An Appointment with a Doctor? Or Handed Off to Somebody Else?

I participate on discussion boards around the 'net -- mostly I read what others have to say, and it gives me ideas for what to write for you. A recent discussion centered on patients who are upset that they have an appointment with their doctor, (MD) and end up instead being examined by a PA (physician's assistant) or an NP (nurse practitioner.) They feel as if they aren't getting the same quality of care.

I believe they may be getting even better care.

So -- I jumped in with this response. Perhaps you've had the same concern.

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"You might be surprised to learn that a PA (physician's assistant) and an NP (nurse practitioner) have a great deal of training in primary care. In fact, if given the choice, I would rather see the PA or NP for routine care than my MD. (by the way -- a nurse practitioner and a nurse are two different things -- NPs have a great deal more training.)

When it comes to the routine stuff -- check ups, basic symptoms, regular tests, etc, PAs and NPs ARE experts. Plus, because of the way billing is handled, they can spend more time with you than the MD can. More time may lead to even better care.

When it comes time to review unusual symptoms (unusual for YOU) -- they can do the preliminary review, and then hand you off to the MD in the office. At the point where there may be a diagnosis needed, then yes, the MD may be a better choice -- but even then, not necessarily. With unusual symptoms, your primary care MD will likely have to refer you to a specialist anyway.

Two other points:

1. There is a shortage in the US of primary care physicians, most notably geriatricians (doctors who care for those age 65 and older). Estimates are that we need 14,000 more primary care/family practice doctors than we have. So -- having PAs and NPs who are so well versed in primary care is a blessing. We'd be waiting weeks instead of days to get see a doctor for care if we didn't have PAs and NPs.

2. I went through a horrible misdiagnosis in 2004 -- I was told I had cancer and I did not. I was able to figure that out on my own despite real hurdles from my oncologist. (You can read about it here.) -- BUT -- the PA in my doctor's office was one of the real heroes. He never made a misstep. It was the labs and the specialists -- the MDs -- who made the mistakes.

The real problem here is not that PAs and NPs aren't able to do the job. The real problem is that nobody has ever explained to us patients why they are such good choices for our care.

It makes the most sense for us to embrace the PAs and NPs for our routine care, and call in the MDs when we need that extra step for unusual symptoms."

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Hope you find this helpful, too!

Do you have a story to share about care provided by a physician's assistant or nurse practitioner? If so, I invite you to share it in the Patient Empowerment Forum. See you there.
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Photo © Leah-Anne Thompson