Is your PCP an MD or NP?

[Anonymous]

Another person with a PA as my PCP; she's in a practice with other PAs and a bunch of internists she can and does consult when the need arises. But mostly I'm there for a quick, uneventuful checkup.

I picked her partly because I wanted someone who was in the same hospital group as my OB/GYN. Although my gastroenterologist is with a different hospital, so my system needs tweaking, I guess.

[Anonymous]

Anonymous wrote:

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 .

No, they don't. I've seen different doctors eye glaze over when I tell them of my condition. I see them disappear and when I ask them if they were googling, they admit it. Maybe they learned about it for two minutes twenty years ago.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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 .

No, they don't. I've seen different doctors eye glaze over when I tell them of my condition. I see them disappear and when I ask them if they were googling, they admit it. Maybe they learned about it for two minutes twenty years ago.

NP. Fantastic, then you don't need an MD or DO. Just go with an NP or PA who is already familiar with your diagnosis and doesn't have to do any searches.

[Anonymous]

Anonymous wrote:MD. I’ve had NPs misdiagnose and miss diagnoses. While I am generally healthy, I have a couple of chronic conditions that are not degenerative and do not affect my life expectancy. My experience has been that NPs do not have the same training and judgement-based experience as doctors to be a partner in managing things and being discerning about new symptoms.

However, for the privilege of using an MD, I pay entirely out of pocket for a concierge practice.

I’ve had MDs ( opthmalogist specialists) miss easy diagnosis (glaucoma) which would have resulted in better care. Otho, my PC is an NP - have had excellent experience with her. Just depends on the person treating you really.

[Anonymous]

I see a NP. However, I can easily see a doctor in the practice if the NP is not available.

I was seeing an integrative doctor who went concierge. He sent me to specialists and told me I probably had blood cancer. I did not. One of the many specialists I saw at the direction of the integrative doc said the integrative doctor was a quack. Basically, the concierge is to lure in wealthy Bethesda ladies who have health issues. When they sold me supplements that were supposed to fix tinnitus, I was done. I returned them and left the practice.

So, yeah, I’ll take my NP over that concierge guy and work with specialists as needed.

[Anonymous]

Anonymous wrote:I see a NP. However, I can easily see a doctor in the practice if the NP is not available.

I was seeing an integrative doctor who went concierge. He sent me to specialists and told me I probably had blood cancer. I did not. One of the many specialists I saw at the direction of the integrative doc said the integrative doctor was a quack. Basically, the concierge is to lure in wealthy Bethesda ladies who have health issues. When they sold me supplements that were supposed to fix tinnitus, I was done. I returned them and left the practice.

So, yeah, I’ll take my NP over that concierge guy and work with specialists as needed.

My experience with concierge has been the opposite. Same day appointments, 30-minute consults, blood work multiple times a year, 90-minute physical, I have her personal cell phone number, she will meet me at the office on weekends if needed, she has a back up doctor when she is out of town, she coordinates specialist appointments and has never tried to “sell” lw anything. Couldn’t be more pleased.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I see a NP. However, I can easily see a doctor in the practice if the NP is not available.

I was seeing an integrative doctor who went concierge. He sent me to specialists and told me I probably had blood cancer. I did not. One of the many specialists I saw at the direction of the integrative doc said the integrative doctor was a quack. Basically, the concierge is to lure in wealthy Bethesda ladies who have health issues. When they sold me supplements that were supposed to fix tinnitus, I was done. I returned them and left the practice.

So, yeah, I’ll take my NP over that concierge guy and work with specialists as needed.

My experience with concierge has been the opposite. Same day appointments, 30-minute consults, blood work multiple times a year, 90-minute physical, I have her personal cell phone number, she will meet me at the office on weekends if needed, she has a back up doctor when she is out of town, she coordinates specialist appointments and has never tried to “sell” lw anything. Couldn’t be more pleased.

as they say, you get what you "pay" for.....If you have enough$$, you can have full time doc at your disposal.

[Anonymous]

She’s an NP and I’m very happy with her.

[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.

me too. I have a PCP who is an NP and I love her. She's kind and thoughtful and does a great job for treating random minor illness, blood work, mamogram tracking, etc. For my more complicated condition, she provides whatever referrals/recommendations I need and she and I both trust the specialists to treat those issues. I wouldn't trust a PCP MD to treat them either, and I have had MDs in the past feel like they could do so and give me a hard time about referrals.

[Anonymous]

Anonymous wrote:

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 .

Laughed our loud of picturing myself trusting an internest instead of my JHU cadiologist. "Sorry world renowned heart specialist, but my internest said that the procedure might not be a good idea"

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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 .

No, they don't. I've seen different doctors eye glaze over when I tell them of my condition. I see them disappear and when I ask them if they were googling, they admit it. Maybe they learned about it for two minutes twenty years ago.

NP. Fantastic, then you don't need an MD or DO. Just go with an NP or PA who is already familiar with your diagnosis and doesn't have to do any searches.

I have an MD but I made sure they're on the same portal as my specialists to avoid repeating labs. I don't see the PCP much. If something is going wrong, I'd usually contact the specialists first, unless it's strep throat or similar.

[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”?

NP. It's "not right" because people -- and especially people with insurance -- should be able to get basic, competent primary care from a medical doctor. That shouldn't be just for people who can afford concierge. We're not talking about "world class" primary care docs or even high-level speciality care (although one could make a separate case that that shouldn't just be for the rich either). We're talking about average to above-average doctors.

The truth is primary care docs, and many specialists, in this area can go concierge because there is a lot of disposable income in certain portions of the MD-DC-VA Metropolitan area. In short, there is too much money chasing too few resources. Docs know they will get paid regardless, and they can charge more and discard the hassles of dealing with insurance companies. In some cases patients do benefit, through, for example, longer appointments and more personal attention for the doctor. But, as someone whose family members have experience with three different concierge docs, I can tell you that even the concierge experience can vary widely. Some doctors are smart, helpful and available, with good networks of specialists to refer patients to, while others are just interested in a guaranteeed revenue stream and a lighter workload.