:38 PM Jul 2020

Do you see a "doctor" or PA or NP?

PA - Physician's Assistant
NP - Nurse Practitioner

I haven't seen my doctor in 2 or 3 years.
I've had several office visits for one thing or another, but I don't see her any more.
I don't like that.

Here's a primer on PA vs NP:
https://nursing.usc.edu/blog/np-vs-pa/

17 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
Do you see a "doctor" or PA or NP? (Original Post) trof Jul 2020 OP
She took a tick out of my stomach a few months ago leftieNanner Jul 2020 #1
Doctor, elleng Jul 2020 #2
Not sure what my PCP's actual title is... Wounded Bear Jul 2020 #3
I have been going to the skin doctor for about ten years and have never seen him. doc03 Jul 2020 #4
I've had good and bad both. safeinOhio Jul 2020 #5
PA + MD Binkie The Clown Jul 2020 #6
PAs and NPs seem to listen a bit more and are knowledgeable. I'm fine with them. Hoyt Jul 2020 #7
Doctor fleur-de-lisa Jul 2020 #8
sometimes a doc, sometimes a PA Skittles Jul 2020 #9
Never anyone but an M.D. Jirel Jul 2020 #10
Step daughter is a P.A., and a damn good one. 3Hotdogs Jul 2020 #11
MD... 2naSalit Jul 2020 #12
Both, Depending The River Jul 2020 #13
My doctor's group has several PAs and several NP csziggy Jul 2020 #14
I'm with you, trof lillypaddle Jul 2020 #15
I see a doctor, not a "doctor". Here's a "doctor": JustABozoOnThisBus Jul 2020 #16
Ha! trof Jul 2020 #17

elleng

(129,780 posts)
2. Doctor,
Tue Jul 28, 2020, 07:44 PM
Jul 2020

but saw his PA when he was out of the office (6? months ago returned some weeks later to see him.

Wounded Bear

(58,362 posts)
3. Not sure what my PCP's actual title is...
Tue Jul 28, 2020, 07:54 PM
Jul 2020

but she does a good job. I know she's not a Doctor because some things don't get done without a consultation.

Other than that, I have no problem. I figure most nurses, after a few years on the job, could do 75% of what a doctor does anyway when it comes to general stuff that comes up in standard office visits.

When I had Kaiser back in the 80's-90's was the first time I saw NPs instead of "real" doctors. It never really bothered me.

I'm at the VA now, and this is how they do it. It helps the GPs handle more patients in more of a supervisory role.

doc03

(35,078 posts)
4. I have been going to the skin doctor for about ten years and have never seen him.
Tue Jul 28, 2020, 08:02 PM
Jul 2020

I have to pay for a specialist and get a PA.

safeinOhio

(32,461 posts)
5. I've had good and bad both.
Tue Jul 28, 2020, 08:06 PM
Jul 2020

Starting to like my new GP. She’s a DO and cured my hives. Suffered for years and been to the ER a few times. She prescribed an asthma drug, I don’t have asthma, and have not had a hive yet. Singular. See her PA next month for my senior wellness check up.

 

Hoyt

(54,770 posts)
7. PAs and NPs seem to listen a bit more and are knowledgeable. I'm fine with them.
Tue Jul 28, 2020, 08:13 PM
Jul 2020

So much of primary care nowadays relies on protocols, lab tests and specialists for things difficult to manage. Just about anyone can read lab tests and refer you to an appropriate specialist.

Most conditions can be easily treated, and a high percentage of the issues most of us seek care for will likely self-correct given a little time.

It’s not until you are involved with someone in a serious healthcare crisis — parent, child, yourself — that you realize doctors aren’t miracle workers, especially if a bunch of organs/conditions are involved.

Skittles

(152,918 posts)
9. sometimes a doc, sometimes a PA
Tue Jul 28, 2020, 08:25 PM
Jul 2020

I'm fine with them

I would not like it if I NEVER saw the doc though.

Jirel

(1,986 posts)
10. Never anyone but an M.D.
Tue Jul 28, 2020, 08:52 PM
Jul 2020

PAs and NPs are not the equivalent of MDs unless you need a band-aid. I work with people with disabilities. Many of them are in the bad shape they are because they’ve been treated by PAs and NPs for years, exclusively or nearly so. Their diabetes is crap. Their treatable musculoskeletal issues aren’t left untreated as they’re told they just need to “live with it.” Seizure disorders are uncontrolled as patients are told “Oh, try one more month on these meds...” rather than being sent to the neurologist to try something else because the regimen simply isn’t working. It goes on and on. The only - and I do mean the ONLY - time I’ve seen PAs work well is in extremely specialized settings, for visits that are purely for cardiac, pulmonary, etc. retests. They can be just fine for scheduled testing and going over therapies.

I made the mistake a handful of times in my life of letting them set me up with an NP or PA in an emergency. Every one was a laughable failure.

- I fell off 7 inch heels in the ice at a club and hurt my elbow badly. The NP was available to order an x-ray. She called me back to tell me my arm was broken. It was complete fiction, and NOT the findings on the x-ray. An orthopedist let me know that it was a bruised nerve, several days later.

- I had an exposure to very active TB at work and needed a Mantoux test. NP did fine administering it, but another one had no clue how to read the result several days later, and hemmed and hawed until a doc came to sort it out.

- I finally said no more, and refused to sign the agreement at my clinic to allow any NP or PA to treat me. My doc had put me on blood pressure meds for the first time in my life, during a period of gruesome stress when I started having bad BP spikes when emotionally triggered, like my mother developed late in life. Months later, with stressors resolved and BPs always low or normal, I developed a known but less common side effect to the PM dose. I took myself off the bedtime dose for a week, the side effects vanished immediately, and my BPs were rock solid. So I called my doc to make it official that I would still be on the AM dose, but drop the PM. (The plan had been to get me off completely in a few months, BTW.) The NP did everything she could to avoid giving my message to the doc. She finally suggested the stupidity of “Why don’t you take your ‘whole’ dose in the AM instead?” Excuse me, but my BP was perfect on this dose - no need to double it! I told her to butt out, and got to my doc, who said it was great, so let’s kill the PM dose and just keep monitoring for a month before we call it permanent.

Just don’t do it to yourself. Get a doc, and insist on that doc. Especially if you’ve been out of medical care a few years, do ONLY an MD. If, in the course of working with that doc, you discover that the doc has a fabulous NP or PA, and all the diagnostics and treatment tweaks are done so you only need occasional monitoring checks, then maybe occasionally see THAT fabulous NP or PA but don’t let them switch you to any others. Medical personnel are not fungible. You find the one that’s good, and you keep that one.

3Hotdogs

(12,145 posts)
11. Step daughter is a P.A., and a damn good one.
Tue Jul 28, 2020, 09:07 PM
Jul 2020

She's been at it for 20 years now. Yale Med School.

On her third week on the job, she saved a kid's life. Kid showed up with some unusual symptoms. Coincidentally, E. had just attended a presentation on that disease. She took a few minutes to look at the kid and told the mother to take her immediately to the E.R. and have them check for (whatever).

Days later, Mom came into the walk in clinic and reported that the E.R. people said that a delay would have cost the kid's life.

2naSalit

(85,637 posts)
12. MD...
Tue Jul 28, 2020, 09:12 PM
Jul 2020

Would have been truly fucked if I hadn't complained to the admin. about how the PA was handling my problems.

The River

(2,615 posts)
13. Both, Depending
Tue Jul 28, 2020, 09:29 PM
Jul 2020

Dr. and NP at the VA. I also see a Naturopath, Nutritionist and Acupuncturist all rolled into one. When speed counts, a Doc-in-a-box will do.
Check your states' "patient bill of rights" if you think something is amiss.

csziggy

(34,115 posts)
14. My doctor's group has several PAs and several NP
Wed Jul 29, 2020, 12:49 AM
Jul 2020

I have seen both in the past but in the last few years my doctor sees me for the annual checkups. If I have to go in without much notice and they have to work me in, I usually see a PA or a NP.

I don't mind - in 2017 a visit with the NP probably saved my life. I'd had shortness of breath for several years. She noticed a heart murmur which the doctor had not seen at a previous visit only a few months earlier. I was sent to a cardiologist and underwent a series of tests that showed a calcified aortic valve which needed to be replaced - only 40% of the blood was making its way through!

More tests on the way to getting a replacement valve showed a mass on my left kidney that would not have been found in time otherwise. Normally by the time the cancer showed symptoms, it would have spread. Because the heart tests and scans showed it early, they were able to remove the kidney before that.

If it had not been for that NP, not only would my "shortness of breath" worsened until I had heart damage, the cancer would have killed me. I will happily see whichever medical professional they have available.

lillypaddle

(9,580 posts)
15. I'm with you, trof
Wed Jul 29, 2020, 08:03 AM
Jul 2020

I canceled my last appointment with the pulmonologist because I was pissed he hadn't seen me in 3 years - I always saw his NP. Makes you feel like they don't give a shit about you.

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