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NURSE PRACTITIONER VS MD

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Ulcerative Colitis
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Posted 3/5/2009 12:56 AM (GMT 0)
I have an appointment tomorrow with a new GI practice and I was told I would first see one of the staff NP's.  They also asked me for procedures, which of the Docs I would lile to use.  I have a list of questions prepared to address to the NP so I'm prepared but what has been the experience from you folks who have worked with NP's with thise disease?  What can I expect from this first visit?  I'm told NP's can be more caring than many MD's.

Is NP care becoming more common these days?

Posted 3/5/2009 2:59 AM (GMT 0)
NP care is becoming more common. I've had 50/50 luck with NPs. I do know many people (non-UCers) who see NPs regularly and like it because they are able to get in faster. NPs are usually able to spend more time with you than an MD. So that is a definite plus.

I would approach the appointment the same way you would approach it with a new MD. Perhaps (out of curiosity) ask what the difference is.

Good luck tomorrow :)
Posted 3/5/2009 4:33 AM (GMT 0)

I have a primary care NP young man and now I have a NP I see at the gastro doc office.  I love them both.  I can request seeing the doctor but probably take longer.  My gastro NP, a young woman, very caring and takes time with this senior to answer all questions or get the answers for me.  I understand she sees most of the patients unless the doctor is requested after the first visit while things are doing ok.  She has a weekly conference (more if necessary) with the doctor going over all his cases and test results, recommendations, etc.  I love it and I can call her with questions and she will return my call usually same day.

My husband goes to VA hospital and has several NP and PA who follow his various health problems always consulting with his specialists, etc.  Works great!

ElaineNY

Posted 3/5/2009 1:31 PM (GMT 0)
I've never seen a NP but I have PA and I will never ever again see a PA. She was a general medicine PA and she was extremely arrogant and assumed she knew more about my UC then me. She prescribed me an antibiotic for a UTI and after I called her several times because I was almost close to going to the ER in pain she kept trying to tell me that it was normal to feel that way. Turned out the antibiotic I was taking contained sulfa and I'm highly allergic to sulfa. But that is just my experience. I've heard great things about NP's though. My MIL see's one and she loves her to pieces.
Posted 3/5/2009 9:48 PM (GMT 0)
Good grief. That PA needs to get out of medicine.

My doc's office is small and I don't think she uses an NP. But generally I believe they know as much as many docs.
Posted 3/5/2009 10:28 PM (GMT 0)
UPDATE:  I went to my appointment and the NP spent nearly 1.5 hours with me - in all the years with this disease I've never had anyone spend that much time with me.  I found myself to be more relaxed with her than I have been with MD's for some reason so I'm pleased so far.  One of the MD's in the practice will be performing the next colonoscopy, of course, but for office visits and maintenance advice it seems the NP is more than qualified.

Posted 3/5/2009 11:05 PM (GMT 0)
I don't want to see a NP unless they are discounting the cost.
Posted 3/5/2009 11:33 PM (GMT 0)
not likely - the way they see it, an office visit is an office visit for specialized service regardless of who offers the care.  I was charged the usual 'specialist' insurance copay.
Posted 3/5/2009 11:47 PM (GMT 0)
I don't have insurance, I pay out of pocket. Even if I had insurance I would still expect a reduced bill if I am seeing an NP. The NP isn't getting as much for their time - why should you pay the same amount?

Posted 3/5/2009 11:53 PM (GMT 0)
good point, but frankly I could care less what the NP is making for a salary.  if the care they provide keeps me from running to a  bloody toilet 15 times per day, I'll pay their office visit.

Posted 3/6/2009 12:12 AM (GMT 0)

As long as the doctors office is up front about it when I make the appointment - I don't care.

Sometimes cost isn't an issue, especially if you're in the midst of a terrible flare. I would inquire about the price difference between a GI and a NP, I am always trying to cut corners. If they said it was the same cost, my preference would be to see the GI. Of course, if I were in pain, I would see the NP and hope for a good experience. It sounds like it worked out well for you.

Posted 3/6/2009 12:14 AM (GMT 0)

You know it really depends on whom you trust and have a good rapport with.  I have been going to all kinds of doctors - Army, etc. around the world for over 50 years.  If I don't like the person (don't care whether they are doctors, NP, PA, nurses), I just have a problem dealing with them - a personality conflict sometimes.  We just can't "get along" with everyone.  Some think I am funny that I can't "get along" with a good doctor no matter what their personality is - just don't trust them, I guess.  I went to three knee surgeons before I found would I could "get along with".  Either NO personality or sense they really didn't care about ME!

Right now I have a great, experienced gastro doctor who is also an internist.  I trust his opinions, treatments, etc.  BUT - first time I saw the NP I knew I would see her as much as possible.  She is caring, listens better to me and takes her time (no matter how far behind she may get).  I am on Medicare and supplement insurance so they really do try to limit the time since Medicare is so "cheap".  I do see the doctor anytime I request (although may have to wait a week or so longer) AND this next appointment is with the doctor because he put me on 6MP to see how I am progressing.

You have to trust and believe in your health care provider - no matter for what conditions, etc.  If you don't - try to move on to one you do!!

ElaineNY

Posted 3/6/2009 1:41 AM (GMT 0)
Test Flyer - I am so glad you had such a great experience with the NP. 1.5 hours! My goodness - that's absolutely unheard of with an MD.

Best of luck with your scope next week!
Posted 3/6/2009 5:40 AM (GMT 0)
My GI spends time with me.
Posted 3/7/2009 9:28 PM (GMT 0)
     This modern method in many doctors offices cracks me up.  I worked for an Internist/Endocrinologist as his lab tech for many years.  He had his own practice and was very picky about who would treat his patients when he was on vacation.  I bet he is just turning over in his grave with this physician assistant and nurse practioner business.

     I was going to a family physician but he decided to open a larger practice and hired a nurse practitioner, physician assistant, two MD's and two DO's.  The physician assistant prescribed Paxil for me when I first started with symptoms of UC.  It gave me severe headaches.  Needless to say, from then on I insist on being seen by the MD's.

Posted 3/7/2009 9:44 PM (GMT 0)

I have had the best treatments from NP not the PAs!  My gastro NP never prescribes anything for me unless approved - recommended by the GI doc BUT her imput seems very important as she really knows ME better - not my insides, not my UC maybe - BUT ME!!  She takes time to ask about other aspects of my health and my life.  She knows my stress level and my anxieties, etc.  Doctor has never ask me why I fear or don't like something.  I have written on my chart - NO MORPHINE.  Doc never even ask if I was allergic or anything.  BUT - Rachael, my NP, ask me about it and I told her because I saw what it did to my husband and Mother and preferred to leave it for the day when NOTHING else worked for the pain!  I am happy she has at least weekly consulations with him for all aspects of my care and the other patients.

ElaineNY

Posted 3/7/2009 11:01 PM (GMT 0)
I see PA at my regular doctors office and at my cardiolagist office I actually prefer them they take a lot more time to listen to what I have to say. and they are both cheaper. And a lot easier to get into in a hurry. Mine listens to everything I suggest when talking about my UC when it comes to antibiotics. I just fine them more caring then some doctors. Dont get me wrong I like my doctors alot if I didnt I would find a new one. But at my regular doctor I save 10 bucks a visit and about 48 bucks at the cardio which helps when u dont have insurance.
Posted 3/8/2009 1:49 AM (GMT 0)
Love, love, love my NP. Like my doctor, too, but my NP is really great. If things are really bad (after I'm out of the hospital, etc.), I'll insist on the doc, but typically I'm just as happy with my NP.
Posted 3/8/2009 5:44 AM (GMT 0)
My experience with the GI office NP has been positive overall, better than with the PA in the same office but I think this was as much a personality thing as it was a philosophical difference (as a general rule PA's are trained under the medical model (disease-centered), NP's are trained under the nursing model (patient-centered)).
I think mid-level practitioners (NP, PA) are great once you are in the maintenance stage or if you have an uncomplicated course, but it's also good idea to check in with the dr. from time to time to keep a good rapport with the person that does the invasive stuff (colonoscopy, etc...).
I was kind of disappointed on my last visit to the NP though because he said that I've taken longer than most of his patients to get the UC under control. He recommended a visit with the GI doc in a few months. At least he knew when to send me back to the dr. I do like him though. He's warm, caring, listens and teaches.
I've made an appointment with a different GI doc for a second opinion.
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