Patients who sometimes just want to see a doctor rather than a PA or a NP.

[Aznfarmerboi]

I was the starter of the DNP verus MD discussion. The thread has enlightened and informed me a lot about the situation. I noticed that someone posted about that and I read up on it. I noticed that a lot of you guys use the sometimes a person just wants to see a doctor arguement. As a pharmacy student looking into medical schools, AND first hand experienced the pains and failure of the healthcare system (i now have tons of medical bills with no results and two huge scarring on my face), I am intrigued and decided to make this second post.

I paid 300 dollars for my dermatology visit each time. Each time (despite the fact that I made my reservations ahead of time), I had to wait approximately 30 minutes. I chose this dermatologist because it is my face and red rashes on the face was not exactly the best way to get a girl. Anyway, after waiting 30 minutes, it is always the medical assistant who comes in and takes down my complaints. The nurses then comes in next to check my symptons. Then I waited some more before the doctor comes in for FIVE FREAKING MINUTEs each time before wrapping things up and ordering tests and labs (w/o consulting me of course) and prescribing me random assortments of creams and ointment before leaving his medical student to wrap up whatever is needed (hydrocortisone shots, wrappings, and blood tests).

Now it can be only this doctor I had the same experience with almost every other doctor that i visisted. Even when i had a bunch of questions, the doctor would be so rushed to leave that it would only allow me to get an extra 5 to 10 minutes.

Now, is it me. . . or even if I DO want to see the doctor, I spend 85 percent of my time with nurses, pa's, and medical assistants instead. If i am lucky. . ., i might get a medical student who can only tell me that the cream the doctor is giving me is a non steroid cream. . . that she repeated 3 to 4 times as if me, a pharmacy student did not know that.

Lets also keep in mind that I have to base my schedule on his which is so ever irregular. . . 99 percent of the time, the doctor is probably away or playing golf.

PS, i am not looking to troll and would appreciate positive feedback to this.

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[MossPoh]

I have no idea what kind of feedback you expect from this? I guess that is one of the perks of getting into dermatology? I mean that doc doesn't sound particulary great but there are some things that can't be helped. One will almost always have to wait in an office even with an appointment. It isn't to spite you....but 3 or 4 minutes extra x 5 can easily bump off a schedule. There are plenty of things that are going on outside of each examination room. I'm sure the person doesn't stand there and stare at a wall with his thumb up his a$$ the entire time (there could be a few minutes of it..I don't know) I am not going to justify the ignored questions and what not..since that usually doesn't fly with me. If he did ask you if you wanted the tests would you have said "No, If you don't know what it is from first sight I'll just continue with it." ..while he SHOULD ask..the vast majority of the people say yes to getting tests done because they want to figure out what the hell is wrong with them...frivoulous tests are another story. As for the creme explanation about what to do....well once again the vast majority of the people AREN'T pharmacy students...so it isn't always a given that a person knows. ..it is better to have it explained and have people roll their eyes then to not have it done at all. (Once again..doctor should've probably done it but I've encountered plenty of times where they haven't) It is the same kind of thing on a plane...how many times have you heard the seatbelt, oxygen mask routine and just kind of ignored it...probably a lot because I know I have...but it is better to go over it because there is always the person, that whether it be from pure stupidity or just lack of experience don't know what to do. Pointlessly long post I know...sorry. Anyway. Yes nurses and the like see a lot of the patients for often times a longer period than the doctors...but to me it is the work that goes on behind the scenes where the expertise is needed most. Some people prefer to see doctors that is how it is...heck since my dad was an oldschool MD for a chunk of my life we refused to even go to DOs(since his perspective has changed vastly..but he was going back on the days when it really appeared to be inadequate training compared to MDs)

 

[PhDtoDO]

I was the starter of the DNP verus MD discussion. The thread has enlightened and informed me a lot about the situation. I noticed that someone posted about that and I read up on it. I noticed that a lot of you guys use the sometimes a person just wants to see a doctor arguement. As a pharmacy student looking into medical schools, AND first hand experienced the pains and failure of the healthcare system (i now have tons of medical bills with no results and two huge scarring on my face), I am intrigued and decided to make this second post.

I paid 300 dollars for my dermatology visit each time. Each time (despite the fact that I made my reservations ahead of time), I had to wait approximately 30 minutes. I chose this dermatologist because it is my face and red rashes on the face was not exactly the best way to get a girl. Anyway, after waiting 30 minutes, it is always the medical assistant who comes in and takes down my complaints. The nurses then comes in next to check my symptons. Then I waited some more before the doctor comes in for FIVE FREAKING MINUTEs each time before wrapping things up and ordering tests and labs (w/o consulting me of course) and prescribing me random assortments of creams and ointment before leaving his medical student to wrap up whatever is needed (hydrocortisone shots, wrappings, and blood tests).

Now it can be only this doctor I had the same experience with almost every other doctor that i visisted. Even when i had a bunch of questions, the doctor would be so rushed to leave that it would only allow me to get an extra 5 to 10 minutes.

Now, is it me. . . or even if I DO want to see the doctor, I spend 85 percent of my time with nurses, pa's, and medical assistants instead. If i am lucky. . ., i might get a medical student who can only tell me that the cream the doctor is giving me is a non steroid cream. . . that she repeated 3 to 4 times as if me, a pharmacy student did not know that.

Lets also keep in mind that I have to base my schedule on his which is so ever irregular. . . 99 percent of the time, the doctor is probably away or playing golf.

PS, i am not looking to troll and would appreciate positive feedback to this.[/QUOT



I totally understand your frustration. the second guy had some points though. I have tinitus now...although my hearing has returned after a 2 yr ear infection around the age of 12. I went to my regular pediatrician's office (great practice..but no one is perfect) many times and was finally told that I had an antiB resistant infection and was sent to a specialist. The first specialist made my mom fill out 20 pages of forms...sent me to a hearing test before seeing me then came in and told me I had hearing loss...no treatment (we already knew I had hearing loss). My mom had noticed that there was a big sign on the way in saying free hearing tests and this guy was such an ass...we didn't have health insurance and this guy charged us 150+ for several hours of crap.
THE THIRD SPECIALIST...took one look in my ear and said no wonder...you have a fungal infection (two second diagnosis)...tons of expensive antibiotics courses that would give tenative relief...(antibiotics tend to be antimicrobe) but no cure...two years...and all I needed was a twenty dollar prescription.

I'm not even going to go into how my mom was treated with her emergency open heart surgery/near death experience...being treated like crap for needing 'charity medicine' and our family bankrupty...literal and figurative.

It's worse when its serious and the doctors don't know what the problem is. Most...the vast majority of problems can be treated very well with the present system.

I also have unique skin conditions (the only negative thing on my inheritance of great health genes from my dad...not my mom). I'm severely allergict (can't spell) to poison ivy and oak...potentially life-threating and I have strange skin reactions to medication (which I avoid with good reason) and stress.

Saying all this, I'm finishing my PhD, am rebuilding my house and suing my insurance company...lets just say I'm just taking prescription Claritin to keep the strange not hives/hives (doctor doesn't know) down.

I'm going to med school...but the majority of my health-career friends went to nursing school...and they are way smarter than many of the med students I've come across over the years (I work in a med school). They were turned off by the competitiveness and ego.

My best friend also just had her second baby...and she hated the OB from the first time and had major trust issues with the next. (The first enduced her so he wouldn't have to come in on the weekend).

It's all about the doctor MD or DO....and when you really need one you can trust even if they can't fix your problem, is the worst time to try and find one.

Shop around and don't think that they're all bad. If you think the MDs really can't figure out your problem, go to a homeopath...even acupture has shown positive effects for skin conditions...which are very often infection/hypersensitivety issues.

One of my best friend's husbands...also a best friend...is my all-in-one-source for holistic health info...and he's head of computers/computer programs at a transit company. I'm going to be calling him for info long after I finish med school and residency.

I wish you the best. But, trust me, youre not the only one who feels the effects of the downside of the business of medicine.

PhDtoDO

 

[Empress]

I've said before that patients don't simply want a MD/DO over a NP/PA, they want many different things that any of those can provide. In my own experience it's been a huge variation of the care provided and little to do with the person's title.

My first OB was a prick. The second was worth her weight in gold. My primary care doctor was a saint, and in fact, left private practice to work with uninsured people at a sliding scale clinic. I knew an EM PA who was better than any of the other EM MDs. The first ped neuro I took my daughter to was rushed and did little more then check off a list, and the second ped neuro was a dingbat but had an excellent NP who streamlined her battiness so it was a little easier to swallow (I am looking for another one because of insurance changes, ugh.) The NP I saw as a young adult for minor health issues, like seasonal allergies, was abrupt; the PA who replaced her was technically excellent but didn't inspire a lot of confidence because he was so unsure of himself.

I think we should hold all health care providers regardless of title to a higher standard then we are getting. It's not about midlevels, it's about tolerating mediocrity in MD/DOs as well.

 

[Dr Trek 1]

Doctors work hard at what they do. You are talking about dermatology, and keep in mind that dermatology attracts many physicians who just want a lavish, relaxed lifestyle (of course not all dermatologists are this way, however).

I have nothing against mid level practicioners. Many patients don't even know that their NP/PA is not a physician. However, those who do likely do not understand the difference between a NP/PA and a MD/DO. And, of course, people fear that which they do not understand, so of course these people are more likely to demand seeing a physician.

 

[Aznfarmerboi]

Doctors work hard at what they do. You are talking about dermatology, and keep in mind that dermatology attracts many physicians who just want a lavish, relaxed lifestyle (of course not all dermatologists are this way, however).

I have nothing against mid level practicioners. Many patients don't even know that their NP/PA is not a physician. However, those who do likely do not understand the difference between a NP/PA and a MD/DO. And, of course, people fear that which they do not understand, so of course these people are more likely to demand seeing a physician.

ohh okay thanks.

 

[Empress]

I have nothing against mid level practicioners. Many patients don't even know that their NP/PA is not a physician. However, those who do likely do not understand the difference between a NP/PA and a MD/DO. And, of course, people fear that which they do not understand, so of course these people are more likely to demand seeing a physician.

Ahh, another "patients are stupid, and don't know any better," statement. No wonder patients are so frustrated with healthcare with all the paternalism going around.

 

[scpod]

Ahh, another "patients are stupid, and don't know any better," statement. No wonder patients are so frustrated with healthcare with all the paternalism going around.

Patients are stupid, but it's not really their fault. They've been sold on the current insurance sytem. They really have no idea how much they are paying for healthcare. If they were smart, they would buy an extremely cheap policy that pays only for catastrophic events (hospital stays) and use a health savings plan for "fee for service" payments with the physician of their choice.

 

[Jack Daniel]

Patients are stupid, but it's not really their fault. They've been sold on the current insurance sytem. They really have no idea how much they are paying for healthcare. If they were smart, they would buy an extremely cheap policy that pays only for catastrophic events (hospital stays) and use a health savings plan for "fee for service" payments with the physician of their choice.

I agree with the essence of the insurance/fee-for-service plan that you describe. Unfortunatey, I think it's challenging to find out how much a physician will charge for a particular service because few, if any, posts his or her fees. Our current system just isn't set up to allow people the option of "shopping" around for the best price.

 

[Dr Trek 1]

Ahh, another "patients are stupid, and don't know any better," statement. No wonder patients are so frustrated with healthcare with all the paternalism going around.

You are missing my point entirely. Patients are certainly not stupid, they just misinformed at times.

 

[steponie]

I grew up going to an Indian Hospital. Waiting 30 mins for an appt is NOTHING compared to getting there at 8am with the hopes of being seen by a Dr by 3pm that afternoon.

You really think a Dr. just wants to spend 5 mins w/ their patients??? You DO realize that hospitals and patient care groups pressure docs to see as many patients in a day as humanly possible, and the docs that spend too much time w/ any given patient actually gets written up or reprimanded by the admin. You surely understand that insurance companies that pay 30% of the actual cost of medical care (set by medicare) have pushed docs to practice in a money-first state. No, it isn't fair, to either doctor OR patient, but unless we force our legislature to fix things, it isn't going away either.

I work in a Drs office, and for every second the Dr. is not in an exam room w/ a patient, they are covering their assets by documenting EVERYTHING to prevent being sued by some patient, or returning calls from referral docs, or approving Rxs over the phone w/ pharmacies, or analyzing test results, etc. I don't know ANY docs that actually spend the afternoon golfing. That is a great lie that TV has sold us, but don't believe it.

You get what you pay for. It is very sad, but the uninsured only get what the current system gives them. Also, I seriously DOUBT that Dr. was the one that billed your mom $150 for a hearing test, simply because the Dr. usually doesn't have time to do the billing. That is what the recepionist and/or Accounts Receivable is for. Everyone wants to blame the doc for every single thing, but in an office, the doc is usually so tied up w/ patients and charting, that is all they actually do. That nursing staff that you are complaining about seeing all the time are actually very happy to have jobs and grateful to have the opportunity to do the small stuff so that the doctor can focus on actually figuring out what is wrong w/ you. As a pharmacist-to-be I bet you won't be complaining too much when you have someone filling bottles, checking drug interactions, calling insurance companies, confirming w/ drs offices, etc, so that you can actually mix the meds like you were hired to do!

Yes, there are a few people that become docs bcs of the pay. But I can tell you right now, the people I go to medical school with are some of the most caring, giving people you will ever meet. Alot of us spend time volunteering our services around the world in underdeveloped, underpriviledged communities. Most of us, just to qualify to get in, had to prove that we were humanitarian at heart, by showing YEARS of volunteer work in our communities. And honestly, just because you have had a few bad experiences with apples going bad, do you stop eating apples all together??? Do you protest apples, insist apples are out to destroy the world by spoiling just as you try to eat them, that all apples hate you and want to see you miserable?!? How ridiculous that sounds!!

People often make the mistake of thinking those that become doctors are somehow better people and should therefore be held to higher standards than the rest. In medical school, they teach you that you are more accountable for your actions than others because the decisions you make effect peoples' lives. But the truth is, we can only work within the boundaries that society has placed us in. You cannot tie the hands of the doctor by giving all control and power to the insurance companies and lawyers, then expect the doctor to stand solely responsible for the resulting failures in medical care. You as a voter must take some of that blame. You as a society must carry some of the burden to make medical care CARING again. By choosing a doctor that you can trust, that your personality meshes with, and staying loyal to that doctor, you are sending a signal to all the other doctors that you are not a SHOPPER, you are a PERSON that expects respect and loyalty in return. By voting for representatives, senators, and judges that care about torte reform, changing the face of the mobsters you call insurance companies, and protecting physicians from frivolous lawsuits, you are sending a signal to the government that you are not a POLICY, you are a PATIENT that expects competent and affordable healthcare.

Okay, stepping off the soapbox.

 

[Empress]

Patients are stupid, but it's not really their fault. They've been sold on the current insurance sytem. They really have no idea how much they are paying for healthcare. If they were smart, they would buy an extremely cheap policy that pays only for catastrophic events (hospital stays) and use a health savings plan for "fee for service" payments with the physician of their choice.

Oh yes, we do know. Especially the working class/lower middle income families who have children. We know exactly how much it can cost if we don't have adequate coverage, and even the costs with decent insurance. Group insurance is your best bet if you have any pre-existing conditions in your family, private insurance does not have to cover you. And if you have kids, unless you absolutely cannot get any group insurance, it would be beyond stupid to do the catestrophic thing. You cannot predict what your child is going to need. People would rather use the money in a HSA for real savings account. They don't rollover, and when you need the money it takes too freaking long.

Many people, your future patients, know the score and are doing the best they can under the circumstances. Don't patronize them, which is exactly what you're doing with your above statement.