PA Versus MD

todd121

I've been seeing the same oncologist for 4 years. It's been 2 years since my last tumor (adrenal gland). So far in all my followup appointments, I've seen the oncologist. On this last one I was surprised that the oncologist didn't see me. A PA saw me. I asked him what's going on and he said that since this is routine followup and the doctor is busy, he's going to see me now. He told me not to worry, that the oncologist had reviewed my CT and blood tests and everything is good.

To be frank, my oncologist never did a very thorough exam. His physical exam consisted of "acting" like he was listening to my breathing and that's it. I've never liked that. When I raised concerns, he's always said I should talk to my primary care doctor about that because he knows it's not cancer because my CT and blood test is good. Or he's referred me a couple of times to other specialists when I had concerns. My adrenal gland met was not discovered by him. It was discovered by a visit to the cancer hospital's urgent care.

Who else sees a PA instead of the oncologist for their routine followups?

This is happening more and more. I couldn't even get an appointment this week with my family doctor. I saw his PA. Even my local dermatologist I've never even met him. I'm treated by the PA every single time.

The bills for services are pretty similar. I'm not even sure the bill is cheaper when I see the PA. To me, this seems like a watering down of services for the same price. I don't like it at all.

Would love to hear what you guys think of this? What's your experience with PAs been?

Best,

Todd

Bay Area Guy

I've been offered the

I've been offered the "opportunity" to see the nurse practitioner if the schedule was more amenable.  No thanks.  The only two I want to see ar either the urologic oncologist who first diagnosed the lesion or the surgeon who sliced it out.  I saw the NP for some of the surgical prep and she's friendly and competent, but for my money (well, the insurance company's moey I guess), I want the doc.

db8ne1

PA Here, too

For my kidney cancer, I saw the onc/kidney surgeon both pre and post op.  For all follow-up appointments, I've seen his PA. I had stage 1 RCC so I'm not too concerned.  I need follow-up CT's for my CRC cancer, anyway...

For my colorectal cancer, I saw my CRC onc during all chemo and treatments, but once I was done with those, I was done with him. (He's a tool...the radiologist that delivered my chemo/radiation for CRC was the one who found the kidney mass and pushed for further investigation.  My regular onc did nothing).  I now go to my GP and have him order scans and such.

mrou50

PA Vs. MD

I see a PA every other visit. I get seen twice a month and one visit is with the PA and the other is with the MD.  My PA is awesome, as well as my MD. They stay in touch and have constant meetings over all of their patients and basically speak for each other.  I do notice I get a cheaper rate when I see the PA.  She is very thorough in her exams and if there is an issue she contacts the MD that day and calls me with concerns or issues.  I am quite happy with the situation and feel I am getting quality health care.

Mark

JerzyGrrl

Overall...

Overall, my experience with PAs has been OK. They have ranged from fantastic to good to not-so-much to ARGH-useless. The only time I've had contact with a PA in regards to my RCC was a phone call from the 2nd opinion surgeon's office.  That PA called me, told me the physician felt surgery was the way to go.  I asked the PA if the radiologist's report indicated the details of the cystic nature of the mass. The PA said, "Hang on," then -- instead of telling me that the report didn't say -- brought up the MRI and attempted to read it (I'd already had four opinions from three physicians at that point).  Told me, "Looks solid, all the same." That led me to believe that perhaps surgeon #1 was a tad inept because he didn't see the mass as all solid or homogeneous. However, when I got the radiologist's report, there was no mention of solid or cystic. I guess it was the PA's day to play radiologist (Yeesh), but at least I finally got the info.  All was forgiven.  Surgeon #1 did the surgery. 

Footstomper

I dont mind at all

I trust the team. Having said that, if I spend most time with the PA, it is always because of workload in the clinic (I get the impression that [a] my onc is very sought after and [b] could be better at time management) the Doc always pops in to see if there is anything I want to say or report anything worth reporting.

hardo718

PA vs MD

Having worked for many years in the hospital setting I can assure you there are some PA's that are awesome and some, not so much.  Likewise with MD's.  Sounds like your MD falls into the not so awesome group.  I don't tolerate that very well.  For instance at our PCP's office, she was on maternity leave and we (my husband and I) each saw the PA on separate occasions.  She's nice enough, but we went in for completely different reasons and both came out with the same prescriptions!  I went in because of a thyroiditis bout, my husband with a chronic dry cough and she ordered each of us a prescription nasal spray, a steroid pack and 2 allergy meds!  Neither of us will see her again.  I actually had to go back today and refused to see her, instead saw a new MD in the practice.

Kind of a crap shoot I guess.  Do whatever makes you most comfortable.

Donna~

dhs1963

For me....

I see both:  PA will come in an do a detailed exam, spend about 20 min with me.  Bascially make sure nothing has changed.    The Dr. comes in, cursory exam, and tells me the scan results,

When I was at NIH, I learned the 10 minute clinic visits were good news; long visits meant they were concerned.

foxhd

once you are stabilized

a PA is fine. There is a protocol they follow. Any issues should be run past the doc anyway. I had a superb PA my first several years. I had extreme confidence in him and he was so easy to talk with. But he moved onward and upward.