Anonymous
Post 05/30/2023 13:50     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:That's your right OP. If that's what you want and willing to wait, insist on it. DW is a cardiology NP and had a patient like you. Rather than seeing DW, wanted to wait 6 weeks for a doctor. The idiot died of heart attack while waiting. DW could've saved his life by catching his problems but what can you do.


That's fine for your DW but patients who want to see a cardiologist MD and make an appt to do so should be able to as well. It's not irrational to have the preference for the person with more training, sorry.


MD cardiologist - had to take premed courses, take MCAT and score above 90th percentile, medical school with multiple board exams, 3 years of internal medicine residency working over 80 hours a week. Had to at the same time publish and be top of resident class to
Match into cardiology. In addition to another board exam and also internal medicine boards.Then 3-4 years of rigorous fellowship training in cardiology with board exam at end.

NP- nursing school, then NP school (sometimes accelerated) with 500 or so clinical hours in a variety of fields. Then immediately works in cardiology.


Yes of course they are the same.


Every day, if you live in Germany.

It's like you have a honda civic vs ferrari f40. most of the time, either is fine. if you are driving the autobahns in germany, yes, def you want a f40. how often do you drive the autobahns?
Anonymous
Post 05/30/2023 13:47     Subject: I do not want to see an NP!
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.


At least an NP sees actually patients all throughout 4 yrs of nursing school and even if getting NP online, is likely working as a nurse seeing patients concurrently.

PAs see zero patients during all of undergrad while they major in biology or whatever science (or sometimes not even science) they pick as their major. During their 2 yrs of PA school, they have a couple clinal rotations for a portion of that time. If anyone is vastly undertrained, it is PAs
Anonymous
Post 05/30/2023 13:46     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:This entire thread is so stupid. And OP, you are one dumba$$. If you want to see a doc, make sure your appt is with a doc. If you are happy with NP, then see NP. WTF are you folks arguing about?


Agree - all this tit for tat. We could spend months with example after example of where the NP/PA/MD did one wrong. This is where you get to be a consumer - you don't like it, move on.


I agree that it does no good in this forum to go after who got what wrong one time, although they're all valid personal experiences.

This is more about the fundamental lack of knowledge and understanding of the separate pathways and training of those who are seeing you and me as a patient. And it is about the lack of understanding that even though everyone gets something wrong; these different professions are held to VASTLY different standards, in every aspect of training and care, starting from different bachelor classes of the same topic, to rules/regulations, exams, licensing, ethics, all the way to the court system.

OP here. This is the problem I made an appointment to see a doctor. I was very clear about not wanting to see a mid level provider. The appointment was switched to an NP 24hrs before.
An NP is not the same as an MD. They have vastly different levels of training. An NP is fine for follow-up for some things.
If people want/prefer NPs that's fine. But that's not what I wanted or requested.
Anonymous
Post 05/30/2023 13:42     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:This entire thread is so stupid. And OP, you are one dumba$$. If you want to see a doc, make sure your appt is with a doc. If you are happy with NP, then see NP. WTF are you folks arguing about?


Agree - all this tit for tat. We could spend months with example after example of where the NP/PA/MD did one wrong. This is where you get to be a consumer - you don't like it, move on.


I agree that it does no good in this forum to go after who got what wrong one time, although they're all valid personal experiences.

This is more about the fundamental lack of knowledge and understanding of the separate pathways and training of those who are seeing you and me as a patient. And it is about the lack of understanding that even though everyone gets something wrong; these different professions are held to VASTLY different standards, in every aspect of training and care, starting from different bachelor classes of the same topic, to rules/regulations, exams, licensing, ethics, all the way to the court system.


You keep saying that. I don't know why you assume people don't understand that NPs and MDs aren't the same. Yes. I fully understand they have different training pathways. Yes. I fully understand that medical school and residency takes a whole lot longer than becoming an NP.
You, however, seem to have a fundamental understanding that some people are perfectly OK with those differences for some issues in some scenarios.

oops... left out the "lack" there.
You, however, seem to have a fundamental LACK OF understanding that some people are perfectly OK with those differences for some issues in some scenarios.
Anonymous
Post 05/30/2023 13:41     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:This entire thread is so stupid. And OP, you are one dumba$$. If you want to see a doc, make sure your appt is with a doc. If you are happy with NP, then see NP. WTF are you folks arguing about?


Agree - all this tit for tat. We could spend months with example after example of where the NP/PA/MD did one wrong. This is where you get to be a consumer - you don't like it, move on.


I agree that it does no good in this forum to go after who got what wrong one time, although they're all valid personal experiences.

This is more about the fundamental lack of knowledge and understanding of the separate pathways and training of those who are seeing you and me as a patient. And it is about the lack of understanding that even though everyone gets something wrong; these different professions are held to VASTLY different standards, in every aspect of training and care, starting from different bachelor classes of the same topic, to rules/regulations, exams, licensing, ethics, all the way to the court system.


You keep saying that. I don't know why you assume people don't understand that NPs and MDs aren't the same. Yes. I fully understand they have different training pathways. Yes. I fully understand that medical school and residency takes a whole lot longer than becoming an NP.
You, however, seem to have a fundamental understanding that some people are perfectly OK with those differences for some issues in some scenarios.
Anonymous
Post 05/30/2023 13:40     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:The best nurses become NPs and PAs. The worst doctors become PCPs. I’m fine with NPs.


This could not be more untrue on all accounts. You don't even have to have ever worked as a nurse to become an (D)NP. You can go straight from a 15+months online degree after your bachelors to working as an NP. Nurses cannot become PAs. Your doctor statement is just an imbecile insult. Primary care physicians are family medicine residency trained, or general internal medicine residency trained, or pediatrics residency trained. Which residencies are more competitive to get into changes every year and also changes greatly over longer periods, and this change is due to a lot of factors.


To become an NP you need a BSN, which in VA requires 500 clinical hours + pass the NCLEX and be licensed in your state as a nurse. Then do grad school for the NP, which requires 800 hours of clinical experience, pass the certification exam. Many NP programs also require actual work experience as a nurse prior to starting the NP program. Yes, absolutely not as much experience required as to get an MD but PP's post suggests that you can get an NP while barely ever doing anything but an online program.

I don't think I'd be comfortable with a NP in a 100% independent private practice but I have no issue with seeing a NP as part of a larger practice where an MD is available if needed.

If people don't want them and PA's to be the default for primary care, then our country has to invest in greatly expanding spots in MD programs and lowering the cost to get an MD.


The point remains that there are no standardized requirements, exams, or licensing, it's state driven. Virginia has much stricter requirements currently, and no independent practice authority for NPs.

The trend is towards online degrees, and no hands-on nursing experience. In many states this, as well as independent practice authority, is a reality already.
Anonymous
Post 05/30/2023 13:34     Subject: I do not want to see an NP!
Be glad they didn’t just cancel you and leave it to you to reschedule. That’s what happened yo us after a long wait. I’d be thrilled to see the NP.
Anonymous
Post 05/30/2023 13:34     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:This entire thread is so stupid. And OP, you are one dumba$$. If you want to see a doc, make sure your appt is with a doc. If you are happy with NP, then see NP. WTF are you folks arguing about?


Agree - all this tit for tat. We could spend months with example after example of where the NP/PA/MD did one wrong. This is where you get to be a consumer - you don't like it, move on.


I agree that it does no good in this forum to go after who got what wrong one time, although they're all valid personal experiences.

This is more about the fundamental lack of knowledge and understanding of the separate pathways and training of those who are seeing you and me as a patient. And it is about the lack of understanding that even though everyone gets something wrong; these different professions are held to VASTLY different standards, in every aspect of training and care, starting from different bachelor classes of the same topic, to rules/regulations, exams, licensing, ethics, all the way to the court system.
Anonymous
Post 05/30/2023 13:30     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:The best nurses become NPs and PAs. The worst doctors become PCPs. I’m fine with NPs.


This could not be more untrue on all accounts. You don't even have to have ever worked as a nurse to become an (D)NP. You can go straight from a 15+months online degree after your bachelors to working as an NP. Nurses cannot become PAs. Your doctor statement is just an imbecile insult. Primary care physicians are family medicine residency trained, or general internal medicine residency trained, or pediatrics residency trained. Which residencies are more competitive to get into changes every year and also changes greatly over longer periods, and this change is due to a lot of factors.


To become an NP you need a BSN, which in VA requires 500 clinical hours + pass the NCLEX and be licensed in your state as a nurse. Then do grad school for the NP, which requires 800 hours of clinical experience, pass the certification exam. Many NP programs also require actual work experience as a nurse prior to starting the NP program. Yes, absolutely not as much experience required as to get an MD but PP's post suggests that you can get an NP while barely ever doing anything but an online program.

I don't think I'd be comfortable with a NP in a 100% independent private practice but I have no issue with seeing a NP as part of a larger practice where an MD is available if needed.

If people don't want them and PA's to be the default for primary care, then our country has to invest in greatly expanding spots in MD programs and lowering the cost to get an MD.
Anonymous
Post 05/30/2023 13:26     Subject: I do not want to see an NP!
Point of order, physicians who own their own practices are making an active choice to hire out for NPs and PAs, and pay them less than they would pay additional physicians in the practice. This is not the fault of NPs/PAs. Physicians are welcome to spend more time with patients for less pay, they just choose not to, or go concierge. If you’re lucky you can find the old school docs who do spend the time because it’s the right thing to do.
Anonymous
Post 05/30/2023 13:25     Subject: I do not want to see an NP!
It should be disclosed to the patient. I had a PA read an xray in the ER, he had a white coat on and never said his title - he missed a fracture on the xray (which was obvious when the subsequent DR who looked at it showed it to me). The visit cost the same as though I'd seen a Dr and almost caused severe harm had a subsequent DR's review of the xray a few days later identified the mistake.

Also had a derm who when you called to see a DR would schedule you with a PA and you didn't find out unless you looked up their website to see the training for the last name of the appt you were given.

If you go to a law firm there may be many things a paralegal can do well but that doesn't mean you don't need a lawyer sometimes. Same for this - the training is not the same and it should be disclosed to the patient up front and be up to the patient
Anonymous
Post 05/30/2023 13:25     Subject: I do not want to see an NP!
Anonymous wrote:
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 !


Change provider.

If you specified you were requesting a physician and they "forced" a NP on you, then stop giving them your business.

That is clearly their business model. It would not work for me either.


This, OP. Don't go to practices that do this.
Anonymous
Post 05/30/2023 13:23     Subject: I do not want to see an NP!
Also I'm 13:22 and I see a NP derm specialist for my wellness check. I liked her until she effed up a spot she burned off. So, now I'm back to finding a new derm.
Anonymous
Post 05/30/2023 13:22     Subject: I do not want to see an NP!
Anonymous wrote:This entire thread is so stupid. And OP, you are one dumba$$. If you want to see a doc, make sure your appt is with a doc. If you are happy with NP, then see NP. WTF are you folks arguing about?


Agree - all this tit for tat. We could spend months with example after example of where the NP/PA/MD did one wrong. This is where you get to be a consumer - you don't like it, move on.
Anonymous
Post 05/30/2023 13:22     Subject: I do not want to see an NP!
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Op made an appointment with a doctor, months in advance, and then the office switched it to an NP a few days in advanced. That’s not cool and I can understand why she is upset.

Sometimes I prefer NPs - I find they have better personalities and are less arrogant a lot of times.


It's infuriating. I've had the exact same thing happen several times with a gastroenterologist in Arlington, even though I specifically state I do not want to see his NP. They agree, make the appointment with the doc (supposedly) and then when I show up I'm stuck with the NP.


With specialists, it’s a different story. That does seem unethical and infuriating. NPs can be great in general practice, but not when specialists are using them this way.


I think that NPs for specialists are fine if it is just for management. I see an NP half the time and I'm fine with that. I want to be seen by a doctor (in addition to an NP for a followup because two heads are better than one) if I know something funny is going on, regardless of the issue in question.


But I do agree that if you wait a long time so that you can see a doctor it's totally valid to be upset if they switch at the last minute, particularly if this is a new issue and not routine.