Pts want to see a doctor

Specialties NP

Published

I just graduated in December 2013 and now work full time in a clinic. It really bugs me when a patient insists on seeing a doctor when I walk into the exam room. Have you guys experience this? What do you do? How do you respond?

I'm an Emergency Nurse Practitioner in Scotland.

Now that's awesome!

Specializes in Emergency Department.

Now there you go, just as I said it is no biggie up pops a patient I saw who asked why no-one gets to see a doctor nowadays. :)

Actually felt a bit aggrieved for a minute then thought, sod it, and got them a senior doctor to confirm exactly what I had diagnosed and what my follow up plan was.

Specializes in FNP, ONP.

I haven't had anyone express ideas of this nature aloud to me since I was a new grad, but I've been told people mumble things akin to this to the staff from time to time. It isn't surprising, given the physician centric culture we still support in the US. I'm too busy to fuss with grumpy patients. If they don't want to see me, I really am OK with that, and I say that amicably without a trace of bitterness. There are a few of them I'd rather not have to see as well, lol. But I have a professional responsibility to them and I behave professionally; presumably whatever prompted them to make the appointment 2-3 months ago was bothering them enough they don't want to forfeit their co-pay just to reschedule and wait another 2-3 months so see someone else, so we both suck it up and learn to deal with our frustrations. They live (because I'm good at my job) and I live, (because even the worst of them are just people, and most people are basically good) and we all move on. I suggest you adopt a similar attitude or you're going to be constantly upset by failing to meet the narcissistic expectations of strangers.

It reminds me of a situation with my neighbor. He choose his neurologist because she went to UPenn (great school, I'm an alum) even though he'd been referred to someone those of us on the inside well know to be a far superior physician, but apparently had the misfortune to go to medical school at the Universidade Federal do Parana, Brazil. My neighbor could not accept that someone who went to any Ivy League medical school would not be a much smarter, kinder, probably more attractive ;) physician in every way, than someone who went to school in Brazil. I mean, do they even have aspirin in Brazil yet? How could anyone educated outside of the US, much less outside of the Ivy League, possibly know anything? :roflmao: So no matter what his own PCP advised him, what his oncologist advised him, what I advised him, he looked up the CVs of all the providers on his ins plan and chose the one with the credentials he liked best. I don't think Dr. Brazil (who is internationally known, published in his field and hugely respected) is going to lose a moments sleep over it, and neither should we.

My neighbor is still waiting to see his Penn neurologist. I hope he is happy with her, I am confident he will get competent care. His confidence in her is a very important part of their therapeutic relationship, and for that reason alone, I think he is better off with her than her more talented colleague from Brazil. My neighbor has to feel safe, comfortable, assured. Our patients must also feel so under our care. Speaking for myself, if they do not, I'd rather they saw someone with whom they did. Their trust is integral to their health promotion, as well as implementing any treatment plans we have to adopt. Without it we are going to get nowhere, and neither of us is going to be better off for that.

I don't have anything to prove anymore at work. I know I'm good at my job. My colleagues know it. Most of my patient panel feels like they know it, lol. When you are a new grad, and still do have to build that reputation, let it be about the work and not about the personalities. Excellence in practice and quiet dignity, along with tincture of time seem to earn most NPs and PAs I know the complete respect of physician colleagues. Rising to the bait from the jerks among them gets you nowhere. Believe me, you won't be the only one who notices some people have attitude problems, but you don't want to be the first one or the only one to say it. I wouldn't ever put up with abuse, and I've had a 'quiet word' with a few people here and there. I think that's par for the course in most adult work places. But again, that is always about personalities, not usually performance. For now, focus on performance and the rest will sort itself out.

Specializes in Internal Medicine.

If they want to see a physician let them. Articulate that you can provide the same service and address their problem, but ultimately they are free to choose if they don't mind waiting longer.

I hate when NP's or PA's try to mask the fact that they are NP's or PA's. The best thing we can do for our profession is clearly state what we are, and then do a great job. This will allow you patients to not only appreciate you and your skills, but also respect the profession.

I appreciate all the responses! I had an episode last week where I saw a pt and gave my treatment plan, he still insisted he only wants to see the doctor. So I said ok let me call him in. The doctor came inside the room and repeated the same recommendations for treatment. When the doctor left, the pt was surprised and said oh it's just the same thing. I just chuckled and said yeah I know hehehe

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