Question about seeing a PA

really depends on youre situation and the doc an PA. If you are at a critical point you should be seeing a the doc. If it is on going monitoring the PA can be fine depending on the PA. Many PA s do a better job of communicating and even evaluating than the doc. they are often better with people and evaluate the whole person. they commnicate with the doc and all recomendations and decisions are done in consultation with the doc. They are a team and if it is a good team then you will be fine. But again if you are at a critical point where you have serious question that need immediate answers then you need to see the doc. Regarding what the insurance pays-you have a point they should not be charging as much if you are seeing a PA. Myself I am on active surveillance and I see the docs RN mostly and I finder her very good and thorough and defintely better at communicating

My regular PCP is part of a very busy practice. They have about 4 PA's and 3 of them are excellent and the 4th is okay. I don't mind seeing any of the PAs for routine medical matters. I haven't seen my RO at Umich in YEARS. I regularly consult with his very fine P.A. via ZOOM, usually regarding my PSA and other regular blood tests. She and I are on the same page: if results suggest further action on my part (PSMA scan), I'll be consulting with my RO.

Mel

For the last two years, after the first visit following the end of SRT+ADT, i have seen the Nurse Practitioner. I have no issues with that, they are very knowledgeable. With that said, if i were to become detectable again, i would want to see or at least speak with the RO.

Aleph, in your siutation, IIRC, i would prefer seeing the Onc.

This is an interesting question. Most of my "doctors"outside of PCa have been NPs. I don't know if PAs and NPs are exactly equivalent. I suppose NPs/PAs have extra training in their areas of specialization. I think this set of medical professionals could sometimes bring current ideas into a practice that might have MDs who are fossilized into doing things the old way. But, that might mean trying to overrule the supervising MD, so I don't how all that might work.

I've been very satisfied with my NPs.

A common question that can play a role: "Do you want to see the PA this week or the Doc in May?"

Everybody here nailed it. I would want to see doctor in event there is a major change in treatment plans. I feel PA would be there with the Doctor. Right now things are fine with PA. However, if things take a turn in the other direction let's bring in Doctor and PA.

Every three months is same with PA. She relates "psa looks good (.03), blood panel fantastic, go get your shots (Lupron and Prolia)".

Post Edited (mr bill) : 3/13/2022 11:04:55 AM (GMT-6)

My experience with physicians assistants has been positive. Of course, if I felt I needed the physician, I would make the request.

Apparently there is no legal distinction between PA’s and NP’s from what I read. However, the states have different rules about them as noted below:

“ Although PAs can serve as primary care providers, they are required to work under the direct supervision of a physician or surgeon. NPs must work under the supervision of a physician in 11 states. However, in 24 states and U.S. territories, nurse practitioners can operate their own practice with full autonomy. (The remaining 16 states and U.S. territories have regulations that are somewhere in between.)”

One thing my wife and I have learned, you don’t want shots, throat swabs, or blood drawn by a doctor nowadays.

According to Tufts University Medical Center ( I am paraphrasing) both require graduate level accomplishment. The stated difference is that the PA follows the Medical School Physician training and education model usually alongside medical students and the NP follows nursing education and training model. Both have to work under the supervision of a physician. The PA is more qualified in the diagnosis and treatment areas.

See hhma.org, “What is the Difference Between a Physician Assistant and a Nurse Practitioner”?

The PA that I see as my PCP did his training at Duquesne University Medical School in Pittsburg. They now offer the first five year integrated Bachelors/Masters PA program.

Once I decided on RA my Uro turned me over to a NP for any questions I had. It is much easier to get an appointment and the NP spends much more time with me. Any questionable calls are given to the Uro who then relays the answers back to the NP. IMHO, Considering how much more time is spent with me, the cost should actually be higher for the NP than the Uro. If I call my RA, he calls back quickly to reassure me and to provide ideas to combat my SEs. The NP there works side by side with the RA for any appointment I may have.
Wishing you all the best and to Jerry and Jeff keep it going brothers.
Jack

According to my ER doctor son-in-law in residence, PAs and NPs are basically equal, and second level practitioners. 2nd team IOWs.

Still not happy about this, I was thinking about quizzing her on me, seeing if she actually read my chart.
But I tend not to be the type to do that, so I won't.

I'll sit back watch my own progress, and if anything changes dramatically, I will expect to see the Oncologist.
Still thinking about the specialist charge I'll be paying, I'd think that was insurance fraud.

I have written here in the past about my 3 poor experiences with PAs at my local hospital. The short version on the first one was when my PCP referred me to urology after a suspicious DRE and a PSA of 4.6. The PA I saw offered a biopsy which I accepted. It was ordered by the PA but performed by the urologist. The results went to the PA would should have notified me but did not. After 2 weeks and not having my calls returned I had to pull the results up on my patient portal and figure out what they meant on my own. I eventually went 5 states away to Cleveland for surgery.

A friend who works there in admin (IT) l recommended that file a complaint with patient services which I did. They told me they would look into it and get back to me. It’s been 4 years and they never had.

I do like the urologist and although she didn’t do my RP she did install my AUS which went just fine.

The other 2 times I saw PAs I was misdiagnosed, once for a hernia (which didn’t exist) and the other for a bulging disc (which she said was a muscle spasm because my leg muscle felt hard. I’m a distance runner, I have actual muscles.)

That said, my wife has had good success with a couple PAs at the same facility and I went with my mother to see one (in another state) and it was excellent.

So, I guess it depends and just like in all fields, good help is hard to find.