Patients wanting to see THE doctor!

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As a new NP, I find myself running into this frequently. I am the first NP for a specialty practice, in which the majority of patients do not understand what an NP is, or what we are all about. I get called "nurse" numerous times a day, as in "I don't want to see the nurse!" Don't get me wrong, I can sympathize wanting to see a physician for a new or dangerous condition. However, I often see the "easier" per say patients, follow ups and lab checks. In reality, an RN could realistically do my job, however patients seem to want the Dr. for EVERYTHING! I am at my wits end about this, I guess it is my fault for starting a job at a practice that has never had an NP or PA before. Any suggestions? Has anyone run into this before?

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Specializes in Nephrology, Cardiology, ER, ICU.

What about providing some literature to pts/families about the new provider? Include your qualifications, a brief bio. Then, close with the fact that since the practice added a provider, the pts can be seen quicker and receive the same quality care they are used to from XYZ practice.

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Tell patients they can see the Dr., but you need to see them first, towards the end of your visit, summarize your plan, ask them if they don't mind waiting a few minutes to see the Dr. Often they will be so satisfied with your care, they will tell you they don't need to see the Dr. Plus, we all hate waiting:)

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Specializes in Peds Urology,primary care, hem/onc.

Are there a subset of diagnoses in your specialty that you will be following or do you see everyone? In my practice, I see a specific set of patients. The MD's I work with will let the patients know that they will be following up with me, that I am an expert in taking care of this diagnosis, that I have more time to spend with them etc.... I have only had 2 patients in 6 years that said they did not want to f/u with me. Your practice could also send out letters/etc introducing you, your qualifications etc.

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My patients don't have a choice unless they want to go to a different clinic! I work in a small rural clinic and I am the only one there. Just me, my nurse and the receptionist. No one has ever asked to see a doctor instead of me.

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How odd. I prefer NPs over physicians and request them whenever possible. In my experience, particularly with women's health, NPs provide much better care. Not that you can say that to your patients, but some kind of notice should be given in the waiting room, so that patients can read about you and your expertise.

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I think this is a tough one. If I am referred to see a SPECIALIST, I want to see that specialist and no one else...and I'm an FNP! It is my experience that other physicians get a little ticked sometimes when they refer to a specialist and the patient is seen by an NP.

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Specializes in Nephrology, Cardiology, ER, ICU.

But that is the reality of the situation. I refer many of my nephrology pts to say a GI MD or a urologist and if I can get them in sooner with a mid-level, go for it.

I always explain to my pts who they are going to see if I know about it. However, my pts are very used to seeing me and I've heard nothing but good comments back from them.

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I think this is a tough one. If I am referred to see a SPECIALIST, I want to see that specialist and no one else...and I'm an FNP! It is my experience that other physicians get a little ticked sometimes when they refer to a specialist and the patient is seen by an NP.

You bring a great, valid point. When patients get sent to the specialist, they are scared, and think their problem is special and unique. However, I work on the other side of the fence, in the specialty, and 90% of patients fall into three or four problems. If the patient wants the specialist to also be a skilled surgeon, then the specialist has to spend more time in the OR, and not funneling the patients through pre-operative testing, that in reality an RN could oversee. However, it took me working in a specialty to realize this.

I have great respect for those working in primary care, such as you carachel2, I couldn't be an expert in so many areas :)

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How odd. I prefer NPs over physicians and request them whenever possible. In my experience, particularly with women's health, NPs provide much better care. Not that you can say that to your patients, but some kind of notice should be given in the waiting room, so that patients can read about you and your expertise.

I completely agree with you, everyone has their preference, and they are welcome to insist on the Dr, but it just seems silly to demand a surgeon to review labs or put in a few sutures?!

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How odd. I prefer NPs over physicians and request them whenever possible. In my experience, particularly with women's health, NPs provide much better care. Not that you can say that to your patients, but some kind of notice should be given in the waiting room, so that patients can read about you and your expertise.

I personally see an FNP as my main provider and have for years. However, if I have a special problem as in a cancer scare, a surgical need or a new onset neuro problem I WILL want to see the MD. If it is just a matter of a preop surgical clearance that is different altogether. If it is a matter of sitting down with a provider and going over the risk, benefits and outcomes of a multitude of treatment options I'll more than likely want to see the specialist.

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Specializes in Nursing.

If my doctor refers me to a specialist he EXPECTS me to be seen by that specialist, not a nurse practitioner because the whole point of referring me is that he needs someone with more expertise on my condition to look into it. Someone with less education and training isn't going to be of any help. My primary care physician referred me to a neurologist 100 miles away and when I got there I was seen by his nurse practitioner who referred to my migraines as "headaches". (Even though, in my chart, it stated that I had chronic migraines with aura). She literally did not know that migraines caused any other symptoms like nausea, dizziness, blurred vision, sensitivity to sound and light and touch, fatigue, etc. She knew nothing about my medications. Nothing was accomplished during my appointment. From then on any time I am referred to a specialist I call weeks in advance and tell them I am only willing to see the specialist in person, even if it means waiting for a later appointment. I have never had a problem.

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