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jca2's avatar

When you go to the doctor, do you see the actual doctor or do you see a Physican's Assistant?

Asked by jca2 (16328points) 1 month ago

I do the majority of my doctor visits in a large city in CT, and when I go to the doctor, I see a doctor. Dermatologist, regular doctor, etc., it’s always the doctor. The nurse or other assistant may do the blood pressure and other checks, but the doctor always does the exam.

A friend who just moved to a southern state, from a county here in NY that is not a poor county but is not one of the top ones known for good medical care, told me when she went to the doctor here where she lived and also now in her new southern state, she sees a PA (Physican’s Assistant).

I am assuming her insurance is coding it for an actual doctor’s visit. She said when she has said something, they tell her that the PA is much more in depth than the doctor is. She also said because insurance companies nickel and dime the doctors, they need to do what they have to do to keep costs down.

To me, the doctor has the education and experience that the PA doesn’t have. I’m not arguing with my friend about it, because it is what it is, and it’s her care, not mine, but it doesn’t seem right.

I’m curious if this is the norm elsewhere. When you go to the doctor, do you see the actual doctor or do you see a PA?

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47 Answers

canidmajor's avatar

My regular medico is a DNP (Doctor of Nursing Practice) who can do all the regular stuff. If a need a specialist physician, she refers me, but for all other stuff she is my go-to.

I really prefer these modern medical protocols, where most of my health care needs can be met by someone who is educated and qualified in most general medicine, including performing and interpreting standard tests, prescribing medication and the like.

I will take the PA, the DNP, and the CNP over the MD any day for the routine stuff.

chyna's avatar

I see a PA as my PCP and at my dermatologist. I like both of them and feel they are knowledgeable and helpful.

RocketGuy's avatar

I’m with Kaiser. I get a real doctor when I go. But sometimes I also get an intern. A two-fer!

Tropical_Willie's avatar

MD for most of my visits, PA if I have a urgent need in PM, MD is part time at his own office, has PA cover PM. He only works mornings, starting at 6:45 to noon. I had a wound that needs tending and the Wound Healing center I went to was staffed with two PAs, multiple RNs and a MD

KNOWITALL's avatar

So my insurance has options yearly on plans.
Blue cross blue shield. I always see actual doctors but the cheaper plans call those out of network.

Smashley's avatar

I see a PA, who is one of a team overseen by an MD. Arguing that an MD is better is like arguing your car is best worked on by a mechanical engineer. PAs and NPs are well trained specialists, and can effectively do primary care work. Where they lack knowledge, they refer, just like any practitioner.

Hawaii_Jake's avatar

I see the MD. In the past, my psychiatric care was done by an APRN-RX. She gave fabulous care. I trusted her completely.

zenvelo's avatar

When I go for routine stuff, a PA is sufficient. But even when I went to urgent care for some issues, the PA brought the doctor in as it was a little over her head.

And at the Cardiologist, the PA just does the vitals but the doctor does the exam.

LifeQuestioner's avatar

It varies. For my primary care physician, I always get to see the doctor. For my endocrinologist, it’s more like I alternate between him and his physician’s assistant/nurse practitioner. Although actually, I just switched my endocrinologist and have not seen the new one yet so that may change. Other than that, I always see the actual doctor. That’s for eyes, kidney doctor (except this upcoming visit because she’s on vacation), hematologist.

Forever_Free's avatar

I see my various Doctors in the Boston area. They all are Doctors for my visits. This being Primary Care, or a list of specialist Doctors.
If I call in or post a question on my portal, I may get a first callback or response from a PA.

seawulf575's avatar

We see a PA. But he is regarded as better than some doctors in the area. Nurses and other doctors all around the area know him and no one has ever even given an odd look about him.

JLeslie's avatar

In Memphis, TN I mostly saw a PA or a Nurse Practitioner and less often a doctor. In The Villages, FL I also see a variety. In South FL I usually saw doctors, but that was many years ago and it might have changed there now.

Dutchess_III's avatar

Real doctor.

Tropical_Willie's avatar

Forty years ago I went into doctor’s with an abscess, PA drained it and bandaged it.

He was Navy Medic in Vietnam, he called himself a “Band-Aid Boy for Marines.”

janbb's avatar

My doctor isn’t in every day so if you are sick or have a medical emergency, you might be seen by his PA. For annual check ups or scheduled visits, I usually see the doctor. At my gynecologist, I prefer seeing the NP – she’s great.

gondwanalon's avatar

My family practice, eye exam, annd dermatologist appointments are always with MD’s.

I usually see a nurse practitioner at my cardiology appointments but sometimes it’s with a general cardiologist.

Only 1 time in over 3 years I had an appointment with my heart electrophysiologist. Most the appointment is with the an RN. I’m OK with that. Their team is very sharp and responsive quickly to my non emergency questions that I send to them on MyChart.

MrGrimm888's avatar

I see both. Depends on why I’m being seen.

As an organ transplant patient, I am in medical facilities often.
At this point, I don’t usually speak to my surgeons anymore.
I have a “health team.”
I don’t know who organized it, but an organ transplant comes as a package deal. Once I got big time insurance, money was no object.

Before my transplant, I didn’t have insurance. So I had to use the ER, as my doctor.

Now. I feel Canadian. I can get an appointment with a specialist in a jiffy, and I can actually be somewhat proactive with my health.

Caravanfan's avatar

We don’t have PAs in our system but NPs. I’ve seen both NPs and physicians.

JLeslie's avatar

I’ll add that some of my best experience have been with NP’s compared to PA’s, and you know me, I have a lot of anxiety dealing with “doctors,” I’m not an easy patient.

smudges's avatar

I almost always see a physician, but when they don’t have any appts available and I need to be seen, the office will ask me if I’m ok to see PA, which I usually am.

I DO, however, complain that if I see a PA then I shouldn’t be charged the same copay as when I see a physician. That happens and it pisses me off and isn’t right.

Strauss's avatar

I usually see the MD. In the 10 or so years I’ve had this primary, I’ve seen a PA only 2 or 3 times

Dutchess_III's avatar

I find them females PAs to be more….compassionate than the MDs. Except for my new doctor. He’s fantastic.

MrGrimm888's avatar

^Females usually have the superior “bedside manor.”
I think that raising children, which is instinctive for females, requires a lot if the same tools. Like multitasking.

Dutchess_III's avatar

manner Grimone

Caravanfan's avatar

What an odd thread to see overt sexism.

smudges's avatar

^^ I don’t see why it’s odd at all. Historically, male doctors have been less interested in what a female’s complaint is and more focused on her problem originating in her imagination and what he and her husband can do about it. Locking her up was a common solution not that long ago. Even today there’s evidence that male doctors have less interest in and compassion for minorities, females in particular. Many studies reveal this. Just sayin’.

Caravanfan's avatar

So you admit you are sexist. Okay then.

janbb's avatar

@Caravanfan The expression of facts about women’s experiences is not sexism. If one said that every woman doctor or PA is more caring than every male doctor that would be sexism.

JLeslie's avatar

I have had good male and female doctors. I always chalked one of my problems with doctors up to a good number of them probably had a parent who was a doctor and most of the medical students are likely very healthy to get through med school. That changes as the doctors age, but talking about younger doctors. NP and PA education and training are less rigorous.

Having a parent as a doctor and then you are a doctor, you get treated differently by doctors and you know the system better than people who work outside of the system.

Woman deal with health issues younger than men on average. So your female doctor is more likely to have dealt with health issues herself.

Our insurance system in the US twists medical care so that doctors get boxed in and so do patients.

NP’s sometimes are nurses for several years before becoming nurse practitioners, which I think gives them a different perspective.

Dutchess_III's avatar

There is still a lingering idea that women are hysterical ninnies. In my experience women doctors can zero in on my issue, what ever it is, with an understanding that many male doctors can’t relate to.
I’ve been lucky as hell with all my physicians I’ve settled with tho, most of whom have been male. Had to go through a lot of indifferent, dismissive ones first tho. But maybe they were indifferent and dismissive with ALL their patents. IDK.

smudges's avatar

So you admit you are sexist.

Believe what you wish. I would think that you, @Caravanfan, of all people on this forum, would be willing to acknowledge the dubious history of medicine. For example –

I’ve had many wonderful doctors, most often they were men simply because there are more male doctors than female. I was only responding to your assertion that this was a “sexist” thread. If most of the respondants had been male and said that male doctors were ‘better’ and more sympathetic to patients than women, would you still think it’s a sexist thread? I don’t think so.

Demosthenes's avatar

Many people have gender preferences about doctors and I don’t think there’s anything inherently wrong with that. I can certainly understand a woman not feeling comfortable with a male gynecologist, for example. When I go to the doctor’s, I do see my actual doctor, who is a woman, and has been my doctor since I was in college (as long as I’ve been living in this area). I have had good experiences with both male and female physicians and it’s not a factor for me, but seeing a doctor is very personal and I can understand if some have preferences in that regard.

Dutchess_III's avatar

Oh! Loving this from your link @smudges: “While Raulin noted that both men and women could contract hysteria, women were, according to him, more predisposed to this ailment because of their lazy and irritable nature.:
Well kiss my ass Raulin!

Dutchess_III's avatar

My mom suffered from “hysteria”. Dad, who was from Texas, called them coniption fits. Not fun. This would be in the 60s and 70s. She would scream and cry wildly over the smallest things.
I now know she was probably suffering from genetic depression. They weren’t diagnosing those things then, or treating them, aside from occassional periods of lock u in the psyc wards. 5th floor of Wesly Hospital in Wichita. Everyone just blew her off.

Dutchess_III's avatar

PS. I have spoken with @Caravanfan over the phone. I got the impression that he had great compassion. It shows here too, and on Facebook. IMO he’s probably a great doctor. IF he would settle down and come home!

smudges's avatar

^^ I agree with your assessment about @Caravanfan!

I’m so sorry your mom went through that. Poor woman. :(

Dutchess_III's avatar

Yeah. It was hard on the whole family. And then, when I was a teenager….she started drinking. Oh God.

smudges's avatar

^^ Besides her, it was probably hardest on you kids.

Depression and drinking – insane combo! I know from experience!

MrGrimm888's avatar

Gosh. I just said I thought females were better, overall at such things. It plays to their strengths.

Is it sexist, to say that most men, are better athletes?
Of course not.
Well. Maybe here….

Dutchess_III's avatar

Well Black men are generally better athletes than White men. Just sayin’.

RocketGuy's avatar

Selectively enslaved from Africa way back in the dark days.

MrGrimm888's avatar

It depends on the sport Dutch.
But sure, I think you can make that statement without reason for backlash.

Strauss's avatar

(Ahem…Back to topic)

A couple of days ago I started exhibiting symptoms: runny nose, congestion, fever, etc. So I called my insurance company’s Nurse line. After a brief conversation concerning my symptoms, it was recommended that I schedule a housecall home visit covered by my insurance. A few hours later I was visited by a Nurse Practitioner and an EMT who checked my symptoms, arrived at a diagnosis of pneumonia, and electronically transmitted my prescriptions to my pharmacists.

I will certainly keep visiting my primary care MD, since we have built up our relationship over the past twenty years. But I won’t hesitate to use the services of a NP or PA if needed.

smudges's avatar

^^ Feel better soon!

I’ll have to check into that home visit allowance. I don’t know if my insurance covers that or not but there have been times when I sure could have used one.

Strauss's avatar

@smudges I’ll DM you the company info. The NP said they accept most insurance plans as well as Medicare and Medicaid.

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