Nurse Practitioners versus Doctors

I’d be concerned. You should see whom you made an appointment to see.

Op welcome to the REAL WORLD

I'm about to go see my nurse practitioner right now, OP. I actually prefer seeing and talking to her rather than my doctor. She's much more communicative and responsive than he is, and seems to actually remember who I am from to visit. For a yearly physical, she's great.

NP's are fucking fantastic, in my experience. They have prescribing power and oftentimes are better with patient care.

She can write prescriptions! Just go, the NP is always fast and efficient in my experience.

I haven't seen my doctor in years. It's always the nurse practitioner.

[quote]Op welcome to the REAL WORLD

I guess so, this is the first time I've ever had to see an NP. But it makes me feel better that others have had positive experiences.

I agree 100% with R4. If you speak to people in the medical industry, many will tell you an NP is more knowledgeable - in most cases - than the physician. You should be in very good hands. Just be prepared with a list of questions you have and concerns - they will take the time to talk to you.

I have two different nurse practitioners in two different specialties. They're both great and really seem to care.

My NP is a specialist in HIV! But I usually see the doctor, I like when I get to see her, she can fill any prescription.

R3 Same thing. The GI guy who manages my UC is great, famous, and very thorough, but the biologicals work. Thank you whoever invented Stelara, and until it stops working, he has bigger fish to fry than me - it's under control.

But for day-to-day stuff I prefer his NP. He's as much a scientist as a clinician (which is good) while she's focused on the here and now. I sent my husband to her, not him, to schedule his colonoscopy: she's great at dialing back anxiety levels and explaining things in ways you can understand.

NPs usually wear scrubs and the ones I’ve visited have handsome asses. The scrub manufacturers make the fronts very modest and I think that should be changed.

I always see my NP, she can give me adderall. I'm in!

I've seen a couple of NPs. I'm in the UK, so the rules might be a bit different here, but the last time I needed a prescription the NP could 'write' it (ie print it off) but she had to take it to a doctor to sign it.

Which struck me as silly because the doctor didn't then come and see me, he just signed it based on the NP's say so. Though it's not like she was prescribing me addictive painkillers.

What's the difference between an NP and a Physician's Assistant?

I asked the last one I saw why she didn't just become a Dr. and she said she didn't want to be thousands of dollars in debt. She had studied as long as the Dr. and was much more preferable to me than my Dr. I suggest you make a list of questions because not only will she be happy to answer them, but I am sure she will know the answers to them.

R15 I think NP's have more schooling.

I always see an MD.

For the high cost of my insurance premiums alone, I want to be treated by a full-fledged MD, not the staff. Much like I'd prefer a criminal defense attorney over a paralegal should, God forbid, I ever need defense counsel.

I always choose a doctor over a NP. I recently went to urgent care and was given a NP. He was fine, even handsome, and he diagnosed correctly.

However, with your health, make sure you are always satisfied, and never feel like you are receiving subpar care.

If you are going for non-serious condition, I think it is fine.

I see a doctor for physical things but an NP is fine for psych meds, or I think so.

[quote]For the high cost of my insurance premiums alone, I want to be treated by a full-fledged MD, not the staff.

You sound like my parents, who are incensed that they don't get a discount for seeing an NP rather than an MD.

r22 I agree with your parents only because you know that the NP is not being paid as much as the Dr. even though they collect the same fee to see either one of them.

Problem with MD's is if they often times can think they have all the authority and don't change their ways. This is less so in the US but definitely more so in Europe.

If your goal at appointments is to "feel heard," and if you like to use empty phrases like "holistic approach" and guide your own treatment based on worthless internet research, knock yourselves out with NPs (and naturopaths and chiropractors). They're happy to collect your money and insinuate you both know more than physicians as you engage in a costly and potentially dangerous folie à deux.

One of the best HIV doctors in San Francisco has many physician assistants and nurse practitioners because she has more people wanting to be her patient than she can serve. Because she is so damn good, I trust her hiring judgment.

Trust me they are the same in the US. I asked my BIL who is a retired Dr. for some medical advice and he demanded I do what the told me or wouldn't help me anymore. He doesn't understand the difference between advice and demands.

Unless r25 can specifically point to where nps are trained in unscientific approaches, they are just as superstitious as the woo woo pseudoscience people.

R28, you've not looked into this very deeply if you don't understand how vastly different NP and physician education and training are, and if you're unaware that the NP education industry is just that, an industry, one that's currently overrun with diploma mills. 'Good' NPs are well aware of that and many find it upsetting and even alarming.

And why do very good doctors in private practice not associated with any hospital networks hire them? Why do hot top 10 hospitals and their top 10 programs, like oncology, hire them?

NPs are just like MDs but without the superiority complex.

My friend always went to a nurse practitioner and then she died.

Hey now. Your MD surely has a vital golf game to finish today!

But seriously: A nurse practitioner is basically a physician in all but name/credential, especially the older ones who've practiced more medicine than most doctors could ever know.

I think NPs are better than PAs. And PAs are often called "Doctor" and they don't correct people who call them that. My NP was pretty straight with me that she is an NP. I could probably insist on seeing a doctor, but I like her and I don't want to have to wait.

[quote]Nurse practitioners and physician assistants both undergo extensive clinical training and education, both in medicine and in important soft skills. Primarily, NPs adhere to a patient-focused nursing model, whereas PAs follow a disease-centered (medical) model of practice.

[quote]“PAs use the medical model and they tend to have a lot more of a science background,” says Carol Martin, Assistant Dean of the Nurse Practitioner Program at Regis College. “NPs use a nursing traditional model where we see the patient holistically and use a wellness approach to care for the whole person.”

Not an issue for me. My HMO only pays for witch doctors and faith healers.

[quote]I think NPs are better than PAs. And PAs are often called "Doctor" and they don't correct people who call them that. My NP was pretty straight with me that she is an NP.

The newest craze in diploma-mill NP education is the "DNP" certification. You can guess what the 'd' stands for.

"Damn! I knew trump U should've been a medical school!"

"To become an NP, you must first be a registered nurse by completing your Bachelor of Science in Nursing (BSN), passing the National Council Licensure Examination, and obtaining a license in the state you wish to work. Then, you will need to earn your graduate degree, such as a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)." So they have a bachelor's and a master's.

In order to become a physician assistant, you must first complete a related bachelor’s degree before enrolling in a two- or three-year master’s-level PA program. Then, to obtain licensure, PAs must pass the Physician Assistant National Certifying Examination (PANCE).

Yeah it seems like NPs have a little more schooling.

In the United States, there is a serious shortage in most areas of primary care physicians.

Nurse practitioners and physicians assistance are the new primary care providers.

Call me a snob, but I prefer a physician, always. M.D. or D.O., please and thank you.

I go to my physician for matters of concern, but I go to his PA for routine exams and STI testing. It has been much easier to get an appointment since his arrival.

The US general public is very misinformed about MD/DO, NP, and PA in regards to their schooling and training. NPs, especially the newer ones from online diploma mills, are the most unqualified providers around and poorly trained for medical care with diagnosis and treatment. Their didactic training is in the “nursing model” and not the “medical model” that MD/DO (PA try to emulate in a fast track way). They’ll hammer “holistic” approach all day but they don’t have the understanding of pathophysiology and pharmacology that’s taught in med school. My eyes are rolling out their sockets at anyone saying NPs have more schooling than MD/DO and even PA. It might be longer in terms of years but the quality of education is abysmal. I’m 100% against this new push for independent practice for PA/NP. We function best under the supervision of a physician.

^Correction longer in terms of years PA. Full fledged attending physicians have 8 years of college (4yr undergrad + 4yr med school) plus 3+ residency (+/-fellowship). Also DNP curriculum is full of BS stuff like nursing theory and nursing research that does not help with clinical decision making at all.

R8 a NP does not trump a MD in education and training.

What it comes down to is we will eventually just have to heal ourselves. I am at this point now. No one wants to treat me. I have excruciating muscle spasms in my back and no one knows why. I had been on opiods for the last 5 years but my PCP got in trouble and had to stop giving them to me. So now I am suffering big time. No one wants to give opioids because of the DEA. I never took more than 2 a day and watched carefully so I wouldn't become addicted. What I did become addicted to was having my body get rest twice a day so I could continue suffering. Now I have nothing but constant pain. A lot of it. I went to the ER 4x's in 9 days. Each time they would give me a few pills and send me home. I finally said to them if I came in with a gunshot wound would you give a few pills and send me home. One Dr. told me he was only there to save lives. Our entire system sucks.

R46 Try kratom. Or weed, I don't do the weed thing but I know many do. I'm sure you can find a strain for it. If you aren't getting the meds anymore, you won't have to worry about pissing clean for a test like I know they often make people do to get pain meds.

I'm sorry, R46. I hope things improve for you soon.

R46 I have the same sort of issues you do I have excruciating back pain right now. I have several muscle spasm knots in my neck that are killing me. I can’t even turn my head to the left so I know somewhat what you’re going through. I also have very bad psoriatic arthritis, which I think a lot of medicine for. as far as your neck and back goes into a pain doctor outside of your regular doctor that can prescribe and give you pain relief treatments. I’m getting nerve blockers in my neck and lower back every six weeks. It helps some, but isn’t 100% I also take opioids every day which is tramadol. I take Tylenol arthritis. Also on a heating pad. I take Epsom salt baths. I use a Thera gun I buy Cause Medic CBD lotion and am prescribed Voltaran gel. I still do not get complete rel. I sympathize with you.

This bullshit is common now. Many people who care pick Drs based on if they are board-certified, where they have worked and even where they studied. People might also check reviews for feedback before booking.

When they send in the B team, patients have no clue what degrees and qualifications these people have. Sure they may be more jovial and spend more time with a patient, but these practices are guilty of false advertising.

Worse is if you chose a Dr based on their sex and the opposite strolls in.

There is an app that lets users swipe right to pick a doctor by his/her profile pic. I see this commercial on TV and think about how utterly stupid it is to choose a physician that way

For me it was always a difference between seeing a male or female (the NP). I always try to see female doctors because the male ones are on a high horse and act like they don't like you or their jobs. Nowadays, the younger men are so much better than the elders - MDs or NPs.

R46, has any of them talked about Methadone? It has to be prescribed correctly or it will kill you - there's a build up in your system, it's not taken when you have pain. It saved my brother from after back surgery.

Thanks for he suggestions. I had been on hydrocodone. At the ER they gave me oxycodone, didn't work. I have a pain Dr. who doesn't give pain meds but did give me a small prescip for Tramadol. It didn't work. A few years ago at the Er they gave me Fentanyl, it worked for 2 hours. I have an appt. for a pain clinic that does prescribe pain meds but couldn't get in until next month.

I will look into the Kradom and the Methadone.

thank you r48

When this is done I am going to look into advocating for those in pain that can't get help.

and 95% of Pain Dr.'s will Not prescrip pain meds. you can always tell people that have never really suffered.

r49 I hope you get the help you need as well. What is the point in having meds and Dr's. if they aren't going to treat you?

R46 Chronic pain is very complex and if all prior work up (labs/imaging) are negative, you can see if any pain specialists offer alternative treatments, like acupuncture and Botox. Obviously, I don’t know your history but long term opioid use, even as needed, is not a good regimen.

OP, can I have your stuff?

R54 Yes, someone mentioned methadone too. That and subutex are also good for chronic stuff. Or is it suboxone? But yeah, those don't have to be taken constantly.

Tomorrow I'm scheduled for a colonoscopy in the Dollar General van, with a student nurse 'Jack McFarland'. Wish me luck.

r55 I understand that but I'm almost 75. I've had a hard life and would just like to have a little peace instead of this constant suffering. I've even made an end of life plan if I get a fatal disease but this hanging in limbo is getting to be too much to bear,

How would you like to be 50 yrs old with that much pain, r59

[quote] For me it was always a difference between seeing a male or female (the NP). I always try to see female doctors because the male ones are on a high horse and act like they don't like you or their jobs. Nowadays, the younger men are so much better than the elders - MDs or NPs.

Exactly, and at least in my experience, much more well hung. The last Dr. that I saw was 37 and was wearing the absolute tightest pants imaginable. I couldn’t stop myself from looking at his massive quads and bulging package. I got caught and he just smiled and then adjusted his junk. I about came in my pants.

r60 I have been in this much pain off and on for years. it is only the last 5 years that it hasn't stopped and of course I wouldn't want to be and would wish it on no one. I hope that you find relief way before your 70's.

NPs and PAs are fine. Most regular check ups can probably be done by just a nurse.

However, if I have something serious (cancer, heart attack, stroke, surgery, etc.) the ONLY person I will listen to is the MD. NPs/PAs are like paralegals to lawyers.

I'm not putting my life in the staff's hands. I'm putting my life in the hands of someone who has everything at stake.

Why do you think lawyers and doctors are so arrogant?

[quote]What's the difference between an NP and a Physician's Assistant?

They have different educational paths and licenses. A CRNP (nurse practitioner) is first an experienced Registered Nurse who goes to graduate school to learn advanced practice. A PA can have any sort of background and go to a university program to become a PA-C.

In reality, they can do almost the same things in practice. One difference is that Nurse Practitioners can legally work independently, while PAs must legally work in collaboration with a physician.

PAs and NPs are sometimes collectively referred to as “mid-level providers” or “advanced-practice providers” (APPs)

[quote]What it comes down to is we will eventually just have to heal ourselves.

Aside from an occasional physical, I had never really interacted with the medical profession until my dad was stricken with some mysterious malady a few years. He experiences bouts of debilitating weakness and he sometimes sleeps for 15-16 hours a day, but all his tests come back fine, so the doctors just throw up their hands and say, "Well, he's old." Infuriating.

I have concierge doctor care so I get instant access to the doctor while others wait for days or weeks. Cost a bit but totally worth it. I don't do waiting rooms.

My clinic system has a same-day clinic for urgent care. When I went in, I was seen by an NP. She recommended a medication I knew was contraindicated because my doc had warned me to be careful. When I told the NP, she disagreed, stating that her mother was on the same combo. I held firm, she looked up the contraindications and realized I was right. So, while I liked the woman. she was [italic]not[/italic] as good as seeing my PCP.

I saw a nurse practitioner last summer when a power outage closed my doctor’s office. This congenial woman very matter-of-factly diagnosed me with COPD. When I saw my regular doctor the next week, he said there was “zero chance” that this diagnosis was correct.

A friend went to the ER over the weekend, where a DOCTOR put him on meds that today he learned should not be prescribed for his condition.

There are bad professionals everywhere.

My primary care provider is a PA, and I’m happier with him than I have been with past MD’s.

I do not require a lot/on-going medical care though.

What I seek from a doctor is their talents as a diagnostician, but that has to be a REALLY great doctor—a doctor that will order every test and will enjoy the challenge of getting to the bottom of my symptoms. Many doctors become quickly jaded and don't listen to or believe their patients, writing off what they have to say pretty quickly and taking the path of least resistance. Basically, they get lazy. The biggest red flag of a bad doctor is one without curiosity. Like, Dr. House is obviously a caricature of this, but I bring him up because I don't seek actual CARE from a doctor, I seek their knowledge and diagnostic skills.

What I seek from an NP is someone who excels in overseeing the treatment of that diagnosis and prioritizes care and consideration. Someone who is patient, nurturing, holistic in their mindset. A good NP should have the foundations of a good nurse, which is based in care, but the schooling and knowledge to extend that care into managing an actual treatment protocol.

If you have serious medical needs, your treatment team would ideally consist of one of each, and they would be in regular communication with each other. Expecting both from a single physician is a pipe dream, and that dream physician probably also has a waiting list longer than your remaining years.

NP tend to spend more time with patients.

[quote] My primary care provider is a PA

A what?

Physician's Assistant = PA. Closer to an MD than an RN.

If I had a minor issue, I'd be okay with an RN. I feel like nurses overestimate their expertise. At the end of the day, MDs are the ones who have been through med school. I'd rather an asshole who can save my life treat me than an RN who's got a caring personality. I watched a boyfriend die of cancer, and I stand by my estimation of RNs vs. MDs.

There are good PAs and bad ones. There are good NPs and bad ones. And there are very good doctors and very bad ones. Unless you know someone who is in the medical profession and personally works with these people or knows of their reputations…there’s really no way to know what quality of care you will be getting.

I think I found a decent dr. but when I called they said his next opening is in January and that was a few weeks ago.

NPs are mostly deluded and think they know a lot more than they do. They are not even close to being as knowledgeable as MDs.

I had a good doctor, but he was convicted of first degree murder.

In most cases, my first visit with any healthcare provider has been with the primary physician. Most follow up visits have been with with PAs and that’s perfectly fine with me. They keep the treatment and associated prescriptions moving forward. Thank god we have them or most people would be waiting months for appointments.

NPs are great if you just need to get a refill or have something really simple snd obvious. It doesn't take a genius to do that or to order basic blood work and shit like that. But they are not doctors and do not have the knowledge that doctors do. If you have something that concerns you, make sure you see a real doctor.

The education is different, and each one's approach to a health problem is different.

I have found a physician more interested in what is not working right (find the diagnosis, solve the problem). A nurse practitioner is more focused on overall wellness: assess the symptoms and find out/teach you how to keep you better.

I have found that a team that has both is the best of both worlds -- the inquisitiveness of a Sherlock Holmes in the MD and someone trying to keep me well (and out of the medical office) in the NP.

I've had the same GP Dr. for 5 years. Only saw him once. All the other visits were with his various PA's.

My longtime specialist says he’s cutting back, and so I’d rather continue to see his very good NP for a generously provided thorough half hour or so’s time, rather than for my specialist to traipse anymore into the exam room for just 2 minutes at the exam’s end in order to just put a stethoscope on me and then hand me a $60 insurance co-payment bill while he rushes out the door telling me to take care.

For physical exams, I have noticed that the older, foreign-born doctors have fewer qualms about the nudity of the patient; don't worry about draping, just get down to it and disregard most of the modesty bullshit.

Is this thread a joke? Always go to a medical doctor if you have the option. NPs are just glorified nurses who have prescription authority.

NP's are a waste of time.

Anyone can pass a nursing exam.

An NP didn’t believe my friend’s kid had a broken arm and refused to X-Ray. Then lied about it when her boss, the doctor, called her out.

I honestly don’t see the point of them.

The point of them is to cover for a shortage of actual doctors.

"... glorified nurses who have prescription authority."

I had one who was pushing pain meds on me. I just wanted to know what was wrong, not a dope fix.

R78 Was your doctor Gerald Wolfe in San Diego?

Yeah if you already know what you need and just need meds, an NP is good. Like people who want Ozempic, I'm sure could get them from an NP. For diagnostics, a doctor would be better, D.O.s are the best.

R84 Yes, my MD is Indian and she doesn't worry about being modest and getting a bunch of people in the room, she has me strip down and do the physical.

They’re all a bunch of liars!

[quote]Yes, my MD is Indian and she doesn't worry about being modest and getting a bunch of people in the room, she has me strip down and do the physical.

I haven't been "stripped down" for a physical since a high school football exam.

The first thing I do when I see my doctor is strip naked that way he can access my skin, check for lumps and digital prostate check

The last time I saw my doctor for a physical (2020) he did a prostate check. I've seen his NPs ever since and they've never done it.

[quote]I haven't been "stripped down" for a physical since a high school football exam.

I think you may be confusing that with the porn movie you did.