Tuesday, September 25, 2007


My wife recently took my 18 month old to a pediatric neurologist that was recommended by our pediatrician. I like our pediatrician. She’s very direct and “old school” and is highly competent. So I trust a recommendation from her.

She may be right, and this pediatric neurologist may be great. However, I would never know because my wife told me that she NEVER EVEN GOT TO SEE HIM!!! No, she saw the Nurse Practitioner (cue scary music). And then when my wife protested, the staff told her “Oh, don’t worry. The doctor will come in to see your child afterward”.

Well, that turned out to be a gigantic load of bird-plop! He wasn’t EVEN IN THE OFFICE!!!

I called the doctor himself to protest this shoddy treatment. He reassured me that his NP was his “partner” for six years, that the NP had published more papers than the doctor had, that the NP’s capabilities were superb.

I told him that, while all of this may be true, there was one indisputable fact: I know what kind of training (for the most part) a pediatric neurologist has received. I have NO FREAKING IDEA what kind of training a pediatric neurology NP has received. And what’s more, I really don’t care! I don’t care if the NP has written 100 papers, published in every major journal in the nation (well, actually that would be pretty cool).

Also, I object to his use of the word “partner”, as if his credentials were somehow equivalent with the NP’s. What is he thinking?

Look, I understand why NP’s exist. It’s an economic reality of office based practice. It increases the number of patients that can be seen. However, when it comes to a very specialized group of patients, especially nervous parents who obsess about their little one, for whom they’ve lost so much sleep (SO MUCH) in the last 18 months, I think an NP is not good enough. And shame on his staff for lying about his availability. (He states he was stuck at another hospital, which I understand. But the staff completely misled my wife).

I will never employ an NP to see my patients for me. End of story. Ditto for PA’s. They can draw blood, they can do post visit counseling, they can hold a patient’s hand.

But they aren’t doctors.


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Anonymous said...

I completely agree. I refuse to see PA's, Nurse Practitioners (who remind me of midwives, another joke of a profession) and only see my doctor as that is who I chose to see quite intentionally, or another male doc if my hand is absolutely forced (i.e. I'm very sick). I also refuse to see females as they're invasive, order too many unnecessary tests and are less capable, plus as a male I am more comfortable with males.

The medical profession is becoming too watered down with "assistants". They are never partners, they are underlings. At the very least they should have to be checked behind every time they see a patient. They do not even have half of the training a real doctor has; they're insurance's solution to insurance's desire to make money. Perhaps they should utilize them for something they're qualified for such as paperwork and record keeping, blood draws, routine vaccinations.

To be fair, I realize that I type this, a PA - probably a female PA - is probably regretting getting into the field at all. You probably entered with the best of aspirations: to help people live healthier lives and give patients more time when they visit. I will tell this out of guilt: Tessa is an extremely nice person. Outgoing and personable, relatively intelligent I guess, spends time with patients and basically has never been anything but over the top nice to me. She is incredibly patient and sympathetic to my history of abuse and neglect by females. I feel poorly for giving her the silent treatment on one occasion and then just not showing up for the appt with her on the other occasion. If you are in Tessa's position, you are probably a nice, personable person who wants to build a personable relationship with patients and clearly, if you encounter someone like myself, you're probably asking yourself why you bother trying anymore. I know - nothing sucks more than doing your best and being likable - and still being rejected. Let patients like myself go. Just get us in to see the doctor and go about your day. I'm not worth your sanity or concern.

My doctor doesn't routinely push his patients off onto a bunch of assistants, though he recently tried to. (They found a different male doctor instead. Just FYI, I offered to reschedule to see him later but I was walking around with a fever of 102.5 because I had cut myself but had refused to see a female doctor or a male PA earlier for stitches, and he was very worried. He told his office staff to get me in with someone when he couldn't. I'd have gladly gone to the ER though if that meant avoiding the young blonde bimbo named *Tessa who is a "great PA".)

And with all due respect, before a hoard of women and PA's, NP's etc come down on me, I think it's fine if you want to pursue these professions despite your sex. I never have said that women shouldn't be allowed to go to med school - only that I will NOT be your patient which is frankly, a blessing for both of us. You are probably qualified to help others out even if you would not be qualified to treat me, so you're an asset on some level. Furthermore you don't have to deal with me as a patient and I don't have to spend hours Googling whatever you think is the diagnosis to make sure you're correct. I do ask very respectfully even if I don't hide behind some lame excuse nor do I act two-faced. Some of my attitude is based on fact, some of it is gender bias.

At the very least, when a patient chooses a doctor to see as a regular doctor, it is an insult to see a less qualified "assistant" in regards to the qualify of care we'll receive and to the fact that you are forgetting we chose you as a doctor, not Ms. . If I walk into an urgent care type of place, I will choose the male option and let the "PA" part slide...

*Name changed to protect privacy

Nurse Practitioner Colleges said...

Very nice posts.


Anonymous said...

Since this article is almost a full 10 years-old now, I don't know if the original poster still looks at feedback, but I think I'd like to leave a comment anyway.

I am not a physician, nor do I ever want to be one. I respect the position and the time that it took to get there. I have known physicians that are truly wonderful human beings and others that I wouldn't spit on if they were on fire, as I am guessing would be this author's case. Having been in the medical field for over 15 years, it is my experience that the physicians that protest and resist change and growth like this are often the less skilled, dumber ones. You know the type, the ones that you wouldn't let treat your dog.

However, what is important to mention is that your rant (because it is nothing more than an adult-sized tantrum) shows your ignorance and lack of education. Physicians and nurse practitioners can do nearly all the same things in my home state, but how We approach our patients differently. A physician treats disease, whereas an NP treats the whole patient. Also, before I close, perhaps you should look at some data. If you did, you'd see that NPs are capable of providing as good of care as an MD and sometimes, our outcomes are even better than yours (we use evidence-based medicine, not the same ol' stuff we learned in med school and residency). The truth burns a little, doesn't it?

Anonymous said...

True Response- Several Studies support NPs provide safe and quality care. Funny how RNs are left hours in ICU and Medical Surg floor to take care of very critical patients- But can not be trusted As a Advanced Practice Nurse in a clinic? Odd-
PMHNP -Student
RN of 14 years

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Anonymous said...

A physician's assistant and nurse "practitioner" are basically the same thing anyway and generally possess equivalent training to a nurse. Nurses are fine but there are doctors, and there are nurses.

I see neither PA nor NP because they are not sufficiently trained to see patients or prescribe antibiotics. They do not have enough education or experience. I am polite, if not firm, about my stance.

In my dealings, they seem to have more than enough patients without seeing me anyway.

Mizfrosty said...

In your own words you are supervised by an actual doctor. Why see a non doctor who has way less education and has to go ask the Real Doctor if they get in a jam. Cut out the middle man.

Mizfrosty said...

You should never call yourself a doctor because your not. Plain and simple. Over the years I have had my share of NP and PA including tonight at the ER with my daughter. She never mentioned she was a PA and nor did any of the others. She just like the rest were usless and made amateur mistakes with not only my daughter but other patients. Such huge mistakes that she was sent home. For me it will always be MF or DO period.

Anonymous said...

In my opinion NPs are bit smarter than Nurses- But NOT smart enough to get admission to a medical school to become a doctor:-)

Physicians Assistant? What the heck is that? They are neither Nurse nor Doctor. Nurses don't respect them. Doctors treat them as their cheap coolies. They are nothing but bag carrying clerks for doctors..

If NPs get paid 60-80% less by insurance companies compared to primary care physicians. When I got a specialist I have about $40 as co-pay. Why on the world, I should pay such a high pay to see a NP or PA?

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Anonymous said...

Ignorant jerks

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