by Robert C. Laity, ©2023
(Nov. 10, 2023) — How many people reading this get to see their “Primary Care Physician” just once a year for an “annual wellness exam”? Does he or she actually “examine” you in the customary ways like listening to your heart, taking your pulse, weighing you, listening to your lungs, counting your breaths, asking how you feel and the like? Does he or she go over your complaints, review your medications, refer you to a specialist when needed?
Does your doctor see you again during that 365-day period between your “annual wellness exam”? If he or she does then you are lucky.
Many physicians are placing their obligation to care for the patients they take on in the hands of lesser experienced and lesser trained “Physician Assistants” and “Nurse Practitioners.”
Granted, Physician Assistants as well as Nurse Practitioners receive medical training in colleges. That said, it is not of a level commensurate with that of a holder of the Medical Doctor degree. P.A.s usually have only Bachelor degrees. N.P.s are most likely holders of a Master’s degree.
Specialists are given advanced training in a focused specialty and are usually trained years more following four years of medical school.
Reiterating my previous question about being referred to a specialist when needed, do you actually see a “specialist” when you arrive at the “specialist” appointment? Currently, the answer is not always yes.
You may see the “specialist” the first time you visit his or her office and no more. Then on subsequent visits you will most likely be seen by a “Physician’s Assistant.” You are also asked to pay the higher “specialist” co-pay assessed by your insurance company.
What point is there and of what benefit to a patient is there in being referred to a specialist with post-doctoral education and experience (by a physician with a four-year M.D.) only to be seen by a “specialist’s” assistant who possesses a Bachelor’s degree? This is not proper medical care and is detrimental to a patient’s health and welfare.
The medical insurance companies want their cake and want to eat it, too.
One should not pay a P.A. a “specialist” co-pay. If one is seen by a P.A. then the lower-rated co-pay should apply. Furthermore, a “specialist” should be prohibited from denying a patient his expertise while placing that obligation in the hands of a non-specialist.
The Veterans Administration has put Physician Assistants in as Primary Care Physicians. They have even taken to referring to them as “Dr.” They are not doctors. Federal Employee Health Benefit Insurance Programs are likewise guilty of this sub-par system. I urge everyone reading this to stand up to this system. It isn’t helping really sick people, veterans and others to get the medical care they deserve.
If one goes to the doctor’s office he is there to see an M.D. If one goes to a specialist’s office to be examined by a medical specialist who is more highly trained in a particular medical field than one’s primary care doctor then he should on every visit see only that specialist and not his “assistant.”
It is not only Veteran Doctors offices, it is also Private Doctors offices. For example, I went to see a Pulmonary Specialists for Asthma. They started by testing me which took 2 full appointments without seeing the Specialist. Then a Physician’s Assistant (PA) saw me for my first appointment. The next appointment, I was met with another Physician’s Assistant. I said “my doctor appointment is with Dr. Khan, and I haven’t seen him yet?” The PA asked me if I wanted to see Dr. Khan? I said absolutely! She said after I ask some questions about your health, I will go get Dr. Khan. I was flabbergasted by how these doctors are handling their patients. I would think the Medical Doctors and Specialists would open themselves to a lawsuit if the patient is misdiagnosed. I couldn’t believe my first doctors appointment with this group was not with a qualified specialist. I have Medicare plus Blue Cross Blue Shield Texas. I don’t have to pay a co-pay and can see any doctor I prefer. I do not need a Primary Care Physician to refer me either. We are paying $360 a month for our Supplementary. I agree with you, we shouldn’t have to put up with this type of behavior. I may try to find a Pulmonary Specialist that sees their patients. I be it isn’t easy to find these days.
I totally agree. I went for an MRI recently, at a well known private Neurology specialty Center with dozens of Neurologists. My Neurologist had a car accident and won’t be back until he recovers. The center told me that I can have the MRI results reviewed by his P.A. WITHOUT having the Dr. actually IN the office. By Law auxillary personnel like P.A.s and Nurse Practitioners MUST be supervised by an M.D. who must at all times BE present in said office during the time their auxillaries are treating patients.