pediatrician vs nurse practiitoner

[fac]

I am not sure whether I should be concerned or that I have over-reacted.

About 80% of the time when I tried to make an appointment for my DDs' pediatrican, I was directed to have the appointment with the nurse practitioner. Today, I tried to make an appointment for their regular check-ups, again I was directed to have the appointments with the nurse practitioner.

I understand "A Nurse Practitioner (NP) is a registered nurse who has completed specific advanced nursing education (generally a master's degree or doctoral degree) and training in the diagnosis and management of common as well as complex medical conditions.", but then they are not doctors, is it normal? why would anyone study to be a doctor? or should I consider changing pediatrician?

Please help...

 

[Cinderella94]

At my pediatrician's office, the person I like happens to be a nurse practitioner, not a doctor, and I make appointments with her whenever I need to see someone, for a checkup or otherwise.

So no, I don't think the distinction is a big deal.

Does that answer your question?

 

[delilah]

I am not sure of the credentials or training of a nurse practitioner. I am a board certified family physician (MD). Nurse practitioners in our state have to be "supervised" by a physician. They can't independently admit patients to a hospital. Depending on the situation, their documentation must be reviewed and countersigned by a physcian, much like that of a medical student. In our community, they are use to do very routine things, like well exams and simple medical problems. We don't have any in our office. They ar good for doctors who have alot of patients and can triage the simpler cases to someone else.

I like the mix of some easy routine problems and some hard, complex problems. It would be exhausting to see only the tough cases, which is what I would do if we had a nurse practitioner.

 

[fac]

thanks for the quick response, you both have answered my questions. At least I now know it is normal. In the pediatrician's office, we have only one doctor, hence a few times when the doctor is not in the office, we only have the nurse practitioner.


again, thanks for the clarfication.

 

[tar heel]

I loved seeing the NPs. At our practice, they spend more time in the appointments than the docs, and I feel just as confident seeing them as the docs. I scheduled a lot of my youngest DS's appointments with the NP by request. We've switched over to his doctor now that he's almost 15 b/c the NP thought he would be more comfortable with a man.

 

[Pin Wizard]

Let the office know that you want an appointment with the doctor. If they give you a hassle about it, then I would find another pediatrician. And I would let them know why I was leaving.

DS sees a specialist every few months. They tell us we need to alternate between the doctor and the NP. Ha! I canceled every NP appointment we've been given.

 

[Pin Wizard]

I loved seeing the NPs. At our practice, they spend more time in the appointments than the docs, and I feel just as confident seeing them as the docs. I scheduled a lot of my youngest DS's appointments with the NP by request. We've switched over to his doctor now that he's almost 15 b/c the NP thought he would be more comfortable with a man.

That's about 50% of the reason I don't want the NP in DS's doc's office. It's a female. And she sounds like she's talking to a 5 year old. At 16, DS really doesn't want a female. The other 50% is that I'm paying a doctor's rate. In my book, PAs, ARNPs, etc. should all be charged at a reduced rate. They don't have the knowlege that the doctors have.

 

[chloelovesdisney]

I've seen both MD's and NP's. I'm happy to see the NP for a check up, vaccination, or prescription renewel type appointment. If I have something specific that is concerning to me, I see the MD. An NP is not the same as a medical student, as they have already graduated school, and taken their boards. I'm not sure if an MD reviews and cosigns their charts or not, that may vary from state to state.

 

[chloelovesdisney]

That's about 50% of the reason I don't want the NP in DS's doc's office. It's a female. And she sounds like she's talking to a 5 year old. At 16, DS really doesn't want a female. The other 50% is that I'm paying a doctor's rate. In my book, PAs, ARNPs, etc. should all be charged at a reduced rate. They don't have the knowlege that the doctors have.

I do agree they should charge a reduced rate. However, I just have a small copay, regardless of whom I see. I would think that the insurance companies who look for every which way to save a dime, would be all over that already.

 

[shellybaxter]

My "doctor" right now is a Nurse Practitioner. I love her. I won't see the Doctor unless she says I need to see a specialist for something (which happens once in a while). I would pay double to see this lady. She is perfect for me. I don't like doctors - didn't see one for 10 years and a lot of medical problems went untreated because of it. I don't care what her creditials are because her manner and ability to really listen are exactly what I need.

 

[fac]

Let the office know that you want an appointment with the doctor. If they give you a hassle about it, then I would find another pediatrician. And I would let them know why I was leaving.

DS sees a specialist every few months. They tell us we need to alternate between the doctor and the NP. Ha! I canceled every NP appointment we've been given.

It was the reason I posted the question.. I called today to make an appointment, but was told that the only availability for both girls back to back will be in July. Okay, I told her I can bring them in seperately, but still not able to make the appointment for the next 2 weeks for regular check ups, hence I thought about switching them, but wanted to see whether it is normal..

Anyway, given there are a number of people using NPs, I am going to keep the appointment for now.

 

[minniecarousel]

When I take my Mom to the cardiologists, she usually sees the NP. She spends a lot more time with Mom, and we feel that she answers our questions better. Obviously, when she's admitted or has a procedure done, her cardiologist treats her.

 

[Abbie]

I work in a practice of all CRNP's and it's great. We have a dr. who is our "medical director" but she never sets foot in our office and doesn't have anything to do with our practice (other than the check she collects each month!). She is not required to co-sign anything or oversee our patients. And she's not needed to do that. The NP's are highly trained and they don't just do the "simple" cases....how insulting to say that. They do everything the doctor does, but the main advantage (our patients say anyway) is that they take more time and listen better. If our NP feels they would benefit from a specialist, she'll send them out, just like the doctor would. In fact, sometimes she is quicker to do that than some doctors who feel they can handle everything. Sometimes we have patients who question the difference between a doctor and an NP and I have a difficult time answering that because for all practical purposes there isn't much difference. I'm sure that's not the case everywhere, it will depend on the various skill sets each possess.

Oh, and our NP's are all women and we've had maybe a handful of adolescent boys and men who aren't comfortable with that. I respect that but most are able to be mature enough to get past it. Personally I feel like it's payback for all the years I had to see a man gyn!

As far as the original question, if you are scheduling your appointments far enough out I don't understand why you shouldn't be able to ask for the practitioner you prefer. If it's a sick visit, you take whoever's available, but you should be able to book with your preferred provider for an appt that is weeks later. If they don't allow that, I'd be moving on if seeing the ped is important to you.

 

["Got Disney"]

I am not sure of the credentials or training of a nurse practitioner. I am a board certified family physician (MD). Nurse practitioners in our state have to be "supervised" by a physician. They can't independently admit patients to a hospital. Depending on the situation, their documentation must be reviewed and countersigned by a physcian, much like that of a medical student. In our community, they are use to do very routine things, like well exams and simple medical problems. We don't have any in our office. They ar good for doctors who have alot of patients and can triage the simpler cases to someone else.

I like the mix of some easy routine problems and some hard, complex problems. It would be exhausting to see only the tough cases, which is what I would do if we had a nurse practitioner.

That is how it is here in Ca. also...although not sure where you practice.

I have been a Nurse for 28 years. I on occ. have seen the NP with my boys but for simple things like Sinus infections, ear infections and such. We had a choice. To see the Dr. in a day or so or see the NP right away.

However since I have changed to Kaiser I have the choice of many Peds.... but if I want to see my boys Ped sometimes he is unavailable so I just see one of the other Doc's.

Being a Nurse helps knowing if it should warrant an MD or a NP. But when in doubt I always see the Pediatrician

 

[horseshowmom]

I loved seeing the NPs. At our practice, they spend more time in the appointments than the docs, and I feel just as confident seeing them as the docs.

My "doctor" right now is a Nurse Practitioner. I love her. I won't see the Doctor unless she says I need to see a specialist for something (which happens once in a while).

Same here. I've been using a NP for routine visits for a long time. She definitely spends more time with me and listens to what I've telling her. My previous doctor was great too, but I think she let her practice get too big, and I felt like the level of care went down a little.

 

[wdwmom2]

The pedi practice I work at has 5 docs and 1 NP. I would trust my child's life with any of them INCLUDING the NP. My NP has been practicing a long time and handles cases just as difficult as any of the docs. She is very well liked by all our patients. The only thing that she doesn't do that the docs do is hospital rounds. As far as booking appointments, you can't get in any quicker with the NP than the docs. She gets booked just as quickly as they do.

 

[RN4Babies]

My pediatrician's office has a mix of MD's and NP's. My pediatrician is fabulous (I "interviewed" him when I was pregnant with dd, and I loved his philosophy regarding care, his gentle manner, etc). I do feel that two of the other MD's in his office are always rushed because they overbook, and they don't listen to me or my concerns. I adore the NP's (three women and one man) in their office. They're all extremely knowledgeable, thorough and spend a lot of time talking with both me and dd8 (ds started going to a family practitioner when he was 15; he felt funny going into a pediatrician's office at that point. )

I also work with doctors and nurse practioners in a NICU. I have nothing but the utmost respect for those NP's as well. Many of them were nurses in the "real world" before becoming NP's, and often have suggestions for patients' care and well being that doctors don't think of. NP's have as much knowledge as an MD (sometimes more), and to say otherwise is so insulting.

Personally, I don't agree that your charge by an NP should be lower than that for an MD. Their malpractice insurance rates are as high as an MD's. Most of the time they have as many years of schooling as an MD. IMO, people possibly choose to become an NP vs. MD because getting your master's degree as an NP costs a LOT less than going to medical school for three years after you have your bachelor's degree.

 

[aprilgail2]

I would cancel and wait for the real Dr. I have at times seen a NP but when I want to make an appt with a real Dr I expect them to make that appt. I am willing to see a NP when I have strep, bronchitis and things like that but when it is something more concerning to me I want a DR. I pay for a Dr and that is who I want to see. I guess we are very lucky because my daughters pediatrician does not use NP's in her office, there are three Dr's and they are all female so we will see anyone of them.

 

[Piecey]

I don't look down on NPs or anything, but I feel more comfortable seeing the Dr.

I had to apply to get into my chosen pediatrician's practice for my baby and THEN, upon acceptance, found out he has 2 female NP's in his practice, which I was trying to stick with a male for when my son gets older.
Oh well. I won't look down on these NP's for things like well-child visits (after all, they see TONS of healthy babies, right?) but if baby is sick or something, I'll be demanding an appt. with the Dr. I want that medical school degree in there with my son for non-routine visits.


..I might be weird, though. My OB has an NP in her office and I've avoided having appointments with her as much as possible. They scheduled me with her this week and didn't tell me and I'm a little perturbed. This late in my pregnancy I want to see my DR!

 

[npmommie]

I am not sure whether I should be concerned or that I have over-reacted.

About 80% of the time when I tried to make an appointment for my DDs' pediatrican, I was directed to have the appointment with the nurse practitioner. Today, I tried to make an appointment for their regular check-ups, again I was directed to have the appointments with the nurse practitioner.

I understand "A Nurse Practitioner (NP) is a registered nurse who has completed specific advanced nursing education (generally a master's degree or doctoral degree) and training in the diagnosis and management of common as well as complex medical conditions.", but then they are not doctors, is it normal? why would anyone study to be a doctor? or should I consider changing pediatrician?

Please help...

Obviously from my screen name I would not be concerned at all. I will make one comment though if you are scheduling well visits most pediatricians book those out way farther than 2 weeks. really months in advance. so if having the Pediatrician and not the NP is important you should call months in advance and tell them you want the MD.

I am not sure of the credentials or training of a nurse practitioner. I am a board certified family physician (MD). Nurse practitioners in our state have to be "supervised" by a physician. They can't independently admit patients to a hospital. Depending on the situation, their documentation must be reviewed and countersigned by a physcian, much like that of a medical student. In our community, they are use to do very routine things, like well exams and simple medical problems. We don't have any in our office. They ar good for doctors who have alot of patients and can triage the simpler cases to someone else.

I like the mix of some easy routine problems and some hard, complex problems. It would be exhausting to see only the tough cases, which is what I would do if we had a nurse practitioner.

In my state we practice independently, no co signing of notes, I can see all the same types of patients the MD sees, difficult and easy. Complex or simple. You will find NP's in my state in cardiac cath labs, hospitalists, ambulatory care, ER, etc, in other words you find them most everywhere.

I work in a practice of all CRNP's and it's great. We have a dr. who is our "medical director" but she never sets foot in our office and doesn't have anything to do with our practice (other than the check she collects each month!). She is not required to co-sign anything or oversee our patients. And she's not needed to do that. The NP's are highly trained and they don't just do the "simple" cases....how insulting to say that. They do everything the doctor does, but the main advantage (our patients say anyway) is that they take more time and listen better. If our NP feels they would benefit from a specialist, she'll send them out, just like the doctor would. In fact, sometimes she is quicker to do that than some doctors who feel they can handle everything. Sometimes we have patients who question the difference between a doctor and an NP and I have a difficult time answering that because for all practical purposes there isn't much difference. I'm sure that's not the case everywhere, it will depend on the various skill sets each possess.

Oh, and our NP's are all women and we've had maybe a handful of adolescent boys and men who aren't comfortable with that. I respect that but most are able to be mature enough to get past it. Personally I feel like it's payback for all the years I had to see a man gyn!

As far as the original question, if you are scheduling your appointments far enough out I don't understand why you shouldn't be able to ask for the practitioner you prefer. If it's a sick visit, you take whoever's available, but you should be able to book with your preferred provider for an appt that is weeks later. If they don't allow that, I'd be moving on if seeing the ped is important to you.

what she said!