[Shimpy]

Can a doctor be sued for malpractice if he has never seen the patient? Isn't he responsible for his PA who actually represents him? If so I'd say he can be held liable. If he could be legally responsible than I'd put a lot more faith in the PA, otherwise we're paying for a doctor and not getting one.

[skyguy79]

If anyone has any concerns about PA, they should talk to their doctor with those concerns instead of drawing conclusions from the opinions, conjectures or concerns of others that may lead a person to misconceptions about the profession. In the mean time, if one's truly interested in learning about PA's and the role they play, there's plenty of good information and facts to be had at the American Academy of Physicians Assistant's website. Here is the link to that information:

AAPA | What is a PA?

Excerpts from the website:

"The physician assistant (PA) profession was founded on — and remains committed to — the concept of team practice. Working in all medical and surgical specialties, physician-PA teams enhance coordination and quality of care. The physician-PA team is effective because of the similarities in physician and PA training, the PA profession’s commitment to practice with supervision and the efficiencies created by utilizing the strengths of each professional in the clinical practice setting."

"PAs extend the care that physicians provide and increase access to care. Studies have consistently shown that PAs provide high-quality care with outcomes similar to physician-provided care. Additionally, studies have shown that incorporating PAs into office or hospital practice can improve outcomes. Studies have also shown that patients are just as satisfied with medical care provided by PAs as with that provided by doctors and do not distinguish between types of care providers."

"PAs have been recognized by Congress and the President as crucial to improving U.S. healthcare. In the Patient Protection and Affordable Care Act, Congress recognized PAs as one of three healthcare professions in primary care."

[Villages PL]

Originally Posted by skyguy79

[SIZE=3]If anyone has any concerns about PA, they should talk to their doctor with those concerns instead of drawing conclusions from the opinions, conjectures or concerns of others that may lead a person to misconceptions about the profession.

The Villages/USF Health Alliance gave many lectures far in advance of the first clinic opening. Also, the Daily Sun devoted at least one full page per week on Sunday. That effort was to provide information so that Villagers would know what kind of care to expect from this new "revolutionary" health care system. They didn't say, "if anyone has concerns about PA, they should talk to their doctor with those concerns instead of drawing conclusions from the opinions, conjectures or concerns of others that may lead a person to misconceptions about the profession."

To say that we would need to wait for the clinics to open, then join, and then ask our doctor how this system would work, reminds me of someone who once said, "If you want to know what's in the bill, you have to sign it first." It's disingenuous. A lot of people had good reason for wanting to know in advance how it would work because they would have to leave their current doctor in order to make the change to a clinic doctor. The fact that they might often be expected to see a P.A. instead of their doctor might have kept them from joining. They were deprived of that choice, the choice of not joining. Maybe it was more convenient for this new healthcare system to promote the following misconception: "If you like your doctor, you can keep your doctor." But as we now see, you will be expected to visit with a P.A. when they decide it to be appropriate. You will be expected to flow with the system as they have designed it.

[mflasch]

When I started this thread, I was just stating my disappointment with the fact that after all that has been hyped about this new healthcare delivery model appeared to be just that, hype, since I couldn't get an appointment for 5 months. As a f/u to that, I called a physician's office in Lake Sumter who was highly recommended and they got me an appointment in two weeks.
BTW, thanks to the poster who informed me that Marcus Welby is a fictional character. Can you imagine my disappointment when I went and he didn't show up?

[ilovetv]

Originally Posted by Villages PL

.......But as we now see, you will be expected to see a P.A. when they decide it to be appropriate. You will be expected to flow with the system as they have designed it.

Yes. And when a person's re-enrollment comes up, they can vote with their wallet just as many do when enrolled in typical primary-care practices across the country.

For all the system's flaws, we still can fire our dr. and insurer or medicare-supplement insurer and get a different one.

THAT is the capability to be protected amidst the current plea for nationwide single-payer government system. But many turn a blind eye to it by believing everything they're told and by not doing their own homework.

[Villages PL]

I kept wondering how the Villages Healthcare Clinics would make enough money if each doctor only had 1200 to 1500 patients. They claimed they would spend about twice as much time with each patient compared to regular doctors in private practice. But with a P.A., a doctor will perhaps be able to carry nearly twice as many patients as we were told would be the case. And P.A.s, I assume, are much lower salaried employees than regular doctors.

So, if I am correct, perhaps 1000 or more of the doctor's patients will be expected to see a P.A. on a regular basis. The doctor could end up with a total of 2500 to 3000 patients.

Of course this information is not going to be divulged, whether you ask your doctor not. This will be considered private business information and none of your business. So I still believe it was all about "bait & switch" from the very beginning.

[Chi-Town]

Marcus Welby morphed into a "concierge doctor" where we used to live. He promised fewer patients and much more personal care in exchange for a yearly $1500.00 fee (office visits were still charged). A surprising amount of people signed on.

[TheVillageChicken]

Just left Mulberry facility of The Villages Health System. Spent twenty minutes with an assistant followed by over an hour with the doctor who addressed all my issues and then some. Changed some dosages, ordered some new meds and explained why. Ordered labs and x-rays plus return visit in four weeks. Recommended two publications for me to read, and even gave me a shoe catalog to address my heel pain. Couldn't be more pleased.

[ilovetv]

Originally Posted by TheVillageChicken

Just left Mulberry facility of The Villages Health System. Spent twenty minutes with an assistant followed by over an hour with the doctor who addressed all my issues and then some. Changed some dosages, ordered some new meds and explained why. Ordered labs and x-rays plus return visit in four weeks. Recommended two publications for me to read, and even gave me a shoe catalog to address my heel pain. Couldn't be more pleased.

Excellent!

[skyguy79]

Originally Posted by Villages PL

The Villages/USF Health Alliance gave many lectures far in advance of the first clinic opening. Also, the Daily Sun devoted at least one full page per week on Sunday. That effort was to provide information so that Villagers would know what kind of care to expect from this new "revolutionary" health care system.They didn't say, "if anyone has concerns about PA, they should talk to their doctor with those concerns instead of drawing conclusions from the opinions, conjectures or concerns of others that may lead a person to misconceptions about the profession."

Who said, or even implied that they said, "if anyone has.... etc."? I didn't!

Originally Posted by Villages PL

To say that we would need to wait for the clinics to open, then join, and then ask our doctor how this system would work, reminds me of someone who once said, "If you want to know what's in the bill, you have to sign it first." It's disingenuous. A lot of people had good reason for wanting to know in advance how it would work because they would have to leave their current doctor in order to make the change to a clinic doctor. The fact that they might often be expected to see a P.A. instead of their doctor might have kept them from joining. They were deprived of that choice, the choice of not joining. Maybe it was more convenient for this new healthcare system to promote the following misconception: "If you like your doctor, you can keep your doctor."

I never made any statement like you indicated in the highlighted segment above, nor was I trying to imply it. But aside from that, there's definitely a misunderstanding about what I was trying to communicate in this particular posting. My focus here was actually about the PA and not the VHCS itself. My comment was really intended for those who already have doctors and PA's, VHCS or elsewhere, or for when they do have both. My apologies if my communication skills were lacking!

And just what does the "disingenuous" way that the bill your referring to was passed (your statement, not mine even though it is true) have to do with anything I've stated? And why are you still promoting a false notion about not being able to keep your doctor when a number of us have already posted and proven, through our "actual" experience, that not being able to see you doctor is a fallacy? I've already addressed this issue in a prior post, so I'm not going to get into it again!

Originally Posted by Villages PL

But as we now see, you will be expected to visit with a P.A. when they decide it to be appropriate. You will be expected to flow with the system as they have designed it.

"But as we now see"? But, as WHO now sees? Not me and not some other posters Kemosabe!!! Goes back to what I've already stated!

[Villages PL]

Originally Posted by skyguy79

Who said, or even implied that they said, "if anyone has.... etc."? I didn't!

I was suggesting that it would have been improper for them to say that so I wondered why anyone would think that that would be the way to learn about the system. But now you have explained that your advice was intended for those who are already in a system that they had not been properly informed about.

I never made any statement like you indicated in the highlighted segment above, nor was I trying to imply it. But aside from that, there's definitely a misunderstanding about what I was trying to communicate in this particular posting. My focus here was actually about the PA and not the VHCS itself. My comment was really intended for those who already have doctors and PA's, VHCS or elsewhere, or for when they do have both. My apologies if my communication skills were lacking!

Okay, I thought you were complaining that I expected people should have been properly informed in advance.

And just what does the "disingenuous" way that the bill your referring to was passed (your statement, not mine even though it is true) have to do with anything I've stated? And why are you still promoting a false notion about not being able to keep your doctor when a number of us have already posted and proven, through our "actual" experience, that not being able to see you doctor is a fallacy? I've already addressed this issue in a prior post, so I'm not going to get into it again!

The word "disingenuous" was a comment pertaining to the VHCS. About being able to keep your doctor: I was going for a little humor but also to express what I think is going to happen. I think that not everyone is going to get the same - [not sure what word to use]. Some who need lots of care might say that they see a doctor all the time. Those who are in excellent health might say that they see a P.A. 95% of the time. And those in between will likely have a different story. So I don't think you can say that your experience will apply to everyone.

"But as we now see"? But, as WHO now sees? Not me and not some other posters Kemosabe!!! Goes back to what I've already stated!

"As we now see" meaning what we can see from those posting above who have said they are mostly seeing a P.A.. I was just stating from memory. I think there was at least one person who saw multiple P.A.s instead of a specialist. Someone went back a second time and saw a different P.A.

[dotti105]

There seems to be a great deal of confusion and frustration regarding the Villages Health Care model.

I hate to be the one to say it, but if you lived in Smalltown, USA; you would be experiencing the same changes and confusion. Health care has changed, finally, and change is never easy.

For 20 yrs now we have been training advance practice RNs, (Nurse Practitioners) and Physician Assistants to help extend the access of health care to more people. THIS HAS NOTHING TO DO WITH THE ACA. This has been going on for decades.

Our health care system in the US has been controlled, tightly, for the last 50 yrs by insurance companies. With the insurance lobbies, the ACA went into place as a system offering everyone health care, as provided by a particular insurance company. We do not have a single payer, universal system. The private companies, insurance companies still hold the reigns.

During the past 20 yrs as our choice of provider has increased by the addition of NPs and PAs, we are able to provide care to more people as well.

You will see many changes during the coming years. Even the Insurance companies realize that health care in the US was in deep trouble, with costs that were not sustainable. We, as a nation place far behind the other industrialized nations in the quality of our health care. Yet our costs are the highest. There is so much wrong with our health care system that these changes are much needed.

The models of "concierge care" and "packaged pricing" for all care surrounding a particular medical condition are some of the efforts we will see more of as ways to contain costs and still deliver quality care.

It isn't easy for anyone. The MDs are leaving patient care in droves. The hoops they have to jump through for reimbursement from the insurance companies just continue to increase. The insurance companies kick it back to the MD again and again, in order to delay payment. I think we have all experienced that.

I am a RN, still working in this changing scene. It is not easy for any of us. The Provider or the Patient. I personally think the Villages Health Care system is revolutionary and in a good way. They are paying these MDs on a salary, they are provided a health care team of NPs, PAs as well as Medical Assistants (no, they are not Nurses), and Certified Nursing Assistants. As a team they will provide care. You have a much better chance of receiving quality care with this approach.

We just moved permanently in June. We have both seen our new Primary Care Provider, we had un-rushed appointments with great attention to our medical history, our medications were reviewed and in some cases changed. Referrals to specialists were made the same day. In my case X-rays were done during the same visit. We have access, ourselves, to our lab work within 72 hrs.online.

As a RN, I was very impressed with the model for care and for the execution thus far. I understand that my provider WILL be "using a computer" through out the appointment. And I would be very concerned if that was not the case. I also understand that if I need to be seen on short notice, that I will be seen by someone else on the team.

I personally am thrilled that TVHC is pairing with USF med school. This ensures that you have specialists and sub specialists available, within the system. It also assures that your PCP will be up to date on treatment modalities as they change. I think we are very fortunate to have such a well structured model in place.

Someone did a great deal of research and created a model that can provide good care to the largest number of people for the lowest cost. If you are on medicare, this is a bargain! I am still working in Ca and my friends who are ready to retire (Nurses, Respiratory Therapists where I work) can't believe what a great Health Care Plan this is. They are going to be paying much more, for much less.

Ask your friends "back home" how they like their care. IF, and it's a big "if", their long standing MD is still is practice, I will be surprised. There are a few of the "old school" Docs left, but those who are unwilling to work as a team, and unwilling to learn how to chart electronically are leaving health care as fast as they can. And they should. Health care is a dynamic field, requiring creativity and the ability to learn through out their career.

If they are unable or unwilling to move forward, they need to leave; for your sake.

TVHC will have some growing pains. Of course, that is to be expected. But the system allows you to have a primary care physician that knows you and has a team to help provide for your care. That is such an improvement in health care delivery! As patients we are responsible for our own health. We need to work with our providers and educate ourselves on the system so that it can provide us with the best health care possible.

We are thrilled to have access to such quality care here. That was one of my biggest concerns, being in health care myself. To me it is a huge relief to have TVHC as it is structured. Give it a chance!

[LatDoc]

Well said Dotti and spot on.
I am a practicing physician (not in The Villages ) and can only second what you had to say.
I was thrilled to see that The Villages was developing their own system and I feel that "the developer" will do as good a job in the healthcare arena and he has done in all of his other matters.

[Loudoll]

Originally Posted by Villages PL

If The Villages healthcare system had been completely explained we wouldn't be having this discussion and confusion. For example, every Sunday they devoted one full page in the Daily Sun to talking about (and showing pictures) of their new doctors and P.A.s. But did they ever explain exactly in what way and under what circumstances a P.A. would be used? No!

They just kept stressing the point that the doctor would have plenty of time to get to know you (20 minutes or more per visit). You have to wonder about their organizational skills if they couldn't come up with a simple plan to educate current and prospective patients as to how this plan would work.

They just assumed that everyone would know what the duties of a P.A. would be? They are there to assist, yes, but in what way? How do their duties differ from that of a nurse who works in a doctor's office? Will those of us who are well be permanently assigned to see a P.A. instead of our doctor? People like to know what to expect and they shouldn't assume that everyone will automatically have it all figured out.

Look at all the heavyweights they introduced like medical doctors with multiple degrees and decades of experience including experience in office management etc.. And not one of them could figure out that the presentation to the public was lacking important information? Yet they kept saying, over and over, that this new healthcare system would be "patient centered".

Insurance is billed the same if you see the PA. I'm wondering if this isn't a form of fraud?

[perrjojo]

Where is Marcus Welby? He retired after he lost control of his practice to insurance companies, and continued lowering of his fees and increasing costs of doing business.