Doctors vs NP's? - page 4

I hate to say this but I no longer like to see the NP when I go in for a doctors visit. I have noticed that doctors are much more secure with decisions and aren't so scared to prescribe something. I... Read More

  1. by   SpankedInPittsburgh
    Ha!!! Meany Butt Poopy face. Priceless!!!
  2. by   dirtyhippiegirl
    My husband's PCP (who is a MD) has done questionable things that drive me nuts but my husband likes the guy because his office is decorated in Star Trek stuff. Sigh.
  3. by   Davey Do
    Quote from dirtyhippiegirl
    My husband's PCP (who is a MD) has done questionable things that drive me nuts but my husband likes the guy because his office is decorated in Star Trek stuff. Sigh.
    dammit-jim-im-
  4. by   KatieMI
    Quote from SpankedInPittsburgh
    That's true!!! I worked a long, long time in an ER and the fastest way to "no pills for you" was self-diagnosis, an attitude of entitlement and a belligerent attitude. Patients like that typically got to wait for hours in a crowded waiting room for little more than a referral slip, a cold bagged lunch and maybe some Tylenol for the road. I have no doubt that after doing their due diligence they found a Dr. Feel-Good of their choosing but that's both the patient's and the Pez-Dispenser's problem as it is a match made in heaven and they so richly deserve one another. The only exception to this was usually if the patient showed up with all the attitudes above and constantly reminded you that they were a nurse like a mentally deficient Parrot. They also usually didn't get pills, a bagged lunch or any other darn thing just told to go see their doc.
    I must say that, overall, parrots are awfully smart creatures. At least, they generally get it pretty quickly that if the word was "no", then it was what it was and there would be no bargaining about it in the foreseeable future. (that can last 5 min., but that's another story).
  5. by   Skippingtowork
    Quote from FrankRN2017
    Unnecessary consults and repeat testing wastes money. Cost effective healthcare is today's current focus right? All men experience a decrease in testosterone as they age and a general practitioner should be well past capable of handling this just as my past 2 general physicians have. Not only is this a waste of money but also an inconvenience for patients and ultimately affects patient satisfaction negatively. Furthermore, the NP was about to refill my lexapro without assuring that I was in counseling or any type of therapy but she did not. In my opinion, just refilling a psyche medication without any further supervision or therapy is much more dangerous than testosterone as lexapro in certain circumstances can cause someone to commit suicide if not properly followed or managed correctly. Also, if you do not want to be spoken to then don't post on my thread. That's the better way of deciding you don't want to be involved. Thanks! 😊
    NPs usually work for a physician and do not always determine what types of care they will give. Many physician offices have policies dictating what they will and will not prescribe. An NP cannot go against the supervising physician. Many MDs do not address pain management, psychiatric medications (including ADHD meds) even for stable patients. It is best if a patient on psychiatric meds is in therapy, but not compulsary, especially when stable. Most people on those types of meds are not in therapy. As far as testosterone, there are MDs/NPs who prescribe it easily, and those who don't.

    Comments regarding overprescribing and excessive referrals by NPs are worrisome. The growth of the evidence-based movement did not start because of NP practice. It is a direct result of MD practice. If you work as a bedside nurse, you will see that quite a few orders are based on lack of understanding or based on habit. Much of what we do on a daily basis in healthcare is unnecessary. This has nothing to do with NPs. Each time you go in for that Z-Pack and you leave, the doctor may be saying "the patient came and won't be happy unless I prescribe something." It has little to do with good practice.

    Anyone who wants to see an MD only has the right to do so, but denigrating other professionals because of your perceptions is unfair.
  6. by   applewhitern
    Just FYI: I've been on Paxil for 14 years, and not once has anybody, MD or otherwise, suggested I get "counseling or any type of therapy."
  7. by   elkpark
    Quote from applewhitern
    Just FYI: I've been on Paxil for 14 years, and not once has anybody, MD or otherwise, suggested I get "counseling or any type of therapy."
    PCPs all over the country are prescribing antidepressants, and other, more serious psychiatric medications, every day without encouraging people to go to therapy (although psych people think that's a horrible idea), but that doesn't fit the OP's narrative, so ...
  8. by   SaltySarcasticSally
    I largely agree with you and won't see NPs for my or my family's healthcare unless I have 0 other options. They are great NPs out there, yes, but there are far too many direct entry ones or ones that spent too few years at the bedside that I wouldn't trust with my dog..
  9. by   Farawyn
    Quote from dirtyhippiegirl
    My husband's PCP (who is a MD) has done questionable things that drive me nuts but my husband likes the guy because his office is decorated in Star Trek stuff. Sigh.
    Quote from Davey Do
    dammit-jim-im-
  10. by   BostonFNP
    Quote from elkpark
    PCPs all over the country are prescribing antidepressants, and other, more serious psychiatric medications, every day without encouraging people to go to therapy (although psych people think that's a horrible idea), but that doesn't fit the OP's narrative, so ...
    I am not sure this is a good thing though, though at least in my locale, it is (unfortunately) necessary due to a dearth of psychatric specialists. Most PCPs (MD/DO/PA/NP) are not adequately prepared to treat complex mental illness; I do feel like it is important to be acutely aware of what we know and what we don't know.

    Going back to testosterone, I do prescribe it in simple cases after an appropriate workup, but I will not prescribe it in complicated cases. So if the OP is a male under 40 I likely would have referred too. I wonder if the OP would change his tune on the NP in question if the endo discovered a prolactinoma?
  11. by   elkpark
    Quote from BostonFNP
    I am not sure this is a good thing though, though at least in my locale, it is (unfortunately) necessary due to a dearth of psychatric specialists. Most PCPs (MD/DO/PA/NP) are not adequately prepared to treat complex mental illness; I do feel like it is important to be acutely aware of what we know and what we don't know.
    I didn't mean to suggest that it was a good thing -- I'm a psych CNS and think it's a horrible idea -- but my point was that the fact that the OP's NP was prepared to renew a Lexapro rx without insisting he be in therapy is not at all uncommon in the primary care world, and certainly not evidence of sub-par practice by the NP vs. common MD practice.
  12. by   BostonFNP
    Quote from SaltySarcasticSally
    I largely agree with you and won't see NPs for my or my family's healthcare unless I have 0 other options. They are great NPs out there, yes, but there are far too many direct entry ones or ones that spent too few years at the bedside that I wouldn't trust with my dog..
    First, I wouldn't recommend having any medical professional (MD/DO/PA/NP/etc) take care of veterinary health issues. It is outside their education and training. Your dog would thank you for sticking to veterinary professionals.

    Second, how exactly do you know the extent of an NPs relevant RN experience? Do you interview them as to their Rn experience in both hours and practice settings? DO you account for years as a provider as well? Enlighten us so we can all avoid those "dangerous" DE grads. Also, I trust you interview all your RNs as well to make sure they have years of CNA experience prior to being an RN: too many dangerous inexperienced RNs out there. And physicians, they really should be interviewed to make sure they had years of direct patient care experience before medical school.
  13. by   BostonFNP
    Quote from elkpark
    I didn't mean to suggest that it was a good thing -- I'm a psych CNS and think it's a horrible idea -- but my point was that the fact that the OP's NP was prepared to renew a Lexapro rx without insisting he be in therapy is not at all uncommon in the primary care world, and certainly not evidence of sub-par practice by the NP vs. common MD practice.
    Refill lexapro....seems complicated....refer back.

close