# A new widespread trend, or a local thing?



## JaniceM (Feb 23, 2020)

In the past, my experiences with health care services were with individuals who had "comma, M.D." after their names-  medical doctors.  In one place I lived, the local hospital's ER had interns and residents-  medical students from a well-known medical school.  There was also a basic health clinic that was staffed by two FNP's at different times-  but virtually everything they did required approval from their supervising physicians at the local hospital.  

In this area, though, it's almost impossible to find an M.D.  For basic health care, individuals are expected to see FNP's or D.O.'s.  Is there a shortage of M.D.'s these days, or is it a new trend?  

In recent years, I had two experiences with these "Doctors of Osteopathic Medicine"-  one was at a walk-in clinic I went to for emergency services, and the other I consulted for legal advice as he was also an attorney.  To say they were both idiots who didn't know what they were talking about is an understatement.  

It sucks to need a PCP and not have options, so I'm wondering how widespread this is.


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## Judycat (Feb 23, 2020)

I haven't seen an MD at my PCP in a long time. My husband however got the doctor every time he went, but he died anyway so...
I see a physician's assistant. She's pretty good.


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## StarSong (Feb 23, 2020)

I see an MD every time at Kaiser.


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## Kaila (Feb 23, 2020)

I have personally found that many of the Osteopathic doctors are excellent, and many are not.
The same with MD's...and with any medical specialty, or with any other field of expertise.

I have found some of the physicians assistants and nurse practitioners to be excellent.

It seems to depend more on the individual's education and experience and skills and abilities, rather than which initials are after their name.

Some of the MD's are excellent, but some are not.  I learned this both when working with them, and when going to them for medical needs.


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## jujube (Feb 23, 2020)

I had a D.O. as my primary physician for about three years a long time ago.  I really liked him; he seemed to be more open to newer ideas than the MD's in the practice and he always gave me as much time as I needed with him. 

We are going to see a shortage of MD's in the future, especially ones who see senior citizens.  Being a doctor isn't quite as "
godlike" as it used to be and the big money isn't there for the general practitioners, either.


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## jujube (Feb 23, 2020)

I hardly ever see my neurologist any more.....thank goodness...he's an asshole.  I love his nurse practitioner.


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## Catlady (Feb 23, 2020)

When I was working my company used Cigna.  I was told who my doctor was, but after years I never met him.  I was always tended to by his NP and I really liked her so never complained about the situation.  I wouldn't be surprised if he got the biggest chunk of the fees for seeing me, though.  I don't know if that is how it works.


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## Liberty (Feb 23, 2020)

We bypass the PCP look and use our cardiologist...hey, what's the biggest killer for both men and women...duh, heart.  We've had our doc for years now. He cracks us up.

 You know they changed the threshold on prescribing statins and now its like half of the people could be scribed them by docs?  Each time we get the full blown cardio - about once every 3 or 4 years, he studies it and says something like "wish that Ldl was 100 instead of 110 or something - when everything else looks great and the HDL is "over the moon" good.   He does care, and that matters a lot.  The docs that care may be few and far between these days.


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## JaniceM (Feb 23, 2020)

Liberty said:


> We bypass the PCP look and use our cardiologist...hey, what's the biggest killer for both men and women...duh, heart.  We've had our doc for years now. He cracks us up.
> 
> You know they changed the threshold on prescribing statins and now its like half of the people could be scribed them by docs?  Each time we get the full blown cardio - about once every 3 or 4 years, he studies it and says something like "wish that Ldl was 100 instead of 110 or something - when everything else looks great and the HDL is "over the moon" good.   He does care, and that matters a lot.  The docs that care may be few and far between these days.



Re: your question in 2nd paragraph-  no, I didn't know that.  I haven't worked in the field in around two decades, and my own health care is limited to when I need health care for specific reasons- although with lack of transportation and inability to find a regular doctor, not always then, either.  

If I can add:  everybody should read this book written quite a few years ago-  https://sellingsickness.blogspot.com/  as only an example of how nutty it's become.


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## Gardenlover (Feb 23, 2020)

The nurse practitioner always "seems" to spend more time with me during the office visit.


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## Liberty (Feb 23, 2020)

JaniceM said:


> Re: your question in 2nd paragraph-  no, I didn't know that.  I haven't worked in the field in around two decades, and my own health care is limited to when I need health care for specific reasons- although with lack of transportation and inability to find a regular doctor, not always then, either.
> 
> If I can add:  everybody should read this book written quite a few years ago-  https://sellingsickness.blogspot.com/  as only an example of how nutty it's become.


Yes, but with that said, the statistics do show that cardiac events (and lets face it if you have one, its an "event") is lower for those whose LDL particle size and number are within certain limits.  My husband has a high Liproprotein (a) and this marker is very telling as a greater number  of people with this genetic marker have been shown to have heart /stroke related issues.  For that reason, its good to look at everything.  This marker can't be changed but others can.  https://www.lipoproteinafoundation.org/page/UnderstandLpa

More women  die from heart issues that other major health issues  combined.  That's another misconception, that women don't die from heart as much as men.

As far as the statin issue...if they are making money from it it's certainly not from my hub.  His generic statin (which has done a great job of lowering his other Ldl numbers) is like FREE!  Also, going to a good cardiologist lets your blood work do a lot of talking...for blood glucose numbers (very important)  and other  overall related information with respect to in range organ functions.  To us, its well worth the time to go.


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## Aunt Bea (Feb 23, 2020)

I am seeing an MD but I have had good results with nurse practitioners working under an MD.

Try contacting your insurance provider for a list of MDs in your area that are in-network and still accepting new patients.

Good luck!


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## Nautilus (Feb 23, 2020)

What irritates me is when I make an appointment to see a doctor and I'm seen by a nurse practitioner.  What's next, an orderly? Am I not being charged "doctor rates?"  Shouldn't I get a discount?  If I buy a Cadillac should I be content to drive away in a Chevy?  It's bait and switch!


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## Autumn72 (Feb 23, 2020)

Yes me too, I am up there with this way I make an appointment to see a doctor. I was told the doctor who is way younger than me, is the director of the whole medical center where people fr India, irac, Iran etc are sitting in the waiting room. I thought dear god  I on another country.

Then the doctor is holding on to her laptop oversized as makes my laptop look like a Android phone.
The whole time holding her computer asking me what's wrong.

With her two child like service learner's on either side of her in silent newby stance.

What happen to the old doctor office practice?!?!??
Last time I saw her, yet when I asked s doctor there older than me, he said he was only to be there for two weeks.
He was the one who gave me meds to sleep. When I ran out new Dr. Said oh no you can't have this med it's too strong.
I guess this is a gentle way of saying we the young are now taking over and pushing MDS out. We will now call all the shots
Less you know of the systematical change over.

I never went back blood pressure pills same as for Hospital local  I ran out of
It too overwhelming what is happening. What I have been going through dinceay 2019 in


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## Butterfly (Feb 24, 2020)

I usually see a Physician's Assistant or a Certified Nurse Practitioner and I'm fine with that.  Most routine things don't really require an MD to diagnose or follow, and I'm in good health, so what's the problem?  It really doesn't take an MD to look at your labs and say "Yup, you've got a UTI" or sinus infection or your cholesterol is a bit high, or whatever routine thing, and it frees up the MDs to work with folks who really need them.

And, as an added bonus, I've found generally that the PAs and CNPs seem more interested in you and what's going on with you and do spend more time with you and treat you more as a human being than just being "the UTI in room 8."  I like that.


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## OneEyedDiva (Feb 24, 2020)

I still see medical doctors: PCP, cardiologist, GYN. glaucoma specialist and gastroenterologist.  I'm in N.J. and I do know that some offices have the nurse practitioners who see patients. My DIL and grandchildren were very happy with the NP they saw, who happened to be in my husband's doctor's office. I (and his other family members) felt the M.D. was getting senile, thus not competent. When the NP came in and consulted with us...I liked her and had more confidence in her.  
I'm on the patient advisory council at my PCP's office. About 6 patients, the nurse, the NP. the receptionist/secretary and office manager meet 3 or 4 times a year.  A couple of the patients see the NP and are very happy with her care.  Since attending the meetings, I feel if my doctor couldn't see me for some reason, I'd be comfortable with her.


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## Lvstotrvl (Feb 24, 2020)

When I moved here from Fl I couldn’t find a dr that was taking new patient,i finally got an NP after a year. I really like her but, I have a Urologist n Gynecologist n a few more specialist, no Cardiologist yet tho.


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## treeguy64 (Feb 24, 2020)

When I went to an Urgent Care facility, last month, after slicing open my finger, I saw a CNP. Nice guy, but he wore no gloves when examining my wound. True, he constantly hit the dispenser for whatever was in it, but I was po'd about his lack of gloving up. When I was a tattooist/body piercer, I lived in gloves, six hours a day. 

I do think we are entering a physician shortage era. It doesn't matter, that much, to me: 90% of the time, I know more about what's ailing me, than my attending. I do my research, and use a med pro to confirm what I already know.


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## Ken N Tx (Feb 24, 2020)

Liberty said:


> We bypass the PCP look and use our cardiologist.


Ditto...My 2 PCPs retired last year!!


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