Doctor Appointments with PA or NP

[HeatherC]

Does anyone else get annoyed when you make a dr appointment with a specific doctor and then you wind up seeing a Physician Assistant or Nurse Practitioner?

My dad wound up in the hospital over the last two weeks and was found to have a tick borne disease called Babesiosis. It caused his heart to go into Afib which has never happened before. Long story short, we are supposed to see “cardiologist” next week as part of follow up care. Just found out appt is not with cardiologist but a PA. To see the actual doctor would be months.

Don’t get me wrong, I have nothing against PA’s or NP’s. We have about six NP’s in my family. But for something where you are told by an actual cardiologist to see an actual cardiologist and then they pass you off to someone who is clearly not a cardiologist is very frustrating and annoying. Yet I am sure they will bill it as a “dr visit.”

Anyone else get annoyed by this?

 

[ShirikiUtundu]

Yes. I have seen PA/NP frequently and without issue. However for one specific issue I was trying to get a second opinion; I made an appointment with a specific doctor recommended to me by another physician. I could not get an appointment for 2 months. I got there for my appointment and was instead placed with NP. I was pretty flustered about it and unsure what to do and did not want to come off as seeming elitist or whatever. In hindsight I really wish I would have advocated for myself because the experience left a really bad taste and I did not revisit the practice because of it (and therefore my specific issue is unresolved).

 

[Pea-n-Me]

Yes and no. This has happened to us, too, with different specialties, and it has annoyed me too. The only thing I’ll say is that it will get your Dad in, and there will be some things done that are fairly routine. They work pretty closely as teams so they get to know routine practices very well, and the lines of communication with the physicians in the practice are open. So anything above that that will be reviewed by the cardiologist, I’m pretty sure. (I’d ask about that.) If something requires more, the cardiologist will then be involved.

Aside from that, health care is sort of a mess right now post-pandemic. It’s taking a long time to get appts for many aspects of care. And let’s not forget that with the Affordable Care Act model, PAs and NPs were expected to play a bigger role in health care from the get-go, so this is something we’ll see more of.

Slightly OT but I tried to get a veterinarian appt the other day and was met with all kinds of messages about how overwhelmed their practices are since the pandemic, yada, yada, yada. So it’s not just in human health care, either.

 

[Christine]

I've never actually thought I was getting in to see a doctor, only to have it end up being a PA instead. But certainly, with most specialities, the wait to see the actual doctor is weeks-to-months so they will often offer up a PA. This happens a lot in my dermatologist (several different practices actually) and they've told me if the PA sees anything serious, they are usually working office hours with the doctor and the doctor can be called in. I've had that happen once with the dermatologist and once with a gastro. I actually got to see the doctor for a few minutes when the PA called them in.

 

[HeatherC]

Update…so this is another example of how messed up things get. The cardiologist office just called my brother and confirmed an appt for my dad with the actual cardiologist for this Friday. I told him to just take it and we will cancel the PA one afterwards. One hand is not talking to the other obviously.

 

[abdmom]

Up until a few months ago, I lived in a place (in the US) where there were very few specialists. Seeing a specialist would have a required a plane ride. When I broke my shoulder, I never saw an orthopedic surgeon during my entire recovery.

In the past 2 1/2 years, I've had 3 family MD's retire on me. Only one was over 60 years old. There are plenty of other occupations where people are deciding to retire rather than remain in a high contact occupation during covid.

 

[fly girl]

I have only once been irritated with a PA.

It was when dd was very little and they were doing a routine blood test. She came back with low iron. It is not a surprise as I have a minor blood disease (thalassemia) for which I will always be anemic and iron supplements do not work - and can make matters worse. I told her, don't do another finger stick as she likely has thalassemia and we need to get further testing done. I said it 3 TIMES! What did that women do? Pricked her finger again!! I was livid. Who the heck do you think you are when I told you repeatedly not do it? I am still getting mad just thinking about it. I wrote a letter to the practice telling them to listen to a parent when they are knowledgeable on things. (many doctors and PA's do not know about the nuances of thalassemia - even one of the OBGYN's when I was pregnant told me to go on iron supplements. NO!) Not sure if it fell on deaf ears but I absolutely refuse to have my child see her again.

OP, I definitely understand your frustration when it was a specialized doctor you were going to see. General practice, I see no issues with PA's or NP's. But when you are referred to consulting a cardiologist, you want to see a cardiologist. Glad to see you got the cardiologist for his appointment on Friday.

 

[mom2rtk]

My daughter has been seeing a Dermatology PA. I love that she spends plenty of time with her. I love how quickly we can get in to see her. But I will say that we have known each time that we were scheduling with a PA. Would not be thrilled if that was kept from us or changed up last minute.

 

[jaybirdsmommy]

My son sees an NP. I wish he could see anyone else. She literally has one job - keep his prescription current. She has called in the wrong thing more than once (and argued with me that no one told her he'd been hospitalized and had it changed, I was at the appt after the hospitalization and handed her the paperwork myself), let the prescription expire (he has about 48 hours before things get dicey and we've gotten to that point twice now), ignored requests from both him and the pharmacy to renew said prescription, and rarely if ever looks up from her phone while he's in her office.

She was also the only person within an hours drive that was taking new pediatric patients at the time he started seeing her. There's never been an option for him to see any of the actual drs in the practice. I need to tell him to check now that he's over 18 and see if he can find someone else.

The PAs at our general practitioners office are great, no complaints about them whatsoever.

 

[SandyinMonterey]

I find I have to specifically request appointment with doctor if I want to see MD and not a PA or NP. Usually that means a longer wait time for the appointment. What is annoying is making that appointment WITH the MD and waiting all that time and then the office calling you telling you you need to reschedule because he won't be in the office.

 

[tvguy]

I have always seen the Doctor when I make an appointment. I have never seen an option to book with a PA or NP, the people who check me in could certainly be a PA or NP. My co-pay until today to see a Doctor was $400 so I darn well better be seeing the actual Doctor. I went on Medicare (today) so it will be interesting to see if who I see changes since my Primary Doctor visits are completely covered, and Specialists have only a $25 co-pay.

 

[RedAngie]

I have always seen the Doctor when I make an appointment. I have never seen an option to book with a PA or NP, the people who check me in could certainly be a PA or NP. My co-pay until today to see a Doctor was $400 so I darn well better be seeing the actual Doctor. I went on Medicare (today) so it will be interesting to see if who I see changes since my Primary Doctor visits are completely covered, and Specialists have only a $25 co-pay.

$400 copay? That’s higher than the cash price many doctors charge.

 

[holden]

I've been to our local ER recently for two things. One, DD14 had a possible broken bone. Two, I cut the tip of my finger off.

Both visits were with an NP. I thought that was interesting. I didn't expect it. The care was good.

 

[tvguy]

$400 copay? That’s higher than the cash price many doctors charge.

I pulled out the bill. $448 was the Doctor's charge, insurance paid $48. Insurance would start paying 100% after I hit the $5,000 individual annual co-pay cap, but like I said, as of today, I am no longer on that plan, on Medicare. So in the future Medicare and my supplement should cover 100% of primary care Doctor's bill.....and more correctly....the Primary Care Doctor accepts what Medicare pays as full payment. I have $233 annual out of pocket cap now for everything.

 

[China Expat]

Very annoying. The last time I saw my endocrinologist was 2014. Got charged $400 in advance for a telehealth call with my surgeon...an NP showed up on the call. SOOOOOO annoying.

 

[kerry1379]

I will say that there is a particular NP that I will be forever grateful too. My son has many disabilities and medical complications. I remember a few months after he was born, when it became apparent that many of his issues would be lifelong, out of all of his many doctors and specialists, it was one NP that told me about our state's programs that would help with therapy and such as he got older. The thing is, those programs had decades long wait lists. We needed to get on those lists ASAP and she was the only one that mentioned them. I don't think anyone else ever brought it up until he was at least 10. If the NP hadn't given me that info, we would have been 10 years behind the game.

 

[Jennasis]

Some of the best care I've ever gotten has been from a PA or an NP.

 

[disneychrista]

I pulled out the bill. $448 was the Doctor's charge, insurance paid $48. Insurance would start paying 100% after I hit the $5,000 individual annual co-pay cap, but like I said, as of today, I am no longer on that plan, on Medicare. So in the future Medicare and my supplement should cover 100% of primary care Doctor's bill.....and more correctly....the Primary Care Doctor accepts what Medicare pays as full payment. I have $233 annual out of pocket cap now for everything.

That has to be for more than just an office visit.

 

[tvguy]

That has to be for more than just an office visit.

The EOB says Office Visit/Established Patient.

 

[RangerPooh]

Some of the best care I've ever gotten has been from a PA or an NP.

Agreed! The physician who delivered our first child was a DNP and was much better than the actual MD in the practice. My current gym is an NP and is great. I did see the MD at the practice recently for an issue, and together they provide amazing service for women's needs. My current GP is a NP and no issues.

Honestly, as long as it means I’ll be seen by someone in the practice who is competent then I’m fine. Besides, waiting for the MD might take months while the NP/PA might get you seen sooner. I currently have a three month wait for one physician. No NP/PA option available. I’m dreading what the follow up wait might be. DH met with his physician and his next appointment is in October. The earliest avail.