Doctor or a Physician Assistant

[schwarz]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.

[retiredguy123]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.
That has become very common in the last several years. One reason is that insurance companies will pay the same amount to see a PA as they will to see a doctor, even though the doctor makes a lot more money than the PA. So, the doctor gets paid to do nothing more than to oversee the work of a PA. I agree that I would rather see a medical doctor than a physician's assistant. But, I don't think the trend will be reversed unless the insurance companies change the way they pay claims. But, when my doctor wants to schedule a phone call to tell me my lab results, and charge the same amount as an office visit, I refuse and insist on an in-person visit.

[Stu from NYC]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.

We have seen this with specialist a gastroenterologist. The PA was very knowledgable and spent a lot of time with my wife so was ok with it. However for a serious ongoing condition would insist on seeing Dr.

[DAVES]

Solution, I don't have one. Like most things no shortage of conflicting information.
People in medicine even have a name for it GOOGLE MEDICINE. Controls, your doctor can only write prescriptions for a period of time. Medicare and or insurance insist you see the doctor to get another prescription. In many cases unless you have died, you will need that prescription. In many cases, if, you died the office staff probably will not take the time to discover that.
Nurse practitioner? My doctor found some guy right out of school. Pleasant enough, truth he did not know what he was talking about.
Staff? We have no record that you.............. HUM, false name, Mildred we called the office list of times dates etc. In fact we drove over there and I personally handed it to YOU.
Sadly, it is clearly a problem. Sadly, it does not seem to be getting better. There are only so many hours in a day. Doctors and patients are both on an overloaded tread mill.

[DAVES]

That has become very common in the last several years. One reason is that insurance companies will pay the same amount to see a PA as they will to see a doctor, even though the doctor makes a lot more money than the PA. So, the doctor gets paid to do nothing more than to oversee the work of a PA. I agree that I would rather see a medical doctor than a physician's assistant. But, I don't think the trend will be reversed unless the insurance companies change the way they pay claims. But, when my doctor wants to schedule a phone call to tell me my lab results, and charge the same amount as an office visit, I refuse and insist on an in-person visit.

Re: lab results
Your doctor may need to fill out some form. You can set up an account with the lab to see YOUR, test results.
Test results. Stuff like blood tests the report says your count was ....... normal range is ........... If, outside of normal it will clearly show that. Many tests before changing meds etc, they will watch it

[OrangeBlossomBaby]

I'm fine with the PAs at The Villages Health. I like my doctor as well. The PAs are qualified to do almost everything the doctor can do. Not all of it, but almost. So as long as I'm there for just a routine visit, or if I needed basic wound care, I'll be happy with the PA if the doctor isn't available for the appointment.

[retiredguy123]

Re: lab results
Your doctor may need to fill out some form. You can set up an account with the lab to see YOUR, test results.
Test results. Stuff like blood tests the report says your count was ....... normal range is ........... If, outside of normal it will clearly show that. Many tests before changing meds etc, they will watch it
I do get my own lab results. But, the doctor wants to call to explain the results in a 5 minute phone call where I need to pay a $25 copay, and he gets $100 for an office visit. I refuse to do that.

[OrangeBlossomBaby]

I do get my own lab results. But, the doctor wants to call to explain the results in a 5 minute phone call where I need to pay a $25 copay, and he gets $100 for an office visit. I refuse to do that.

Wow that's a bum deal. My doctor explains the results when I go in for my yearly checkup. I get the bloodwork done the week prior to the checkup. CBCs, nutrition panel, and full thyroid panel with the free T-3 or 4 or whatever it is, because I only have half of a functioning thyroid and have to monitor it. The yearly checkup has a $0 copay, it's a service covered 100% by my insurance.

[Stu from NYC]

We see our Dr every 6 months and get bloodwork done a week before and see the results before seeing the DR and discuss results at office appt.

[ThirdOfFive]

Like some who have posted, I have no problem being seen by a P.A. I DO have a problem paying Doctor prices for P.A. service.

That said, I recognize that America has a doctor shortage particularly in non-specialist areas, so I believe that seeing a P.A. instead of a doctor will be more and more frequent.

[Villages Kahuna]

Your doctor should schedule you with him least once per year. Having said that I have found seeing his PA perfectly adequate. It takes lots of training and eduction to become a PA. They're quite knowledgeable.

[retiredguy123]

Your doctor should schedule you with him least once per year. Having said that I have found seeing his PA perfectly adequate. It takes lots of training and eduction to become a PA. They're quite knowledgeable.
I agree. But, maybe things have changed. I have always considered a medical doctor to be someone with more than just knowledge. The title of doctor identifies him/her as a person who has chosen a life long reputable and trusted profession. If the medical industry wants patients to trust and rely on "physicians assistants" in a similar manner, I think they should change their name and responsibilities. Also, they should have personal liability for their job performance. Otherwise, they are just assisting real doctors, and their work should not be billed at the same rate as a doctor.

[gatorbill1]

I have United Healthcare and see my doctor every six months with blood done before meeting. Have read in past posts that The Villages health will put you off to a PA after seeing your doctor once.

[retiredguy123]

I have United Healthcare and see my doctor every six months with blood done before meeting. Have read in past posts that The Villages health will put you off to a PA after seeing your doctor once.
Putting you off is a good way to describe it.

[Altavia]

As in most things, it comes down to the individual.

NP vs. PA: Key Differences

Nurse Practitioner vs Physician Assistant: Key Differences (https://www.usa.edu/blog/np-vs-pa/)

The two most fundamental differences between NPs and PAs are the training they receive and the environments where they work.

Nurse practitioners are trained in the advanced practice of nursing, where they focus on a specialized role, such as that of neonatal nurse practitioner.

Physician assistants, on the other hand, are educated in general medicine; their training follows the medical model and covers all foundational aspects of medicine and specialties.

[davem4616]

nothing against a PA, but like the OP said, they are not a doctor

we switched to a different neurologist for my wife when we arrived for an appointment with the MD and we were told that we would be seeing his new PA

these doctors are 'fishing in a barrel' here in TV... we now use a couple that are outside TV and are quite pleased with them

[NotGolfer]

I have an ARNP that I see all the time....she great! The Dr. assigned to her I reluctantly see. In many cases nurse practitioners know ALOT.

[Two Bills]

If the US is looking to strengthen its borders, I would recommend my doctors receptionist to become a guard.
No one gets past her!:icon_wink:

[PugMom]

I'm fine with the PAs at The Villages Health. I like my doctor as well. The PAs are qualified to do almost everything the doctor can do. Not all of it, but almost. So as long as I'm there for just a routine visit, or if I needed basic wound care, I'll be happy with the PA if the doctor isn't available for the appointment.

i find sometimes the pa knows just as much, if not a bit more than the actual dr. op needs to get to know their pa, it's the common link between dr & patient

[blueash]

i find sometimes the pa knows just as much, if not a bit more than the actual dr. op needs to get to know their pa, it's the common link between dr & patient

If your PA knows as much or more than the "actual dr" you need to find a new doctor. There is nothing similar in the intensity of training. The actual doctor, if this means a board certified medical physician did four years of college then four years of medical school. Two years were basic medical science, learning human anatomy, pathology, microbiology, embryology, physiology etc, then two full years of hospital/ambulatory patient exposure for far greater than the 8 hr work day. Then three to seven or more years of intensive training in a field.

Your nurse practitioner did an undergrad nursing program then a two year nursing master program. Several of these programs have elected to grant their graduates a doctor of nursing degree. Be careful. The health care person being introduced as Dr. Smith may be a nurse. Nothing changed in the program except the title being bestowed. Much of the advanced training is focused on nursing issues, designing nursing plans etc. There is a requirement of clinical time which is less than one year of patient interaction. The link above says 500 hrs of clinical. That should frighten you.

Do you want to see a doctor who spent 3 months learning patient care? Just 3 months.

The PA program has a 2000 hr requirement. That is one year at 40 hr/wk. Now your "actual doctor" spent at a minimum five years learning clinical medicine and their week was longer than 40/wk. So if you believe your PA knows more clinical medicine than the doctor, something is very wrong with the training of your doctor.

[Luggage]

I was actually denied insurance claim, when the PA saw my wife. I had to go to the office manager to get it straightened out. It's very similar to going to a university and paying $100,000 a year to get to it, but most of the lectures are only taughtt by the assistants . It's very unethical in my mind and not very safe has certainly the doctor can see and hear things and an assistant cannot because of the extra years of experience they have.

[Luggage]

Pennywise and pound foolish if you don't go to the doctor for the 25 bucks. He spent half a million dollars on his education and you should take advantage of it. Every time I go to my doctor I learn something new. And if you're worried about the $25 you have the wrong insurance as there are plenty of insurers advantage plans with zero copay for primaries. And in fact for certain things like psychologists you can go every day of the week for free if you need medical and help.

[GizmoWhiskers]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.

Yes, happened to my parents in TV healthcare as well with no warning.

[rustyp]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.

I also belong to The Villages health system. If the staff books me a PA for a scheduled visit they always ask if I was willing to see the PA instead of the doctor. Once I asked what would happen if I was not willing to see the PA. They replied we will simply give you a different appointment that coincides with the doctor's schedule.

[Travelhunter123]

Solution, I don't have one. Like most things no shortage of conflicting information.
People in medicine even have a name for it GOOGLE MEDICINE. Controls, your doctor can only write prescriptions for a period of time. Medicare and or insurance insist you see the doctor to get another prescription. In many cases unless you have died, you will need that prescription. In many cases, if, you died the office staff probably will not take the time to discover that.
Nurse practitioner? My doctor found some guy right out of school. Pleasant enough, truth he did not know what he was talking about.
Staff? We have no record that you.............. HUM, false name, Mildred we called the office list of times dates etc. In fact we drove over there and I personally handed it to YOU.
Sadly, it is clearly a problem. Sadly, it does not seem to be getting better. There are only so many hours in a day. Doctors and patients are both on an overloaded tread mill.

Well said: all of these happened to me

[Altavia]

It's not all about education. I've seen RN's save a patient in the hospital from the Doctor more than once.

[Travelhunter123]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.

In the Brownwood location, there has been a “turnover” of doctors In the last 4 years I have had 5 Doctors, one only lasted 3 months
They schedule PA visits while they wait for the replacement Doctors to arrive

[Chloe Girl]

nothing against a PA, but like the OP said, they are not a doctor

we switched to a different neurologist for my wife when we arrived for an appointment with the MD and we were told that we would be seeing his new PA

these doctors are 'fishing in a barrel' here in TV... we now use a couple that are outside TV and are quite pleased with them
I have United Health Care and was under the impression that you had to see your doctor at least once a year. Fortunately I don't have any health issues at this time so l'm OK seeing the PA. When I was going to have surgery, I went for my pre-op tests and my doctor came in and asked if I had a cardiologist. Something was seen on my EKG that she didn't like. Turns out it was nothing but it made me feel good to know that she was called immediately when there may have been a problem. You can always request that you see your PC at every visit but you may have to wait awhile for an appointment.

[banjobob]

Thats the way it works , for routine blood work analysis why not just have a phone visit to review your results. Making an appointment to see them is a waste of time and money unless you are ill. An Yearly physical examine should be done by the doctor.

[NoMo50]

These scenarios are particularly acute within dermatology practices. For your routine visits, you are going to draw one of the PA's. However, I have found this to be just fine. The PA I see at Alliant Dermatology is thoroughly professional, and is very focused on her patients. The MDs stay plenty busy fielding more serious concerns and procedures, such as MOHS surgeries. In this environment, a good PA is more than acceptable.

[donfey]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.

Our primary care MD at The Villages Health has an EXCELLENT PA assisting him. She is very personable and we feel confident that the care we receive is top notch. Having a competent PA allows both of them to spend more time with patients. We never feel rushed - a definite plus. I wouldn't worry.

[Gunny2403]

I haven’t seen my Dermatologist for 4 years. The PA is awesome and I prefer to see her.

[airstreamingypsy]

My "doctor" is a PA. I don't have a doctor.

[MandoMan]

Like some who have posted, I have no problem being seen by a P.A. I DO have a problem paying Doctor prices for P.A. service.

That said, I recognize that America has a doctor shortage particularly in non-specialist areas, so I believe that seeing a P.A. instead of a doctor will be more and more frequent.

I had a total hip replacement four months ago. The hospital and the doctors and physical therapists combined billed around $100,000. I have Medicare backed up with Blue Cross. The two combined paid about ten cents on the dollar and didn’t allow most of those charges to be passed on to me. I’ve been personally billed, I think, $233. My surgeon was paid about $2,500, and out of that he has to pay his staff and pay for his office building. The physical therapists got about $35 from insurance for each intensive two hour session and I paid nothing. They could probably make more money giving massages or manicures. I don’t really see how doctors and hospitals stay in business given what they are paid by insurance. I do understand why it’s a nurse who generally takes my blood pressure and goes through my meds and medical history and all, which the doctor then looks at on an iPad. I’m glad that so much of medical history-taking is now done with the aid of computer programs that advise what questions to ask. This lets doctors who ranked low in their graduating class discover problems that used to be noticed only by the best diagnosticians. It lets nurses and PAs do much the same while keeping down health care costs.

[OhioBuckeye]

Just so somebody doesn’t remind me that I live in Texas, I know that & yes it’s the same way here in Texas. I’m on heart medicine & if I didn’t see my Dr. for 6 months they ask me to come in to the office so they can collect money from my Ins. Co. but a lot of the time I see a PA.

[mrlee]

I won't mention who my doctor is. But I was always seeing a PA on my visits.
After a couple of years I asked if the Doctor had retired. I was told no, but if I wanted to see him all I had to do was request to do so. I have had all of my visit scheduled with him with no problem. By the way he is a great doctor and I am glad he shares the results of my testing with me.

[Arlington2]

I see my primary MD once a year and his PA in between at The Villages Health. Since I am in pretty good health it is actually a waste of the MD's time with his visits. My blood test results are available to me before my visit so I have a preview of any potential problems. The PA asks the same questions as the MD. I very much like my MD so an annual social visit is nice, but personally I don't need the hand holding of an MD. I also like the PA's I have seen. They are very competent. If I had medical issues that required semi-annual changes in meds I might have a different view.

[Oldragbagger]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.
I just saw the Nurse practitioner at Pinellas this week and she was WONDERFUL. As a matter of fact I commented to the girl at checkout that I wouldn’t mind if she were my primary. They do communicate with the doctors and I am sure would quickly obtain help if you needed something that was beyond their scope.

[Atamasco]

Re: lab results
Your doctor may need to fill out some form. You can set up an account with the lab to see YOUR, test results.
Test results. Stuff like blood tests the report says your count was ....... normal range is ........... If, outside of normal it will clearly show that. Many tests before changing meds etc, they will watch it

I go to Quest for my lab work; they email the same results that they send to my doctor. I just ask them to do it and they do.

[Notsocrates]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.

The care you get from a PA should be the same as you would have from an MD. If
the care was inferior you would be justified to complain. PAs are trained in the same
medicine and practice in collaboration with MDs. I have often read that
patients are happier seeing PAs because they don't rush visits and take time to answer questions.

[mkjelenbaas]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.
You have a decision to make and I would not rely on input from this type of forum!

[thevillages2013]

Last time I saw my doctor at United Healthcare of the Villages I was told that I would be seeing his PA for my next six month visit, and perhaps for other future visits. This was disappointing as my understanding when I joined was that I would always see a doctor. I am sure that the PA is nice and communicating with my doctor but she is NOT a doctor.
Has anyone else experienced this yet? I was basically told that since I am healthy, he could spend more time with other less healthy patients.
I drink to your health:coolsmiley:

[thevillages2013]

You have a decision to make and I would not rely on input from this type of forum!

Easy now. Don’t be so hasty there are a few doctors that are regulars on here. SOME of them actually sound intelligent :popcorn:

[mlmarr]

be happy you're getting treatment .. A PA has plenty of education to handle this position, with all patients being reviews by your PCP

[markusmom]

My son is a doctor. The first two years of medical school is lecture and book work, the next two years are rotations, working with different specialists getting hands on experience participating in surgeries, observing and helping with the diagnosis of an illness or disease, stitching a wound, recognizing symptoms and learning how to treat them. Then on to at least 3 years of specialized training in their field. Someone with a PA degree completes the first two years of medical school, lectures and bookwork. They gain most of their experience while working in the doctor's office. As for "having time" to spend with the patient, that is a characteristic of the person not the degree.

[dewilson58]

Someone with a PA degree completes the first two years of medical school, lectures and bookwork. They gain most of their experience while working in the doctor's office.

So does a doctor.

[JMintzer]

So does a doctor.

Never go to the Hospital in July...

That's when the new Medical Residents show up... :eek::eek::eek:

[mgkw1]

My doctor has a PA that sees patients for follow up visits or illness visits. My yearly have always been with my doctor. The PA I see if wonderful, he is knowledgeable, asks the right questions and has always been spot on with treatment. In Jan I got covid and the Dr was not available, I dealt with his NP. Not having had good experiences with them in the past I was apprehensive. This woman was wonderful, She listened ...... Not just oh these are your symptoms, lets see what the book says. I can honestly say I like my physician, PA and NP. I must be one of the lucky ones

[Golfer222]

As a physician, I have worked with many PAs and NPs. Some are very good and some are very bad. But even the best are not even close to a physician. They lack the rigorous training ( both didactic and clinical) required to be a doctor. I did 4 years of medical school, 3 years of residency and 4 years of fellowship to subspecialize.
Even the most simple symptoms requires a differential diagnosis to exclude rare diseases. This is where I see the most difference. Most Pas and NPs will think of the top couple of diagnoses ( which are usually correct) but fail to exclude more rare causes, which can be fatal if not recognized. Essentially, they do not know what they do not know. Most URIs leave the office with a z-pack and a medrol dose pack , even though it is a viral illness. For any medical appointment I have, I always request a physician. If the office says I have to see a PA/NP, I politely decline and look elsewhere. Just my 2 cents from being in the trenches

[Golfer222]

Also, you have a right to determine who you see, although it may mean a later appointment

[Golfer222]

Would you want your plane flown by a "Pilot assistant" with 1/100 of the training of a certified pilot?

[OrangeBlossomBaby]

As a physician, I have worked with many PAs and NPs. Some are very good and some are very bad. But even the best are not even close to a physician. They lack the rigorous training ( both didactic and clinical) required to be a doctor. I did 4 years of medical school, 3 years of residency and 4 years of fellowship to subspecialize.
Even the most simple symptoms requires a differential diagnosis to exclude rare diseases. This is where I see the most difference. Most Pas and NPs will think of the top couple of diagnoses ( which are usually correct) but fail to exclude more rare causes, which can be fatal if not recognized. Essentially, they do not know what they do not know. Most URIs leave the office with a z-pack and a medrol dose pack , even though it is a viral illness. For any medical appointment I have, I always request a physician. If the office says I have to see a PA/NP, I politely decline and look elsewhere. Just my 2 cents from being in the trenches

If I come in with an angry wound on my arm from a cut that is taking too long to heal and looks to have a bit of pus forming on one end, I'm going to trust the PA to a) assess that yes, it's an angry wound, b) it should/shouldn't need stitches, and c) it's definitely infected.

Other than the stitches, it's something even I, with no medical school at all, can figure out.

I'll trust the PA to a) clean the wound, b) stitch or not, depending on what it needs, c) dress the wound, and d) send me home with an rx for antibiotics OR give me an antibiotic shot if he/she thinks it's necessary OR recommend I redress with antibiotic ointment a few times a day for the next few days.

I'll trust that the PA is sufficiently trained in basic first aid and non-emergency wound care.

I'll also trust that if I insisted that only an MD could possibly handle this, the MD would likely be really annoyed that I wasted his/her time with a cut when the PA was perfectly capable of handling it.