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Cyborg Ninja

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I have Crohn's Disease with several feet of narrowed intestine in my terminal ileum. So narrowed it came up as a "string sign" on my SBFT. I go to a campus clinic at my university and ask for a referral to a GI. I had had another GI that I was referred to by a surgeon that I had for an appendectomy, but I wasn't entirely comfortable with him.

They have an office worker at the clinic who sets up these referrals, and I don't know how much access she really has to individual cases, as these records might be private even to her. She actually sets me up for an appointment with a Nurse Practitioner without telling me it was a NP and not a physician. When I saw her, she never told me she was a NP and I didn't figure it out until days later. I'm not even sure the doctor was there that day, and I'm not sure if she actually consulted with him/her. She couldn't even spell a medicine in a script she wrote for me correctly. It was an anti-inflammatory even though I was on something similarly useless, because my colonoscopy showed my disease was quiescent (meaning the narrowing is fibrotic and not from inflammation). My SED rates have all been normal and so were my WBC counts. Granted, the previous GI had made the same mistake by dismissing this as a cookbook case where you can just say "Has Crohn's, pick one of these medicines and then something stronger if that doesn't work." It's not that simple.

While I'm not in the field of medicine, and don't know much, I feel like this is a case that is beyond the scope of a NP, even if she does specialize in Gastroenterology. I thought that all a NP in this field would see would be the numerous cases of IBS, food poisoning, routine colonoscopy followups, etc. Maybe even for checkups on IBD patients to keep them on the right medication. But I figured with cases of complications this would be too far. Am I right to assume that, or am I just being a jerk? She's a nice person and all, but I feel like I'm getting ripped off and neglected here.
 

Blue Dog

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IMO, if you want to see a doctor, you should say so. You're paying for it, after all. If they're too busy to have an MD see you, go elsewhere.
 

fab4fan

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Agree with Kent.

Several years ago, my father experienced an onset of chest pain while mowing the lawn. He had classic sx of angina. Ate a whole pack of TUMS ("It's just a little indigestion.") Stubborn man, refused to go to the ED but did agree with seeing the doctor.

I called the doc's office, and the receptionist said, "Well, I can put him in with "Michael Smith" tomorrow. I knew he was a PA, so I said, "No, he needs to be seen by a physician. This is a new onset of chest pain and he has several risk factors for heart disease." Then the receptionist said, "Well, I can have him see 'McDaniels' tomorrow. I said, "Is 'McDaniels' a doctor?" She said, "No, she's an NP." By that point I was fuming. I said, "Listen. My father is having a new onset of chest pain. He multiple risk factors. He is having classic symptoms of an impending MI. He needs to be seen NOW by a DOCTOR!"

She very begrudgingly gave me an appt. with a real doctor. Dad would up with an emergency cardiac cath, stent placement for 90% occlusion of the LAD.

Sometimes, you just have to be flat out bossy. If you want to be seen by a doctor, be firm about it. Don't take "no" for an answer. If your doctor's office keeps trying to palm you off on a midlevel when you feel your problem is serious enough to require a physician, get a new doctor.

(Don't get me started on how exasperated I was with my father for refusing to go to the ED...that's a whole 'nother matter. When they talk about denial as a hallmark sign of an MI, they're not kidding.)
 
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Cyborg Ninja

Cyborg Ninja

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I'm sorry about your dad having to go through so much. You'd think he'd listen to his kid who obviously has a medical background, right? Oh well, parents...

What my question really is whether or not people here think my case is serious enough that it should be seen only by a physician, not whether or not it's my personal preference. I'm not in the field of medicine, so that's why I'm asking here.
 

Faebinder

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Cyborg Ninja said:
I'm sorry about your dad having to go through so much. You'd think he'd listen to his kid who obviously has a medical background, right? Oh well, parents...

What my question really is whether or not people here think my case is serious enough that it should be seen only by a physician, not whether or not it's my personal preference. I'm not in the field of medicine, so that's why I'm asking here.

Listen... Cyborg....

No one here and not even a gastroenterologist on SDN can tell you if you need to see an NP over a specialist because we dont have the whole picture but.... everyone here can tell you... a gastroenterologist will know more about crohn's dz than an NP and will have more experience with it.....

So.... what do you think you should do?
 

DrMom

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this is not a site for medical advice. closing.
 
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