Tuesday, September 25, 2007

NP STANDS FOR "NO PLEASE"

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.

235 comments:

1 – 200 of 235   Newer›   Newest»
Chrysalis said...

I completely agree with you on this. I have had the bait and switch and didn't know it, until I was on the table and in a gown. I would never trust an office that had mislead me in the way your wife was.

Anonymous said...

You are ignorant, many Pas and NPs are very educated and experienced, and majority of the time know more medicine than the doctors who emply them.. I agree that the deceit by the doctor your wife wanted to see, would also anger me...but open your mind...

Anonymous said...

THERE ARE MANY OUTSTANDING PAs AND NPs, HOWEVER YOUR POINT IS WEEL TAKEN. IF I OR MY SPOUSE OR CHILDREN GO TO A SPECIALIST THEN WE ARE PAYING FOR A SPECIALIST! NO WAY A PA OR NPs TRAINING IS EQUAL TO A MEDICAL DEGREE AND RESIDENCY, I DON'T CARE HOW MANY YEARS EXPERIENCE SAID PA/NP HAS. I WONDER HOW HONEST/ETHICAL IT IS TO BILL FOR THE EXPERIENCE OF A SPECIALIST WHEN THAT SPECIALIST HAS NOT EVEN SEEN THE PATIENT? I HAVE NEVER HEARD OF A DISCOUNT FOR SEEING A PA/NP.

Anonymous said...

Amen.

As a Pharmacist I can say that I get more scary prescriptions from mid level practitioners. I wouldnt trust one to treat an ingrown toenail let alone something that requires the kind of expertise you were seeking.

Anonymous said...

You all seem very closed-minded on these issues that are reflective of the inevitable medical trends of our country. I myself am an advanced practice psychiatric nurse. I specialize in psychiatric conditions. My scope of practice given to me by accrediting bodies is also outlined within a collaborative practice agreement with a psychiatrist who is available and supervises the service and care that I provide. If there are certain conditions that I feel I am not knowledgeable enough to treat in a competent, prudent manner, I consult with the doctor to assist me in providing the level of care needed by my patient. But, my experience and 5 years of post-graduate education has allowed me to effectively treat conditions that other doctors might find difficult to treat (and do) as I work in an underserved area that is depleted of practitioners. Additionally, if you peruse the multiple studies that compare the level of patient satisfaction with services provided by advanced practice nurses as compared to medical doctors, I think you might even consider seeking the services of an APRN so that you can see for yourself. I am in no way discounting the vast amounts of knowledge an MD has, compared to my understanding which is limited to psychiatry. But,depression is depression and psychosis is psychosis. And advanced practice nurses have specialized in the fields of their practice and are well able to treat such conditions, or they wouldn't be trusted by those who credential them while continuing to further their level of prescriptive authority and autonomy.
Please, become educated about such issues before casting stones at some of the most passionate and dedicated professionals who have fought so hard to serve the patients who are in need of good medical services. These are not phlebotomists or hand-holders. These are trained, well-educated professionals.
And, as far as the pharmacist that commented earlier, I have seen prescriptions by MD specialists that have made my head spin. So, please, do not generalize based on what is most likely your limited experience with who was most likely an inexperienced mid-level prescriber.

A. E. Hart said...

I agree you should not have not been told you were seeing a specialist when you would not be doing such a thing, but maybe you should actually research before you bash?

Anonymous said...

Shouldn't at least the initial patient evaluation be done by the specialist then the follow up visit possibly be done by the NP or the PA. I know other health professionals function that way, such as a patient is prescribed physical therapy, the PT does the initial eval, to decide on plan of care and treatment, then follow up visits performed by the PTA, and reports back to the PT on progress and concerns. By the way dude chill out, have a beer or something you seem way to stressed out to function on a daily basis.

Anonymous said...

You are fooling yourself to think a NP has more knowledge than a physician. Until a NP completes medical school, a residency, and a fellowship, they will never realize how much they don't know yet. As a physician, I cannot imagine how I could have effectively cared for patients without have been through residency.

Anonymous said...

You are right in most respects here. I currently work in retail pharmacy near a couple clinics that pump out huge amounts of volume simply due to the large number of PA's they employ. To them medicine is simply a business so when they fuck up I have to look like the bad guy for telling a patient with stage 1 hypertension that I cannot fill their prescription for Enalapril 80mg BID because the PA was an idiot. THEN, all while the patient is pissed off at me for ever accusing "Dr. John Doe" (yes this PA thought it less confusing for the patients if they thought he was a Dr.) of making a mistake. I call the office and speak with the PA only to get yelled at by him asking me how dare I ever question his practicing..........
Don't get me wrong, there are many many many great PA's and NP's out there and its a shame that they get overlooked due to the massive amounts of assholes who get cocky due to the fact they can write a prescription (though they forget its supposed to be under a PHYSICIAN'S protocol), but I just get tired of seeing prescriptions that are horribly wrong. Especially when its a child's medications, there is just no excuse for that and I see it all the time.

Anonymous said...

I came upon this inadvertantly. I guess I never realized how threatened some people may be by the growing numbers of Nurse Practitioners and Physician Assistants. I can understand the desire to see the MD specialist, however, would it have been better for the office to say, let you reschedule to a later date for evaluation, than try to accomadate you with another provider to get the ball rolling?
Also I must say the term "mid level" is actually quite an insult. I am a NP, I work in a specialty surgery group. I do not believe any of the NP's or PA's in my group provide "mid level care"
As for not hiring an NP or PA, that is your choice, and I am sure that the growing numbers appreciate not working for someone who is obviously unable to function in a team atmosphere. I do however think that the MD's who are as arrogant as yourself should know that MD means Medical Doctor, it is not the same spelling as GOD. MD's make mistakes, errors, and also have to review thier pharmacology time to time. I think that it is disappointing that you behaved in such a way that you felt that you were so much more important than anyone else, and that the office that attempted to accomodate your wife, was not apprieciated. I am sure the NP discusses all of her cases with the specialist, usually that is how it works. It is called "collaboration". There is a definition in Websters, but considering you are so knowledgable regarding practice I am sure you know this.
By the way, are you by any chance a proctologist, because I am sure you would do quite well in that area, since you speak that language.
As for the pharmacists who commented, shame on you. You should be willing to work with all providers, if I came across you, I would recommend my patients find someone who understands that from MD, NP, PA, RN... are supposed to be working together to achieve the best possible care for people, including yourselves.. I love to call my pharmacist and ask for recommendations, I am glad I have not found one like you.

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Megan E. said...

As another unfortunate person commented, I came upon this article by accident. As part of my education as a Nurse Practitioner, we were assigned to write a paper comparing the differences between healthcare providers (MD, DO, PA, NP). I refuse to let your close-minded bigoted views persuade my opinion of physicians, as I hope others reading this will not have a misconstrued idea of Nurse Practitioners. Perhaps it's insecurities or just stupidity, but before you begin insulting a large population of people, please have a little more respect for yourself. I feel sorry for your patients and the staff that is forced to work with such a hostile person. I do not feel the need to justify or explain to you my creditials as a Nurse Practitioner, nor do I give much credit to your views. Perhaps you should have another conversation with the pediatric neurologist you were recommended to see, as he obviously has much more common sense that you.

Anonymous said...

I am a medical student. I was given a prescription at the student health center AT MY MEDICAL SCHOOL by an NP, over the phone. Of course I checked it. It seemed wrong (not even the right category of drug). I called back. They checked, they called back and said it was correct. I TOOK THE WRONG DRUG FOR 2 DAYS. Kept researching. It was completely the wrong drug!! Given that I had a known diagnosis, the prescription was cut and dried. So why did I and others at the school have experiences like this?? I actually think a PA would probably do better, they work more with doctors and work under a doctor. The NPs here don't even know what they don't know!!

Anonymous said...

First hope your little one is ok. Then not to agree on some of your opinion. Sooner or later NP will need a Doctoral degree instead of the current Masters,including many more clinical hours (eq. to residency in Doctor's). NPs are getting approx. same amount of education as the Doctors. Many Doctors in the U.S. are ignorant and misleading, not to say the Nurses and PAs. It just depends on the person. Do not strike a career just b/c you are mad at a particular NP. Just NOT right.

Anonymous said...

ok you are all talking about how NPs are paid the same and its a scam, you are so stupid. NPs get paid 60-80% less by insurance companies compared to primary care physicians. They make less and you don't pay the same. You people need to get your head out of your ass before you talk and shit you don't know. You people make me sick how stupid you are. NPs are also regularly is 6 years of schooling. They are treated in all the same course as doctors with the exception of surgery and niche diseases. They know all the same medicine as doctors and they know most the same skills.
I feel safe being an authority on this because i am a doctor and my wife is a NP. I couldn't be more proud to call her my partner.

Anonymous said...

What really gets me is that people feel that NPs are "less educated" than MDs, Most NPs are trained under MDs just as PAs are. Yes, some may not be that great, but that is the same for MDs as well. I just had a question, did the NP do something that jeopardized the patient, I never saw a comment as to whether or not the child benefited from the consultation. Just that you were upset that your wife did not see the MD. I agree, that you should not have been deceived by the staff, but to hold the NP accountable for that is just ridiculous.
Besides, NPs can not make less than a B average to continue in school, but if an MD makes a C, he is still considered a Doctor... just something to think about.

Anonymous said...

Hey.. I like this blog alot. I'm on the fence as to if chronic lyme really does exist and I happen to have lyme although I'm told my lyme load is not the issue.. I'm handeling that well. But.. it's the bart that I tested negative for?? OK.. yea.. I really question these lyme literate MD's.. seems to me they want your money.. more than they want you to get well. No real compassion or concearn for the patient.. and I'm suppose to have the best LLMD out there. Well I will tell you this.. if you think I believe that fucking up my body even more with lonf term ABX is the answer.. I think not. The crap they tell you to take.. come on now? You think BB will weaken the immune system.. well try taking oral abx for several months... and see the result for some.. and I read about many that have lost there life.. they were on those high does IV things.. something is wrong with this picture.. VERY..VERY wrong. Also the advocates.. that just go on and on.. the ones that have lyme.. some wont shut up.. they just tell ya to take cats claw.. and all this other garbage.. and they go to DC to protest at the white house... come on already?

Anonymous said...

Unreal that we are in 2011 and you people are so ignorant. Nurses, in many hospital and office settings make many important decisions for their patients and you as a patient may not even know it. Nurses are an advocate for you, the ignorant patient, take all your crap and yet we are still the ones who feel for you after all you say about us. The doctor would not hire a Nurse Practitioner to see their patients if they did not trust them. Many nurse practitioners have seen more in the hospital than many doctors as the doctors are only there for what, 3 minutes while the nurse sees what goes on, many times, for 36 to 48 hours a week. The nurse assesses what is wrong with the patient and many times will order testing or treatment before speaking to the MD because they are aware of what is wrong and what needs done. As for the Pharmacist on here, what a crock. I work with many mindless Pharmacists who screw shit up and also, I will call them with a question and they look it up on a computer, like I, the "worthless" NP couldnt have done that myself. Deal with it. NPs will become more and more common as medical students will not go into family practice because none of them care about the patient enough to go into family practice, the money isnt good enough, so they will go into a specialy... Then they will still be overwhelmed and hire us anyways... Good Luck and Open you mind!!!

4tuneteller said...

I agree that patients should never be misled about the qualifications of the clinician who is seeing them. Likewise, physicians should not use the title "Dr." in an attempt to lend credibility to a purely emotional opinion. Obviously our friend, the Dr., is quite emotional about his child's healthcare and understandably so.(The child was taken to the doctor by the wife but 21st century social constructs leave the writer's gender ambiguous. There is ample reason not to assume the writer is a man. However, for the sake of limiting argument, I will refer to the writer as a male.) He is so emotional, in fact, that he abandons all scientific reasoning. By his own admission he does not have all the facts and does not CARE to have the facts. He doesn’t need facts because he is not presenting a fact-based viewpoint. He’s presenting a parental reaction.
All parents are entitled to react -- even doctors. But just as Nurse Practitioners shouldn't attempt to pass themselves off as doctors, the opinion of an hysterical parent should not be given more credibility simply because it is advanced by someone who has the ABILITY to draw conclusions based on scientific evidence. The doctor tells us that he doesn't know or care about the facts regarding a Nurse Practitioner's education. He doesn't offer a single shred of evidence about patient outcomes when treated by Nurse Practitioners rather than physicians. Physician, of course, is a broad term that in this example could mean either a medical doctor or an osteopathic physician. Further, this parent does not distinguish between a poor-performing osteopathic resident who just finished his residency and plopped a sign on his door a few days ago and a renowned medical doctor with years of clinical experience. Either, apparently, is superior to a veteran RN with thirty years of clinical experience in neurology who is a Certified Neurological Nurse Practitioner with a Doctoral degree in Nursing Practice. Even a lay person can see the problem with this conclusion. "Doctors" in any field are trained to employ critical analysis of the evidence as a basis for establishing a scientific opinion. In fact, no respectable medical journal would publish the work of a "doctor" who could not support his opinions with peer-reviewed evidence. Thank goodness we don’t open the annals of medicine to find the unsupported opinions of an emotional parent being passed off as the intellectual work of an educated physician. There are reasons for that. And there are reasons why this Doctor’s paternal opinions are on an internet blog rather than in a scientific journal. The argument used by physicians to insist that doctorally prepared Nurse Practitioners don’t use the title “Doctor” is that it might “confuse” patients. Because DNP’s might wear white coats, diagnose disease, prescribe medication, admit to the hospital, etc. a patient might mistakenly believe they are medical doctors simply because they are using the title “Doctor.” I know this is going to surprise someone, but I can see their point. At the same time, readers might be confused and mistakenly believe that an emotional parent is advancing scientific viewpoints simply because he uses the title “Doctor.” Let’s not let the pot get away with calling the kettle black.

4tuneteller said...

I agree that patients should never be misled about the qualifications of the clinician who is seeing them. Likewise, physicians should not use the title "Dr." in an attempt to lend credibility to a purely emotional opinion. Obviously our friend, the Dr., is quite emotional about his child's healthcare and understandably so.(The child was taken to the doctor by the wife but 21st century social constructs leave the writer's gender ambiguous. There is ample reason not to assume the writer is a man. However, for the sake of limiting argument, I will refer to the writer as a male.) He is so emotional, in fact, that he abandons all scientific reasoning. By his own admission he does not have all the facts and does not CARE to have the facts. He doesn’t need facts because he is not presenting a fact-based viewpoint. He’s presenting a parental reaction.
All parents are entitled to react -- even doctors. But just as Nurse Practitioners shouldn't attempt to pass themselves off as doctors, the opinion of an hysterical parent should not be given more credibility simply because it is advanced by someone who has the ABILITY to draw conclusions based on scientific evidence. The doctor tells us that he doesn't know or care about the facts regarding a Nurse Practitioner's education. He doesn't offer a single shred of evidence about patient outcomes when treated by Nurse Practitioners rather than physicians. Physician, of course, is a broad term that in this example could mean either a medical doctor or an osteopathic physician. Further, this parent does not distinguish between a poor-performing osteopathic resident who just finished his residency and plopped a sign on his door a few days ago and a renowned medical doctor with years of clinical experience. Either, apparently, is superior to a veteran RN with thirty years of clinical experience in neurology who is a Certified Neurological Nurse Practitioner with a Doctoral degree in Nursing Practice. Even a lay person can see the problem with this conclusion. "Doctors" in any field are trained to employ critical analysis of the evidence as a basis for establishing a scientific opinion. In fact, no respectable medical journal would publish the work of a "doctor" who could not support his opinions with peer-reviewed evidence. Thank goodness we don’t open the annals of medicine to find the unsupported opinions of an emotional parent being passed off as the intellectual work of an educated physician. There are reasons for that. And there are reasons why this Doctor’s paternal opinions are on an internet blog rather than in a scientific journal. The argument used by physicians to insist that doctorally prepared Nurse Practitioners don’t use the title “Doctor” is that it might “confuse” patients. Because DNP’s might wear white coats, diagnose disease, prescribe medication, admit to the hospital, etc. a patient might mistakenly believe they are medical doctors simply because they are using the title “Doctor.” I know this is going to surprise someone, but I can see their point. At the same time, readers might be confused and mistakenly believe that an emotional parent is advancing scientific viewpoints simply because he uses the title “Doctor.” Let’s not let the pot get away with calling the kettle black.

4tuneteller said...

As for the student doctor who presents as evidence the fact that ONE NP write ONE erroneous prescription....what is your point? If I say an MD once wrote me an erroneous prescription, does that constitute evidence that MD's are inferior to DO's? No, but he wants us to draw a parallel conclusion based on a single observation. Even the pharmacist that claims to see a pattern of erroneous prescriptions written by NP's presents no credible evidence as to the conclusions that can be drawn. And what is the sample size? Two NP's in a community of 10,000? 250 in a community of a million? Provide some credible evidence worthy of debate.

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Anonymous said...

I'm not sure whether I'm more enlightened or disturbed by this blog. For starters, I just want to warn "The Angry Doctor" that this was one of the first things that came up when I googled "NP." As an undergraduate student at a large state university in the midwest, I am exploring different options for post graduation. I thought a lot about medicine, but I realized that my image was influenced by how our society and culture depicts doctors, not the actual reality. I realized that patient care is my interest, rather than medical science. Nurses work with patients, doctors assess case by case. The two with many other clinicians form a team. I recently completed my CNA, and I hated changing diapers. Stool and other horrible smells really bother me. That's why I'm only interested in a graduate entry nursing program, so I can be a clinical leader, rather than a bed-pan changer. I think this field really needs to be made more public, because its statements like this on google that inform most people unwilling to read a long blog. I think for me becoming a NP would be a perfect goal. I could have a doctorate and work in a practice after I work in clinics as an MSN. I have no interest in traditional medical education, it's just not me. Just like "nursing school" isn't for all MD's or DO's.

Angry Doc, I really hope your kid's okay, and it sounds like the office management was pretty poor. But to degrade the institution of Nurse Practitioners just cements my decision not to enter medicine. It seems like NPs join nursing for the right decisions, unlike some physicians who want the title and the money. If I earn a doctorate, I will introduce myself as doctor, but I will never omit my clinical role. Hi, I'm Dr. Steve Smith, a Nurse Practitioner, but you can call me Steve.

I want to become an NP. It's not because I'm not smart or dedicated enough to become an MD. You're just a really hostile doc, and I hope I never have to encounter burnouts like you.

Anonymous said...

You are an idiot, NP's have a lot of traning, they go to school for 6 - 8 years. If they weren't competant they wouldn't be employed. Anyone who disagrees needs to expand their education on the subject before giving their opinion. NP's know more about the patient than the actual MD!!!

Anonymous said...

You are an Intern not a Doctor... Didn't you just bitch about people calling themselves Dr. without actually being one??? Shut up! One day a NP or nurse will be saving your ass!!

Anonymous said...

To the "medical student" who took the wrong drug for 2 days, u are a total idiot! If u had any doubts, u should not have taken the drug! I'd hate to see u when u become a physician...that's the price u pay when u see the nurse practitioner in the caribbean where u're in medical school....

Sweet Discord said...

NP's do 7-9 years of training, much like physician. Perhaps instead of judging a book by it's cover you should do your research. I understand it is your child, but it is parents like you that are why I will never go into pediatrics.

Sweet Discord said...

NP's do 7-9 years of training, much like physician. Perhaps instead of judging a book by it's cover you should do your research. I understand it is your child, but it is parents like you that are why I will never go into pediatrics.

Anonymous said...

my husband crashed and coded following valve replacement surgery. we were not told that no doctors are part of the cicu staff. the np delayed treatment by ignoring his symptoms of falling bp and falling heart rate. nps have read the cookbook, but believe they are the chef.

Tremors said...

Amen to Anonymous-

Anonymous said...

HAHA @ your ability to not hire a NP, as if we didn't have enough positions that are available, champ.

Anonymous said...

Wow i have never read such blatant idiocy. I just goes to show you. Just about anyone can make pass med school.

Anonymous said...

Sad to see physicians think like this. I feel so fortunate working where I do. I'm an NP at probably the most prestigious hospital in the country. We have some of the highest patient outcomes for trauma and emergency medicine and I ( an NP ) do the majority of the training for the new medical residents the come to the program. The surgeons have full confidence of my abilities. So the questions is... if NP's are good enough to be at one of the most prestigious hospital in the country with some the best patient outcomes and the NP is allowed to train the MD/DO's the question is why are you so close minded. My fellow physicians would say they rely on me as much as I rely on them. They look at me as an equal.. not a physician extender or a midlevel.

Times are changing... thankfully for the better

Dr.AJ-DNP

pathrecords said...

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Anonymous said...

I agree that to provide the best care possible to the patient, we all must work as a team, We all need to know our roles and limitations,
the patients need to be clear on the fact that you are the "Nurse Practitioner", and they can choose to see you if they please, But too often I have seen NP introduce themselves as "doctors" without the Doctorate degree,
Misleadiing to say the least,
when a company hires 2 engineers to work on a project, they expect two Licensed engineers to be working on the project, Not an IT person, or a person who is "good " at what they do, but that is not what was paid for,
As any patient, has the right to know from the start of the visit, "RN, NP, PA, MD, DO" , not find out later on
if you are proud to be an NP, say it and present it to your patient, let them decide,
If you want to be call "Doctor", then get a doctorate, or Medical Degree,
Clearly Nurse Practitioners are trained to work with doctors, but are not trained to work solo,
I can tell you training to be a NP and then going back to get my MD and residency, were Two totally different ball games,
I thought I knew things, but did not have a good understanding of all the things I didn't know,
Not saying you are always going to know more as an MD, but the odds are that you have been put through more and had more hands on experiences in those equivalent number of years, (of course I am not comparing a NP with 30 years experience with a MD with 1 year experience)
Sometimes we think we know a lot, until we realize what we don't know, and that's why there are Medical School and Residency training to help us to have a better understanding of Do No Harm and Risk vs Benefits,
I respect both NP and MDs, but having experienced in both, I can say that 1 year of NP school is in NO way equivalent to 1 year of medical school/ residency, the depth of understanding and volume of information is drastically different, not including the responibilities and challenges faced during residency
I am proud of my background,as a NP, but until you go through both, you won't understand what I am referring to, ask any Doctors out there that were NP's, I highly doubt anyone of them will disagree with me,
I would be interested to know,


Best wishes, We should not forget our mission as health care providers, To help, To Heal, To comfort,
Together as a team,

Dr. Taghiei said...

You are a bitter old school doctor, that has a huge ego. Maybe if you deflated your head a bit you might enjoy life a little more...for sure people around you would enjoy you more. Until you're can let go of your enitlement because youre a "doctor" you should change your blog name to The Egotistical Doctor.

Anonymous said...

Get over yourself! Clearly, you feel threatened. NPs and PAs are highly educated healthcare professionals who are required to pass board certification. Certainly, if one is told that they will be seen by the MD, then they should be seen by the MD. I do not agree with the type of deception that occurred in this case, if in fact your story is even true. However, for you to belittle NPs and PAs only indicates your ignorance! Many national surveys, which are continually conducted, clearly indicate that patients are equally satisfied with the care that an NP or PA provides versus the MD. Certainly, we expect NPs and PAs to practice medicine within their scope of practice and to be upfront with regard to their limitations; however, don't be an ass and demean the quality care that NPs and PAs provide. Moreover, NPs and PAs provide cost-effective care. If MDs (MD = More Doe) were not so greedy and did not demand more and more money, then we would not need to be so concerned about cost in healthcare! In any case, NPs and PAs are here to stay, pal, and they will only become more and more in demand…deal with it!

Unknown said...
This comment has been removed by the author.
Anonymous said...

I'm an MD who went through 4 years of medical school, 4 years of residency in order to practice emergency medicine. I out competed those who didn't get into medical school and didn't get into residency. I would say, you get what you paid for. NP/PA are not doctors, not even close. Sure people say they can handle 90% of the cases and doctors are only needed in the 10%. But think about this, they are not even trained enough to recognize what they cannot handle. That 10% will still get missed because they will not recognize that 10% and send them home! That means they will kill 10% of people. I'm an EM doc. 90% of patients I see get better if you just send them home without intervention. 10% needs some work and 1% needs your help or they die. I doubt PA/NP can recognize that 1% that truly needs my help. No, NP/PA are not doctors. Answer me this, any NP/PA if you are so qualified, would you let another NP/PA operate on your child without the surgeon in the room? Or if you are as well trained as physicians, why don't we just eliminate doctors all together and have you run the hospitals? Why have doctors over see you? Because hospitals try to be politically correct and save money, they put out this lie that NP/PA are just as good, but doctors still run the show because hospitals are not stupid.

Unknown said...
This comment has been removed by the author.
Anonymous said...

I can understand your anger as it was not right what the office did. Always tell the truth as it always can come back with a worse bite. First of all, I hope your child is thriving!! I have been in Critical Care for many years. The Hospitalists, for the most part are great. When the doctor, ie surgeon or specialist, enters the unit, he can barely remember his patients name let alone the condition. Thank goodness for the nurse and Hospitalist's, who work in close proximity to care for the patient. Please do not judge a book by its cover. As a dad, and you will find out if not already known, there are always 2 sides to every story. In reality, there are incompetent nurses, doctors, PA's and NP's. Also, lawyers, pilots and mechanics. You have to weed out the bad ones. You must ask questions to become informed. Thank you!

Anonymous said...

I once took my daughter to a well known Children's hospital's ED. She had fever and flank pain. I requested a scan and was told it was unnecessary. She was sent home on a short course of antibiotics, only to end up in hospital later for several days. She was seen only my a physician. Does that mean I criticize all physicians and never see another one? Intelligent thinking will make allow me to even see the same physician again. Things happen. As for pharmacists piping up with their opinion, when you dispense the incorrect medications to children, who exposes you?

Physicians, please be careful about mindless dribble. The bedside RN may expose your flaws and stop covering your mistakes.

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For you people that are saying a nurse practitioner has the same level of education as a doctor, as you kidding me? A nursing degree is 4 years, then a graduate degree on top...

A doctor completes 4 years of college, 4 years of medical school, 3 years of residency then 2-3 years of fellowship e.g. cardiology, gastro...

In these years the doctors aren't working 40 hour weeks like the nurses, they are working 80 hour weeks...so not only is their education longer, but their clinical experience and exposure is almost double...

Another point, a nurse practitioner isn't really nursing anymore, they are practising medicine...the history, diagnosis and differential, investigations and treatment is a medical model not a nursing one. So of these years of training, only the graduate program really should count.
By that logic we could also discount the college training from the doctor I suppose, but even then its 2 years post graduate training for the nurse.
4 years of medical school, 3 years of resideny and 3 years of fellowship...so come on, to say that a nurse practitioner and a doctor are equivalent is ridiculous.

NPs/PAs are physician extenders to work under and support but never replace the physician, why do you NP have such a problem with this? If you want to be a doctor and practice medicine, go to medical school. But this nonsense of "equivalence" with a fraction of training and none of the exams physicians sit is it any wonder we as doctors get pissy?

I couldn't do a nurses roles without training as a nurse, who do nurses always feel they can do the doctors job just as well with a fraction of training? (Until it all goes wrong...then they call the doctor).

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Yes there are different credentials and different job descriptions for doctors and NPs. They are not the same. NPs do not have the same qualifications as doctors, and if you choose not to have your child see one that is 100% your decision. I also don't think that it is ever right on the practice's part to unknowingly put you in with a NP when you were scheduled to see the doctor. However, you sound extremely ignorant saying that an NP should just draw blood and hold a patient's hand. Very offensive. This is a job description of a PHLEBOTOMIST. Which takes, what, a few months of training? Most NPs now have Doctorate degrees. I believe that qualifies someone to do a little more than draw blood and hold someone's hand. I drew blood daily in my second semester of nursing school, I certainly would not have continued on to 6 more years of schooling and clinicals if that was going to be all I would do on the job. If you yourself are a doctor, then this blog truly disappoints me as you should be more educated regarding the roles of different health care professionals than the average individual.

Unknown said...

I'm an NP currently working in pediatric neurology. I think this rant about seeing an MD specialist vs a mid-level provider is so ridiculous. If you or your wife didn't feel comfortable seeing an NP, then reschedule your appointment to see the MD only. You seem so outraged about it, but you have the ability to change your appointment without question. As another NP posted earlier, we know our limitations as providers and will ask for help from the MDs if needed. We are not parading around as MDs and I always introduce myself with my credentials upfront so there is no confusion. Your comments about not knowing the level of education of an NP or PA is something you could easily research or better yet, ask the provider yourself. Your ignorant attitude about working with mid-levels is really discouraging for the future of medicine and will end up hurting you in the long run. You and your ego can get off your soap box.

Unknown said...

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You are right, we are "aren't doctors" and with you being an example of what a doctor is I can honestly say "THANK GOD I'M JUST AN NP." With 5 years of bedside nursing, 2 years of masters education, and 4 years of undergrad education I certainly do have MUCH more education on patients and how to care for them (that is the purpose of BOTH our jobs remember). While working as a bedside nurse at one of the nation's top oncology hospitals I intervened DAILY to stop MD errors from reaching patients, most of the time preventing deadly errors. The majority of the time it is the nurse who directs the patient's care as we are the ones who are actually with the patient and pick up on MANY things MDs constantly miss. Most doctors don't even know how to administer the tests or procedures that they order, they can't tell the patient anything about what their treatment is going to be like. I personally want someone to treat me and my family, not my disease. It really is unfortunate that your family is missing out on the best and most compassionate healthcare. I sincerely hope correct your bigotry before it is passed to your child and they are perceived to be as uneducated as you are.

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Lol the angry doctor... More like the retarded doctor. This Doc just mad cause he knows PAs and NPs who make more than he does, are younger than him, do a better job than he does and have made better life choices than he has. He probably didn't get the residency he initially wanted and is angry cause he grew up bad at a bunch of stuff except school. Then realized he wasn't good enough at that cause he got a low stage test score. Lmao so funny.

Listen I'm sorry your wife had a bad experience with an NP and you don't respect PAs or NPs. You should be smart enough to know though that there are even bad doctors too. Then again you probably don't cause you're an idiot. I'm sorry your life sucks. Have you tried to see a psychiatrist-- you can trust them and they can write you a script for xanax, or a script for shut your mouth, tid. :p

Anonymous said...

With the statement above: I'm sure you wanted to always be a primary care doctor. Sorry you didn't score or interview well enough to get the specialty you wanted. Sucks man, I'd be angry too for sure. Maybe try harder next time? Or become a PA or NP. Lmao. Haters.

Unknown said...

you are on of the most ignorant people I've ever experienced. I work with amazing NPs and PAs who are extremely educated. Plus, I work in a neurological ICU in one of the top hospitals in the US. So you need to do your research a little better. These NPs and PAs are experienced and take pride in what they do. As an RN who is going back to school to become a NP or CRNA, I just want to let you know that we do a lot more than hold peoples hands you ignorant POS.

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I am not protesting your comment that NPs are less trained and experienced than specialists.My real concern with your unprofessional and insensitive rant is your absolute refusal to hire a nurse practitioner. I find this remark derogatory and offensive to these highly educated professionals. It is people like you and posts like this that make the healthcare world such a demeaning place for nurses like myself, and I certainly hope that someday you are able to look past your elitist prejudices and see these "unequal" professionals for their true value, passion for their clients, and desire to better themselves and their practices.

Anonymous said...

I find this post and its author extremely ignorant and unprofessional. Nurse practitioners and Physician Assistants are highly trained and qualified MEDICAL PRACTITIONERS, and deserved to be treated with as much respect, REGARDLESS OF THEIR TRAINING, as medical doctors. The comment about NPs sticking to holding hands was absolutely uncalled for and infuriating. I am dumbfounded by the stupidity and arrogance of people such as yourself.

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Umm...who do you think teaches Physicians during their Residency programs? The NURSES! They keep the well-intentioned yet naive physicians from harming patients. Nurses are also constantly studying the pathophysiology of their patients' diseases. And observing firsthand the effects of various treatment methods. I would even dare to say that being a critical care nurse is very similar to a physician residency program.

Anonymous said...

To everyone on this blog....this is the future! Srry doc but you don't make the choices anymore nor do patients. Their is a shortage of doctors and money in the health care system is decreasing .and insurance companies decides who you see. Np and pa are more affordable. Unless you want to pay out of pocket to see the doctor. Np and pa are the ones who generally do all the access meets and report those to the doc. You have a point about wanting too see a doctor for the pay but it ain't happening as long as you have insurance.

Anonymous said...

Mike,
Your anger at being misled (intentionally or not) about your child being seen by a pediatric neurologist is understandable. The practice communicated poorly with you and abused your wife's time. True, she could have cancelled and rescheduled etc but she should not have bourne the burden of such a hassle.

As the patient, you and your family have the right to choose what kind of provider you desire.

The pediatric neurologist told you of his confidence in the competence of his colleague, the NP. Your argument is basically that the NP cannot be competent for the work etc b/c she is overstepping the bounds of her education/training. Therefore, your argument is that the pediatric neurologist's judgment about the competence of his colleague is in error.

I see that you are trained as an internist. Therefore, you do not possess the high level of training that the pediatric neurologist has undergone for his specialty (pediatrics plus neurology).

Just as you argue that the NP does not have the training of an MD, YOU do not have the number of years of training/fellowship and specialization that the pediatric neurologist has. Therefore, YOU are not competent/qualified to evaluate the pediatric neurologist's judgment about his colleague. YOU are overstepping the bounds of YOUR training/education when you state that the pediatric neurologist is wrong in his opinion about his colleague, the NP. Only another pediatric neurologist (and perhaps adult neurologist or neurosurgeon) would really have the education/training necessary to make that kind of judgment about the pediatric neurologist's opinion/assessment. You are out of your depth and are failing to recognize the limits of your education/training.

If I wanted to know if this NP were a reliable provider for my child and I wanted an opinion other than that of her colleague, the pediatric neurologist, I would not ask your opinion because I would not consider you qualified to make an informed judgment. I would ask another pediatric neurologist.

That is not to say that you SHOULD allow your child to be seen by the NP. You have every right to refuse care by an NP or PA for any reason whatsover.

But --- you are not qualified to assess the pediatric neurologist's evaluation of his colleague because that is beyond the scope of your knowledge/education/practice/training.

I am an NP. I do not think that I am a doctor nor do I think that I have the equivalent education/training as a physician. Certainly there are aspects of my/my family's healthcare that I would want handled only by a physician. I understand that you take issue with NPs and PAs practicing medicine. Not everyone agrees with the concept; sounds like a pet peeve of yours.

One of my pet peeves is physicians who fail to recognize the bounds of their knowledge/training etc. From my work in the health care system I know that this is not an uncommon event and your post nicely illustrates this.

Anonymous said...

Dear Angry Doctor, I COMPLETELY AGREE with YOU! Those who disagree with me on this blog, whether you are a DNP, CRNP or not, you are NOT a neurologist and doctors should NOT allow you to read MRIs, prescribe medications nor do office visits/exams! Currently, I may become paralyzed due to a DNP, CRNP assuming she knows things, that she does not! As for DNPs, CRNPs, it wasn't until this month that I understood that I've been allowing a DNP, CRNP in Neurology to treat me for 2+ years and she knows NOTHING about my spine! I am shocked! Not only does she NOT answer my questions, she makes statement that has nothing to do with my spine/disks at all! Also, at my last visit she said the report on my brain MRI could mean a tumor. When I questioned her about it, she said she didn't say that! And now, she's being condescending about everything I ask/say! So now she's not only stupid, she's rude as well! NO MORE DNP, CRNP for me. EVER!

Anonymous said...

I just bumped my Adderall down to 60 mg and switched to the XR so my regular doctor can handle it until I get a real psychiatrist again. She seemed so "lassie" when I first met her and has flipped into nurse Ratched so fast it isn't funny. I had her write me some Klonopin when I knew my sister got molested and I wanted 20 or so and she gives me 120 1 mg tabs and then calls in 90 2 mg ativan for me. I felt like such a fool waiting there because they were thinking huh?? and I was too but she yelled at me and said, take what I prescribe or go elsewhere. I do the pill count thing because she probably was called on that scenario among other things and decided to pass the buck to me as a junkie. I have tons of Klonopin left so I will be fine with thunderstorms for a bit when I have panic attacks without her.

Anonymous said...

I've worked with bot NP's and PA's--they both scare me and im a lowly medical assistant--it seems like they are all in a pissing contest to see whose better and who can spout off about their licenses --im with the good Dr. if im seeing a specialist then I want to see the specialist not his sidekick-that's for the movies--- that being said if I wanted an hour long lecture on how to not get pregnant after my yearly pap was done id go to a nurse practioner-maybe....
signed concerned parent..

Anonymous said...

You'll find idiot physicians , NPs, pharmacists and PAs . Don't see them.
You'll find superb physicians, NPs , pharmacists and PAs. Do see them.
But
Damn the person who generalized an entire profession , sex, race, or any defining factor of a people based on a few loose screws in the drawer.


Unknown said...

Majority of the time know more? LOL!!!!!!!!! As if! I've seen NPs/PAs diagnose inflammatory breast cancer as cellulitis, periorbital cellulitis as a 'sinus infection'. There is no shortcut to being a physician. Go to medical school...if you can.

Unknown said...

The flaws in your logic construct are deafening. Finding a niche area of Medicine and trying to extrapolate it to general Medicine or something with greater risk is reckless and disingenuous. In fact, I've heard this same 'straw man' argument before, which tells me there aren't better arguments.

The defect is readily exposed when I then say, "Well, I'm going to take some rather bright high schoolers, fast track them in a 6-month physiology and pharmaceuticals course, and get them out healing the masses. And let's make haste, there's a shortage of 'providers'."
Then YOU would be screaming that they aren't qualified and don't have any business treating patients.

There is no shortcut for this noble calling. Pay your dues, earn your place, and quit trying to 'cherry pick' your way through life.

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Anonymous said...

I think many people have misconceptions about the entire scope of education undertaken by NP and PAs. You can NOT be certified as a PA with only a highschool education. You can be early accepted to a program out of highschool , but you must obtain a BA or a BS before entering a program. PAs spend one year cramming most all the classes (with the exception of biochemistry) that physicians spend two years completing. Related to that, In order to be competitive for PA school you must generally have taken biochem to some degree. PA schools don't take breaks through their course. That's how they fit so much in so little time. The country has a growing deficit of health care providers, especially at the primary care level. For most people considering PA or MD it's is all about life style choice, and what you want in the future. For me, it's a choice I have made because I want to help people. I want to have the interaction with patients without the headache of insurance battles and ego measuring. Bless those who become physicians. They are very special people. I agree, if you went to see the specialist you should have seen the specialist, and then he would have given your case to the NP had it been appropriate. However, keep in mind the only thing that keeps most of those practices open and affordable, or allows you to see anyone in a reasonable amount of time are those mid level medical professionals.

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LR said...

NP's and PA's are absolutely necessary because I don't care how skilled and knowledgeable a physician is, they cannot perform their work at their expected level of expertise if they are burned out. End of story there is a shortage of physicians who are over worked and underpaid for the hours spent overworking and a consequence of that is that they cannot perform as well as the Dr. who has a manageable patient load and fair compensation. In addition PA programs have high expectations in regards to GPA requirements, prerequisites and academic performance as well as experience in a clinical role prior to admission. You also have to take the MCAT to be admitted to a PA program just as you would medical school. Their is a lot more that goes into being a great physician than finishing medical school, residency and fellowship. Incoming NP's are now being required to obtain a doctorate degree in clinical practice not to mention the extra education spent on specialty of choice AND residencies/fellowships. So they are all very skilled, educated, knowledgeable and CAPABLE dependent upon the individual and NOT the title!

Anonymous said...

Well said I am not an NP yet. In my first year of working as an RN in a very well renowned hospital.I encountered many prescription errors made by attendings. And little me fresh out of school had to call them to correct there mistake. Yeah I don't discount that you went to a lot of training. But you are not God.

Anonymous said...

I had a similar experience. My doctor referred me to a specialist but when my appointment day came I was seen by the PA. The Pa assured me that the doctor would be in to see me as well and proceed with the examination and diagnosis. The PA did not answer any of my questions or explain my medical condition and diagnosis. Several minutes later, in walks the condescending doctor. He tells me he agrees with the PA's diagnosis and won't be examining me. I tried to ask him questions and he tells me is should have asked the PA and leaves!

I subsequently saw a different specialist and turns out the PA had misdiagnosed my condition. I will never see the first specialist again nor will I ever allow a medical diagnosis or evaluation to be filter through the abilities of a PA.

Anonymous said...

If NP stands for "NO PLEASE" then M.D. stands for "Major Disappointment". I have a very unique perspective to healthcare because I have a sibling with severe autism, I'm her legal guardian, I have been since I was 18; autism is my life. This doctor has one story about an NP, I have many stories about doctors. You don't know how great prestigious and professional MDs are until you see how they treat patients that they don't think matter. This is just another example of that notorious, and accurate bullying and immature attitude that MDs have. This post makes me just cry. From one of your patient’s families, please work with all of the providers on your healthcare team as professionals, mid- level or low-level.

Anonymous said...

I have been a practicing NP for 14 years, in the nursing profession for 20 years, and am surprised at the age of this blog post and the fact that people are still posting. I am not offended by your comments at all, because I have had similar experiences with your so called more qualified medical profession. I have seen MD's make some grave errors. There is no infallible profession. I also work in a specialty area and have for 10 years. I don't pretend to be a doctor and when someone asks me if they will see the doctor, I tell them they were booked with me and educate them about my training and what I can offer to them. If they still want the appointment, great! If not, that's okay too; I have plenty of paperwork I can work on during that time instead. My specialty training came from one of the greatest doctors I have ever met who was glad I had no experience in the specialty when he met me. He told me "that's great! I want to build you from the ground up and don't want you coming in to this practice with any pre-conceived notions about how to care for these patients." He kept a tight chain on me for a while. Then he gradually turned me loose into a fully autonomous practice. I don't see patients for any physician. I see my own patients. And I do a good job. I am receiving a national award this year because of it. So I guess the bottom line is, NP's and PA's are competent, but yes, there can be a bad one in the bunch, just like there can be bad MD's in the bunch. If you are not familiar with NP's training, then get educated. Figure it out. Ask the NP or PA in front of you about their training and if you are not happy with the care you receive, report it to the appropriate people.

Hairlesswombat said...

You are so incredibly ignorant I wonder if you should write for the Onion.You claim to be a physician but HAVE NO FREAKING idea what kind of training a NP or PA has? Do you know how to Google?
Did you graduate last in your class? Or did you get your degree in a cracker jack box?
I can't even.

Hairlesswombat said...

You are so incredibly ignorant I wonder if you should write for the Onion.You claim to be a physician but HAVE NO FREAKING idea what kind of training a NP or PA has? Do you know how to Google?
Did you graduate last in your class? Or did you get your degree in a cracker jack box?
I can't even.

Anonymous said...

The OP never responded if or why the NP's care was substandard. Was the diagnosis or treatment wrong? Did you get a conflicting second opinion? Was there a bad outcome? There has to be something more. You can't be upset over a degree.

NP Student

Anonymous said...

To say that all a PA is good for is drawing blood and holding a patient's hand is beyond ignorant. You are putting down the thousands of clinical hours that these intelligent people completed to provide equitable healthcare. I am currently a PA-S and assure you we put our blood, sweat and tears into our education to make sure that patients lives are safe in our hands. As a former phlebotomist, I can assure you that the skills and knowledge of a PA-C would be surely wasted sitting in a lab preforming a low level duty such as drawing blood all day. I am .surprised that you were even accepted into medical school with the enormous ego you have. I sure hope that other people who are just as ignorant are weeded out and not allowed to be physicians. To be completely honest, I would NEVER see you or have my child see you. You are so focused on your ego, how do you even provide equitable healthcare? I sure hope there are some PA's and NP's around who can fix the mistakes you make while being too preoccupied with yourself.

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Jonna said...

I was very ill and was recommended by my primary care doc to see a hematologist. On my first visit to this practice, I was seen by the nurse practitioner. It was the first time I had been seen by one and I didn't mind. While she was examining me, her lack of confidence was astounding to me. She seemed scared or something. I had such large swollen glands in my neck that my neck size was probably triple than normal. When she got around to feeling my neck she barely touched me and said she didn't feel anything out of the ordinary. Then the doctor came in the exam room and she told him of her findings, and he looked at her like she was crazy and showed her the swollen glands, which by the way, turned into a diagnosis of advanced lymphoma. If it had been up to the NP alone, I could have walked out of there thinking there was nothing wrong with me. I have stayed with this doctor who has treated my lymphoma for 3 months now and I am due for a follow up visit and they want me to see this NP again. I emailed them through the patient portal that I want to see the doctor, and they replied that it is their policy to have the NP see every patient now and again so she can become familiar with each of them in case of an emergency. Well, too bad. I wouldn't want her to handle an emergency of mine. I am in a fight for my life and I should see the doctor if that is what I want. I replied back to them exactly why I do not want her to care for me and to tell me when my appointment with the doctor is. I am still waiting to hear back from them. I think that the patient should dictate who cares for them

Anonymous said...

My provider is a NP and has provided better care and a more specialized treatment then ANY MD I have ever seen. You are just afraid of the "label". If a NP and MD where in plain clothes and you questioned both, I bet you couldnt tell which was which. Or maybe I just got really lucky...

Anonymous said...

Wow... I guess I should have just accepted the med school offer instead of going to PA school.. then I could have done something more than "hold someone's hand" and "draw blood". Funny, I don't think you realize that is not in PAs job description. In fact, I have never drawn blood as a PA. Instead, I take detailed history and physicals, come up with complex treatment plans for sick patients, some with psychiatric illness, some with liver cancer, treat hepatitis C, also put nexplanon and IUDs in, remove toenails, incise and drain abscesses, give occipital nerve blocks, joint injections, plantar fasciitis injections, perform breast exams and pap smears, order and interpret lab results, read x rays to diagnose arthritis, broken bones, pneumonia, etc, hemorrhoid banding, and asthma treatment specialist. Oh... even found the cause of a couple of patient's symptoms.. turns out one had ovarian cancer at age 2 and one had appendix cancer... not even the specialist thought it would be a good idea to "keep searching" for answers of why this woman was still hurting. So don't tell me that we just need to "hold the patient's hand" after I have worked my ass off in PA school from 7 AM to 11 PM everyday, staying up past 3 AM most nights studying, going to class with the medical students (yes the same classes!!) and then going to PA classes in the afternoon and evening while they get to go home. As a PA I am constantly studying, learning more and more, and training as well. We know we will never know as much as the specialists but that is why it is so wonderful being a PA, we have that general medicine foundation and then can further go on to other areas of medicine. Do you know it is harder to get into PA school now than med school? Wanna know why? Its actually much harder. Its like med school on steroids, done in 2.5 years. Not many people could do that and pass with As & Bs. My school didn't let you pass with Cs.... so we had a few that were kicked out. Plus being a PA is awesome you can go into any field you want in medicine, you get that flexibility. Yes we have to consult with other physicians, our collaborating physicians. But they also collaborate with us too! I cant tell you how many times Ive been asked by other physicians about woman's health or something else I specialize in. So everyone get off their high horse and shut the hell up. Its about the patients people, not the initials after your little name. And for God's sake, educate your self before you open your mouth and make yourself look like a stupid asshole.

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Anonymous said...

He is not ignorant. He's correct. They don't get the same education or training as doctors. When I've seen a PA or NP, I always have to return 3 or 4 times to get any real help. Once the PA even prescribed something that didn't even exist. The pharmacist couldn't fill it bc the medication and dosage did not exist. How hard is it to treat a female yeast infection?? Seems pretty basic at a female clinic. Pfft.

Anonymous said...

Maybe you are actually good. Maybe you're really full of shit. I've fired 3 psychiatric PAs in the pay 5 years. 2 of them prescribed meds that were documented to have adverse reactions, including death, when taken together. The 3rd was content to let me take meds that had a potential to destroy my kidneys if taken at certain levels, yet my blood work was not examined for over a year to check levels in my blood stream. The simple fact is most PA are not fit to treat a dog, much less people. They are gambling and playing with lives.

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Christine said...

I'm a nurse practitioner and I am trained to do more than draw blood and hold hands. You need to get with it.

Anonymous said...

Wow. You're a total douche MD.

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Anonymous said...

You are ignorant to the vast and incredible knowledge of NPs. I have many other things I would like to say to you, however I will not, because you sound stupid and an uninformed MD. Would not make a difference.

I need my NP said...

I ditched my Dr because the NP takes better care of me...listens and stays longer than my Dr ever did.I am complicated ...several health issues... My NP saved my life as the Dr could not figure it out. I'm sorry you feel this way.

Anonymous said...

Mike, your post is almost 10 years old, and I hope that your family is well. I also hope that you changed your ignorant (as in uninformed, not stupid) opinion of NPs. NPs are a nurse first before they commit to the rigorous training it takes to become an NP. Most nurses I know are caring and passionate individuals, and to go further their education to become a mid level provider is admirable. Yes, they do have better bedside manners. Yes, they do take care of more needs than an MD, not just the medical but also the psychosocial needs. No, they are not exhibiting the "God" syndrome that sadly affects a lot of physicians. In most states NPs are permitted to run clinics as the only prescriber. PAs are not granted the prescribing authority that NPs are, therefore they need to work under a physicians auspices.
Those are just my two cents worth - for what it's worth.

Anonymous said...

I am a PA student. I have worked with many RNs that went online and received a BSN then a master's online as an NP. Many of these nurses were not the sharpest tool in the shed. I was once doing some shadowing during my first semester and an NP working there had no idea what a metabolic acidosis was, the DDX, all she knew was that two values on the ABG were flagged. I knew what this was in my first semester. Online NP test taking and education is ridiculous. Now we can have anyone that is an RN practice medicine now.

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Anonymous said...

To the original poster:
How unfortunate for you. However, you should have simply re-scheduled with the doctor you wanted to see. This is America and, you are an adult, yes?
What a HUGE bunch of whining...I mean, really impressive. Obviously, you refuse to accept that there are plenty of very competent PAs and NPs. Sure it's true that some may want to see a fellowship trained specialist or subspecialist and, you had the ability to do just that by rescheduling or--even better--just have been up-front at the beginning and tell the office you would only see the physician. Yeah, the office was at fault for mis-leading you about the physician being there and I'm sure they would have been happy to reschedule and not collect a co-pay, if any.

Here's a truth for you. A friend of mine, who was in her early 20s and fit and otherwise healthy, had seen only her PCP physician, exclusively, for many years, ended up reluctantly seeing the PA in the office one day. The PA listened to her heart, and listened some more... This PA heard a very important heart murmur which was clearly not a new one and had her sent to Boston and very soon after had life-saving open heart surgery. This competent PA heard a very important heart murmur and saved my friend's life.

Your blanket statements and ignorant remarks, among your incessant whining, only completely and rawly exposes you well.

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Anonymous said...

I know this is a very old post, but you must be very intimidated by NPs, who by the way prob have more working knowledge than you will ever have as an MD. NPs must first be nurses, and as we all know, nurses save doctors butts, daily.
NPs have years of experience in the 'battlefield' and years of education.
Don't be such a narcissist.
Np's have better outcomes (per many valid studies), have better bedside manner, and can do the same job as a doc.
Get used to the fact that NPs work equal to the doc.

Unknown said...

Wow. Did you get an MD for your ego too? This tirade of yours is reminiscent of the flamboyant rantings of a 16 year old girl gossiping about her cheerleader counterpart. Get it together. Your a doctor. Act like one.

Zahid Hossain said...

You are tricking yourself to think a NP has more learning than a doctor. Until the point when a NP finishes therapeutic school, a residency, and a partnership, they will never acknowledge the amount they don't know yet. As a doctor, I can't envision how I could have viably administered to patients without have been through residency.
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Anonymous said...

What a pompous ass you are!

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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

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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-
Sincerely
PMHNP -Student
RN of 14 years

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

God is love said...
This comment has been removed by the author.
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