I do not want to see an NP!

[Anonymous]

My primary doctor is an NP! Never had a more attentive and thoughtful diagnostician — much better than any MD I’ve gone to as an GP. And I’m not alone. She is full and not taking new patients (and a number of her patients are doctors!).

[Anonymous]

Anonymous wrote:

Anonymous wrote:It is horrifying to me how many people are unaware of how poorly trained the far majority of NP's are. They can get their degrees from 100% online programs (AKA degree mills). They may be absolutely lovely in person, but the bottom line is that they don't know what they don't know. It is an absolute travesty what they have done to the field of medicine. Primary care is one of the most difficult things because 99% of the time, everything is fine. But you need to see thousands of cases of normal in order to detect the abnormal.

Exactly, I work in medicine. NPs are poorly trained and are not cost effective. The patient is billed at the same rate as an MD but the reimbursement to the provider is lower. So the only person that wins is the insurance company. NPs order more tests and do a lot of unnecessary things because they do not know what they're doing.
I don't want to see an NP because I'm alarmed at the pace at which their scope of practice is increasing. Insurance groups are pushing the NP model because its a huge profit margin for them, but telling people that an NP is the equivalent of seeing an MD/DO trained in family medicine is disingenuous.
NPs misdiagnose all the damn time simply because they do not have the breadth of knowledge to know when something isn't right. I rarely go to the doctor but when I do I want to be seen by a physician.

I was not aware of this, but I do go to the doctor a lot and I'm still okay with being seen by an NP. I don't know if my experience is unique, but I have never been seen exclusively by an NP over the course of treatment/management. On of two things happens: the doctor and NP or PA switch off or I see an NP to do the more thorough Q and A thing and then the doctor sees me more briefly. I would be dismayed if my first meeting with a healthcare professional about a particular issue was with an NP, but for preventative care and continued management I think it's fine, especially since you can often communicate with your doctor through a portal. And as far as I know I have never had an experience where an NP missed something or did something unnecessary. It might have happened, but I know for *sure* that my doctors have missed things.

I do think that the best model for a general practitioner is the new one that's kind of a subscription model where they are cutting insurance out of the practice and charging patients a monthly fee. Insurance companies are definitely screwing things up. They need to also

[Anonymous]

The devolution of the US medical system to increasingly poor quality levels is the fruit of corporatization, abetted by the appalling power insurance companies have been permitted to amass over what constitutes “appropriate” care. Corporate-owned practices (which increasingly are the only thing you can find if you want to use your preposterously overpriced insurance) hire non-physicians to do what properly is physician’s work because the non-physicians are more readily available, are significantly cheaper and allow vastly increased financial leverage and a concomitant increase in profit. People say that their non-physician “provider” is great and will refer them if anything is “serious.” The problem is that few patients have even the slightest ability to determine how “serious” their condition is; regardless of their misplaced self confidence, non-physicians lack the training to avoid mistakes that a physician would catch. Given the rate of physician error, it is terrifying to think how much non-physicians may be missing. I am alive today because a physician noticed a deadly skin cancer when I was in for something else entirely. I have very little confidence that a non-physician would have caught that.

[Anonymous]

Anonymous wrote:Why is it so hard to see a doctor? So many practices want to stick you with an NP or some other APP its just ridiculous.
My last visit I specifically asked to see an MD only to be called the day before to be told that I would be seeing the NP.
Nurse Practioners have no where near the training that a physician has, its not the same as seeing an MD or a DO.
Vent over !

Don't give up, OP! Continue to demand MD/DO and go where they will honor that and won't do bait and switch. The quality of our health care will do a rapid nosedive, if the current trend continues (it's worse in some other locations) but as the patients we vote with your feet/wallet.

[Anonymous]

Anonymous wrote:My primary doctor is an NP! Never had a more attentive and thoughtful diagnostician — much better than any MD I’ve gone to as an GP. And I’m not alone. She is full and not taking new patients (and a number of her patients are doctors!).

Nonsense. Your NP is not a *primary doctor*, and she doesn't have any doctors as patients. At least not doctors of medicine.

[Anonymous]

Anonymous wrote:The devolution of the US medical system to increasingly poor quality levels is the fruit of corporatization, abetted by the appalling power insurance companies have been permitted to amass over what constitutes “appropriate” care. Corporate-owned practices (which increasingly are the only thing you can find if you want to use your preposterously overpriced insurance) hire non-physicians to do what properly is physician’s work because the non-physicians are more readily available, are significantly cheaper and allow vastly increased financial leverage and a concomitant increase in profit. People say that their non-physician “provider” is great and will refer them if anything is “serious.” The problem is that few patients have even the slightest ability to determine how “serious” their condition is; regardless of their misplaced self confidence, non-physicians lack the training to avoid mistakes that a physician would catch. Given the rate of physician error, it is terrifying to think how much non-physicians may be missing. I am alive today because a physician noticed a deadly skin cancer when I was in for something else entirely. I have very little confidence that a non-physician would have caught that.

Well, you don't know that a non-physican would not have caught that. All your criticisms of the healthcare system are spot-on but that doesn't mean that it's always better to see a doctor. I am saying this from the perspective of somebody who has major illnesses and has seen dozens of both doctors and NPs.

[Anonymous]

Anonymous wrote:The devolution of the US medical system to increasingly poor quality levels is the fruit of corporatization, abetted by the appalling power insurance companies have been permitted to amass over what constitutes “appropriate” care. Corporate-owned practices (which increasingly are the only thing you can find if you want to use your preposterously overpriced insurance) hire non-physicians to do what properly is physician’s work because the non-physicians are more readily available, are significantly cheaper and allow vastly increased financial leverage and a concomitant increase in profit. People say that their non-physician “provider” is great and will refer them if anything is “serious.” The problem is that few patients have even the slightest ability to determine how “serious” their condition is; regardless of their misplaced self confidence, non-physicians lack the training to avoid mistakes that a physician would catch. Given the rate of physician error, it is terrifying to think how much non-physicians may be missing. I am alive today because a physician noticed a deadly skin cancer when I was in for something else entirely. I have very little confidence that a non-physician would have caught that.

+1000 The eyes do not see what the mind does not know.

[Anonymous]

Anonymous wrote:The devolution of the US medical system to increasingly poor quality levels is the fruit of corporatization, abetted by the appalling power insurance companies have been permitted to amass over what constitutes “appropriate” care. Corporate-owned practices (which increasingly are the only thing you can find if you want to use your preposterously overpriced insurance) hire non-physicians to do what properly is physician’s work because the non-physicians are more readily available, are significantly cheaper and allow vastly increased financial leverage and a concomitant increase in profit. People say that their non-physician “provider” is great and will refer them if anything is “serious.” The problem is that few patients have even the slightest ability to determine how “serious” their condition is; regardless of their misplaced self confidence, non-physicians lack the training to avoid mistakes that a physician would catch. Given the rate of physician error, it is terrifying to think how much non-physicians may be missing. I am alive today because a physician noticed a deadly skin cancer when I was in for something else entirely. I have very little confidence that a non-physician would have caught that.

You've hit the nail on the head. Most consumers of healthcare do not have perfect information and simply cannot objectively judge if they are receiving good care. Sometimes its left up to the NPs judgment if they involve a physician, that's absolutely crazy.
People are putting their lives in the hands of someone that did a few hours of school online. There are places that offer NP training online in as little as a year! There is no universe where 1 year of online school replaces med school, residency, fellowship etc.

[Anonymous]

Anonymous wrote:My primary doctor is an NP! Never had a more attentive and thoughtful diagnostician — much better than any MD I’ve gone to as an GP. And I’m not alone. She is full and not taking new patients (and a number of her patients are doctors!).

Correction: Your NP is NOT a physician.

[Anonymous]

My DS and DIL are physicians. Their time spend in school, residency and board testing cannot be compared to a NP or PA.

[Anonymous]

Hate to break it to you but mid-level providers (NPs and PAs) are going to be taking over primary care. Doctors don't want to go into primary care due to poor working conditions, less reimbursement, less pay, less prestige. This putting a physician on a pedestal is part of the problem - they think they are owed something (aka money) and in turn, go into specialties that pay more.

Well trained NPs and PAs can do the work and do it well.

[Anonymous]

Anonymous wrote:My DS and DIL are physicians. Their time spend in school, residency and board testing cannot be compared to a NP or PA.

Please tell me they went into primary care. No? Ah, that is why you are seeing more NPs and PAs.

[Anonymous]

Anonymous wrote:The best nurses become NPs and PAs. The worst doctors become PCPs. I’m fine with NPs.

This is complete BS.

[Anonymous]

Easy: Start a a tuition free medical school and raise salaries for medical doctors so that they can compete with wall street.

[Anonymous]

I love NPs! Easier to talk to, easier to reach, tons of clinical experience.