Is your PCP an MD or NP?

[Anonymous]

Yes, it is the new norm. Avoid it like the plague. I had a great physician pcp but at some point it became clear that aside from the annual physical I had to schedule 6 mos in advance I was basically never going to get in to see her again and would always be put off onto the NP.

I finally just paid for concierge. My concierge doctor won't work with NPs, they say the prevalence of MLPs (mid-level providers -- NPs and PAs) is ruining medicine.

[Anonymous]

Mine is an MD, but I pay for concierge, because I am medically complex (life limiting chronic illness/suppressed immune system that leads to a lot of relatively straightforward infections that go asymptomatic to septic in three days—I can’t afford to not get a same-day appointment).

My healthy child’s PCP is a pediatric NP. She is amazing. I need her to not retire for six more years.

If my concierge practice brought on an NP or PA and assigned me to him/her, I would be fine with it. I’m paying for same-day sick appointments, not for an MD.

[Anonymous]

Anonymous wrote:I want my medical care to be provided by someone who completed medical school and a residency, preferably who is board certified.
There is no comparison between that and a nurse, even one with an advanced practice degree

Unfortunately the MDs around here who are highly regarded all seem to be going the concierge route. It is not right.

Why is it not right? After all that training, don’t you think they should be able to choose how and where they practice? Do you hold all jobs to that standard? For example, a world class architect MUST design public housing complexes for Pennies on the dollar or else it’s “not right”?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I want my medical care to be provided by someone who completed medical school and a residency, preferably who is board certified.
There is no comparison between that and a nurse, even one with an advanced practice degree

Unfortunately the MDs around here who are highly regarded all seem to be going the concierge route. It is not right.

Why is it not right? After all that training, don’t you think they should be able to choose how and where they practice? Do you hold all jobs to that standard? For example, a world class architect MUST design public housing complexes for Pennies on the dollar or else it’s “not right”?

I see my PCP once a year generally. I see my specialists much more. Why pay all that money for concierge fees just to get one prescription? The highly qualified specialists aren't asking for a retainer.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I want my medical care to be provided by someone who completed medical school and a residency, preferably who is board certified.
There is no comparison between that and a nurse, even one with an advanced practice degree

Unfortunately the MDs around here who are highly regarded all seem to be going the concierge route. It is not right.

Why is it not right? After all that training, don’t you think they should be able to choose how and where they practice? Do you hold all jobs to that standard? For example, a world class architect MUST design public housing complexes for Pennies on the dollar or else it’s “not right”?

It does not reflect the values of physicians in previous generations, or other parts of the country (save for chi chi wealthy areas). It means they will only care for wealthy people, and the average/poor patient will be stuck with those who can’t fill up a concierge practice.

Many of my providers don’t work even work a full week anymore. Why should I pay them thousands of dollars a year for no services, just for the privilege of being their patient? (They charge in full for services rendered.) The model is greedy.

[Anonymous]

DH, DS, and I all see NPs who we love. DH and I haven't seen ours for anything other than a physical in years. This year the only time DS saw his was for strep. My one health condition is followed by a specialist.

If I had more complex needs I would opt for an MD or DO.

[Anonymous]

Try a family medicine physician instead of NP. Some are affiliated with multi specialties medical practices.

[Anonymous]

I go to One Medical and see a DO.

[Anonymous]

After learning more about the realities of knowledge, education, and skills of physicians versus NPs on the Noctor subreddit, I've switched from NPs to DOs or MDs.

[Anonymous]

Mine is an MD, he sees our whole family, he's terrific but I do drive about 25 minutes to see him. As I aged, now 56 and having developed (through his help very well controlled diabetes that was caught early) it is worth it to me. Not concierge

[Anonymous]

I cancel appointments if I ask for a doctor and they try to schedule me with anything else

[Anonymous]

MD

[Anonymous]

Anonymous wrote:I cancel appointments if I ask for a doctor and they try to schedule me with anything else

Smart.

Unfortunately sometimes that means waiting for months.

[Anonymous]

I have a PA as my primary plus I see my gynecologist, dermatologist, ophthalmologist (glaucoma) and orthopedic surgeon.

My PA manages my Mounjaro every 3 months with labs and handles my annual and any minor issues.

My kid is at fab pediatric practice and sees a senior level MD. He also has an allergist, psychiatrist, urologist and therapist.

All covered by insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If you are healthy it’s fine.
If not try to find a doctor.

I have some complex conditions that most PCPs don't have the training to monitor. I trust the specialists and for me the PCP or NP just needs to issue a couple of routine prescriptions. I didn't go for a concierge doctor because I wasn't paying $2000 for them not to be able to manage my conditions, which are above their pay grade. I couldn't see what their extra special annual check ups would accomplish. My previous PCP (before she went concierge) knew that I knew more about my condition than she did.

A good Internist is a generalist they know how to connect the dots and know if the procedure recommended by specialists is the best option in your specific situation .