Air Force Where are the physicians?

[astrostellar]

Just trying to gauge if this is a common experience. I'm stationed at a pretty large base, but I can't remember the last time I saw a physician at our hospital, with the exception of the handful of psychiatrists sprinkled in with the psychologists at mental health. Between OB/GYN, family health and the emergency department, I haven't seen a single non-mid-level practitioner. I know there must be some. I was particularly surprised about the ED being run by a PA the last time I was there.


Physicians must get stationed here, right? Where are they hiding?

---

Members don't see this ad.

 

[HighPriest]

They're all doing administrative work. Good luck.

 

[Perrotfish]

Just trying to gauge if this is a common experience. I'm stationed at a pretty large base, but I can't remember the last time I saw a physician at our hospital, with the exception of the handful of psychiatrists sprinkled in with the psychologists at mental health. Between OB/GYN, family health and the emergency department, I haven't seen a single non-mid-level practitioner. I know there must be some. I was particularly surprised about the ED being run by a PA the last time I was there.


Physicians must get stationed here, right? Where are they hiding?

The large bases, and particular the big hospitals, tend to attract older, higher ranked physicians. That means they are both better at lobbying for resources (more midlevels per patient) and are forced to do much more admin (fewer patient care hours per physician). So you see.midlevels and the doctors go to meetings.

If you want to see an actual doctor, as a patient, go to a smaller, crappier base. In my middle of nowhere base we have multiple doctors per mid-level, and the midlevels who are here are mostly higher ranked active duty midlevels who are here mainly to do admin.

 

[Atlas Shrugged]

Or just schedule an appointment with a physician. It is your right as a patient.

 

[HighPriest]

Or just schedule an appointment with a physician. It is your right as a patient.

No, it isn't. I've tried. Tricare can and will deny this. I had no choice but to see a PA.

 

[astrostellar]

No, it isn't. I've tried. Tricare can and will deny this. I had no choice but to see a PA.

I've been wanting to ditch my PA for a while now (for many, many reasons) and the only thing they've offered me is another PA. To be honest, I wanted to use the switch as an opportunity make MD/DO contacts for shadowing opportunities, but that seems pretty impossible.

 

[Homunculus]

Just trying to gauge if this is a common experience. I'm stationed at a pretty large base, but I can't remember the last time I saw a physician at our hospital, with the exception of the handful of psychiatrists sprinkled in with the psychologists at mental health. Between OB/GYN, family health and the emergency department, I haven't seen a single non-mid-level practitioner. I know there must be some. I was particularly surprised about the ED being run by a PA the last time I was there.


Physicians must get stationed here, right? Where are they hiding?

where are you?

--your friendly neighborhood they're around you just need to know where to look caveman

 

[HighPriest]

I've been wanting to ditch my PA for a while now (for many, many reasons) and the only thing they've offered me is another PA. To be honest, I wanted to use the switch as an opportunity make MD/DO contacts for shadowing opportunities, but that seems pretty impossible.

Yep. To begin with I was told all the way down the line that I wasn't allowed to see anyone but the guy I was assigned. I tried changing providers online (easy for my wife, but I was denied any change at all), tried changing over the phone, tried changing in person at the office. Every time I was told that was not allowed. It started to make sense, why people just go to the ER for basic medical problems. If you don't like or trust your provider, what else can you do? And of course, 3/4 of the staff were PAs or NPs anyway...plus one doc who I know from her consults was worse than any of them. So who knows if I would have done any better. I didn't know any of the other docs well at my assigned clinic, or I suppose I could have used a backside to get seen, but to be honest I prefer having a PCP that I don't have a beer with on the weekends.

 

[BlackFrancis33]

Where is this military hospital with more PAs than physicians? I haven't been to a large MEDCEN where that is the case. There are services (ortho) with a few PAs, but physicians are delivering most of the care in my large MEDCEN.

 

[HighPriest]

Well, the one to which I was referring was in TX. It wasn't SAMC. It is possible that overall there were more MD/DOs, but that wasn't the case in the clinic to which I was assigned. Or, at least, when I was presented with a list of options, most of those options were PAs/NPs. It is possible that I just wasn't provided the full breadth of options. But it was moot anyway, as I wasn't allowed to change providers. Certainly the vast majority of consults I reviewed were from mid-levels, but of course that is heavily biased.

 

[haujun]

PAs definitely enjoy more autonomy in the military and get surprised when they get out to work in civilian sector requiring more supervision by physicians.

Examine MTOE to determine required number of physicians per unit, base etc...

 

[deleted480308]

PAs definitely enjoy more autonomy in the military and get surprised when they get out to work in civilian sector requiring more supervision by physicians.

Examine MTOE to determine required number of physicians per unit, base etc...

I explained that to an active PA at bolc and they thought I was being mean to them. I was really just saying if they want to be independent today in most states they have to stay in the active army. I thought that was bad for different reasons that the PA did, but it's accurate

 

[BlackFrancis33]

OK, I have also been at a TX hospital, not SAMMC, where much of the primary care from outlying clinics is provided by PAs. While there reviewing and seeing consults, this did often result in over-consulting for problems family physicians handle on their own. In the hospital itself, the majority of the work was done by physicians in all hospitals.

 

[HighPriest]

OK, I have also been at a TX hospital, not SAMMC, where much of the primary care from outlying clinics is provided by PAs. While there reviewing and seeing consults, this did often result in over-consulting for problems family physicians handle on their own. In the hospital itself, the majority of the work was done by physicians in all hospitals.

Certainly the impatient work was done almost exclusively be physicians. And, as I said, it is possible that when presented a list of optional providers they simply included only a few MD/DOs and the rest were mid-levels. I don't know how that works. It is possible that they only show providers who have available time. But my clinic was in the hospital, and that list was almost entirely PAs. In any case, it wouldn't have mattered if it was 100 MDs from Johns-Hopkins and one PA, because I wasn't allow d to change providers.