Remember when you actually got to talk to a doctor when you went to the doctor?

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raisinghellions@reddit

I love my NP and specifically ask for an NP over an MD if I ever have to change providers. NPs spend way more time with patients in my experience and take a more holistic view of overall health than MDs who usually see you for 5 minutes and spend most of that time adding notes to your chart.

Hot take, but I think MDs are more useful in hospital settings, specialties, and research than in family practice. (If you’re an MD that loves family practice and takes a lot of time to get to know your patients, I’m sorry and please know I’m not talking about you)

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mudfud27@reddit

NPs generally have less medical training than a 4th yr medical student. There are a few programs that do a better job of training than others but nowadays most are online and none are even close to physician or even physician assistant training in terms of rigor or duration. The certification process for NPs is truly a farce.

Gently, you need to check your facts here.

Everyone deserves a fully trained and qualified practitioner of medicine (not nursing) to diagnose and treat them. Don’t settle.

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strangedazey@reddit

Yes, and I love my NP. She listens and takes time to address my concerns. No worries

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Revolutionary_Bee700@reddit

I always see my doctor twice a year. She found something rare that was easily treated, that would have been brushed off by someone else.

If I have a minor acute issue I don’t mind a NP at all!

You can’t expect to walk into an urgent care and get controlled substances. If you have chronic back issues you should escalate to a specialist now, instead of relying on urgent cares.

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Solid-Bee-1613@reddit

Most urgent care around me are NPs as well. Sounds like you need to either visit a specialist or go to a chiropractor. An orthopedist will see you without a referral from PCP or ER and will most likely get you into a physical therapy regimen before suggesting surgery. Also there are non narcotic pain medications.

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DramaticErraticism@reddit (OP)

Doesn't help me much when I need urgent care...which is what my post is basically about lol

Yes, there are non narcotic pain medications, obviously. I don't go to urgent care to get something I can just get myself. I want expert advice and someone who can prescribe me something to help my situation...why else would I go? I just want to see a doctor when I go to urgent care OR I want to pay 1/4 the price if I have to see an NP.

I dont want to pay for a doctor and then see an NP. I dont think that is unreasonable.

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Solid-Bee-1613@reddit

Perhaps you misunderstood, there are non narcotic prescription pain medications. I have 2 bad knees, broke and dislocated my wrist a couple years ago and have daily neck pain. An orthopedist can help you. I know when its after hours or a weekend options are slim.

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Hydroidal@reddit

Do not go to a chiropractor. There is a reason chiro schools have a 95% candidate acceptance rate while medical schools have an average acceptance rate of 43%. Chiropractors are quacks.

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Exciting_Pass_6344@reddit

I avoid urgent care places like the literal plague because of this. Unless it’s an absolute necessity, I’ll just go to my regular doctor. I think I’d rather go to the ER (we have several close to where we live) than bother to use the doc in a box.

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Emunahd@reddit

This sounds like more a medication issue than an NP issue. The opioid epidemic makes it impossible to get painkillers now, even for those of us with known and documented issues. My own GP had to refer me to pain management after a car accident. It’s ridiculous.

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Ilovemytowm@reddit

As always with this f** world they go from one extreme to another handing out pain meds like they were candy ..

Now they won't give out any so we all have to pay the price

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Just-The-Facts-411@reddit

This is just one anecdotal situation but I can't imagine Im the only one who has been wondering how NPs have suddenly been allowed to replace doctors with all their education, fellowship experience and intense education with someone who has an online degree from DeVry university.

I don't want to offend people who are NPs...but I just dont understand what their value is? It seems like it is a job that the medical world invented so they could pay someone less while charging patients the same for a reduced level of care. Am I crazy here?

Not sure if you are crazy. Sure that you are rude.

A NP is an RN with advance training in a specialty. The position was created to respond to a doctor shortage in the US. NP can write prescriptions, unfortunately for you not the scheduled narcotics you wanted. 20 years ago, our office had a NP on staff every day in medical and the MD would come in a few times a week. For most visits, the NP was sufficient. This allowed us to have someone available to diagnosis, do referrals, and write basic prescriptions.

Yes, many urgent cares are staffed with NPs and PAs over MDs. It is a cost and availability factor. You can lobby your local state government and insurance board about the costs and ask that visits with NPs and PAs cost less. I would think insurance companies would be on board with that but then again, they'll probably just cover less and the facility will charge the same.

Next time, ask if there's a PA, MD or MO on staff because you need a narcotic.

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PMMeYourTurkeys@reddit

The best general care I ever received was from a PA. My PA correctly diagnosed that my gallbladder was trying to kill me while the ER docs just shrugged. I have personally found that PAs and NPs spend more time listening and aren't trying to hustle you out the door.

I'd still have my PA if we hadn't moved out of state and have considered flying back for annual checkups because I haven't found anyone as good locally.

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MarsupialPristine677@reddit

Yeah, same. Also, PAs and NPs are way more likely to listen to the actual words that I am actually sayimg to describe my actual experiences. Many doctors have seemed like they were listening to me only to just make random shit up. Very tiresome.

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Extra-Blackberry-984@reddit

My PCP is a PA and I’ve been with him for 30 years. Absolutely satisfied with the quality of care!

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bravebobsaget@reddit

Most doctors wouldn't prescribe you pain killers, either.

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RBG_grb@reddit

I’m an NP and not offended! We can legally write for controlled substances but it’s not appropriate for non-specific back pain, especially without trialing NSAIDs, heat/ice, stretching, PT etc. We do actually staff doctors at our urgent care but it’s probably 70/30 mid levels to doctors. I do not think for one second I am the same as or on the same level as a doctor and luckily we always have a doctor available to us to consult at any time.

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-Granby-@reddit

I was salty about it at first. Several years ago I had to start going to a pulmonologist for my COPD. saw the main doctor once and he was meh. For years now I have been seeing the NP there and she is amazing. I love that women. My wife and I both have been seeing a GP actual doctor for several years and again he is meh. We just switched to a different clinic and now we see the NP who is amazing. I'm cool with it.

As mentioned the thing I hate is no pain meds. Like ever. As usual the government over corrected. 15 years ago I agree opiates were over prescribed. It was a problem. Now the problem is they are not prescribed at all. People are still in pain. As an example my mother just had a hip replacement. Had to schedule it like 7 months out. Was in a tremendous amount of pain the whole time. They would not give her anything stronger than Tylenol. Out of the question. It's not cool. Did she need 4, 80mg oxycontin a day for 7 months? Of course not. Could she have used 3, 5mg Vicodin a day? Absolutely yes. It is ridiculous.

People get hurt all the time. Back injuries and such. They don't need pain meds forever but 10 days worth of something while you heal up would be nice.

There used to be signs in hospitals telling you that you have the right to not be in pain. Not anymore.

Of course big pharm ruined it by pumping the shit out there like nothing claiming it was not addictive. People were dying and doctors were getting sued and then they pulled back and now it is under prescribed.

But yeah I don't mind seeing the NP's at all.

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ailyara@reddit

NPs are goated tbh, every one I have seen have been better at listening and really getting to the issue and then making solid recommendations that the doctor signs off on. 100%.

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Adventurous_Gain_613@reddit

NPs are cheaper, make money for the system (research shows they order more testing than physicians), and can be switched from specialty to specialty (which is crazy, considering physicians have loads more education and training, and yet can’t switch specialties without repeating a residency). There is a time and place for NPs, to be used as physician extenders. They are good for algorithmic medicine, easy diagnoses, f/u, etc. They don’t know what they don’t know, however. And most these days do not have the decades or nursing experience that was supposed to substitute for the rigorous education of physicians.

I’m a physician who works with NPs. I review all my NP’s notes and I have caught things that would have led to delayed or missed diagnoses.

I only see physicians.

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ailyara@reddit

You're going to have issues seeing NPs too soon because the federal government decided that nursing does not qualify as a "professional degree" meaning nurses trying to go for advanced education can no longer borrow as much money for education as they could before, meaning fewer nurses will be able to afford getting those degrees.

Great thing to do, considering the nursing shortage. And even if you falsely believe that somehow nurse practitioners aren't good enough to see to your care, who do you think trains new nurses? We have an aging population and our birth rates are trending downward so like with any first world country where that is the case you're going to have fewer individuals entering the workforce to support older people leaving the workforce so ... yeah. Nursing Shortage. Doctor Shortage. You may have noticed a lot of doctors are immigrants and the current administration is making those people feel unwelcome too. So you're lucky to see anyone. I used to be able to easily get a dr appt the same day I called or within a few days at most. Now I'm lucky if I can see a professional in the next three months.

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Alemya13@reddit

I'm a big fan of NPs and PAs. A PA diagnosed an 8-year long issue with one simple ultrasound - one four different specialists couldn't figure out. However, I DO get what you're saying about doctors - and I think it's about to get worse. A friend saw a specialist recently and he apologized for running late - he was training the new AI.

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rks1743@reddit

After my Dr. retired and our health insurance changed providers; I had to find a new Dr./practice. My wife, kids, and myself now have the same Dr. who is probably in his early 30s and is awesome. He talks fast and talks a lot but never makes you feel rushed. He takes his time explaining and then discussing paths forward that everyone can agree on. Hopefully we never need a new Dr.

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nic5678@reddit

I’ll take my NP any day over a doctor. She takes time to listen to me and if she has any hesitation, she’ll give me a referral to a specialist. Some patients might not like that, but she was the only one to refer me to a kidney specialist and we caught an issue early. There is no ego involved with my appointments.

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LuckyAd2714@reddit

I love NP’s and PA’s. But I get my doctor if I ask

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81632371@reddit

I actually love my NPs/PAs (GP and specialties). I get more time and attention than with most docs. But they are in medical practices, under an MD. They can prescribe meds because they are under an MD. I can see the MD if I need to.

I'm not going to an urgent care unless it's truly urgent (like it's Saturday and I have a UTI) and getting whomever they assign. It sounds like you need to make an appointment at a medical office where they can do a real assessment.

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DramaticErraticism@reddit (OP)

It sounds like you need to make an appointment at a medical office where they can do a real assessment.

Mate, the entire point was I needed urgent care, urgently. I expected to see a doctor and get a doctor level of assistance and a doctor level of abilities, not pay doctor prices for someone with much less experience and much less ability to do anything to help.

My back got better on its own after a very painful 3-4 days. I am glad to hear that my experience isn't universal though, you seem to have great luck with NPs.

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notevenapro@reddit

If you have a chronic back issue that requires those drugs you got to go to a pain clinic. Floating from urgent care to urgent care and requesting opioids is going to get you labeled as a drug seeker.

I was on opiods for 18 months. It is really hard to get them using the urgent care route because it has to be managed and followed up.

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butterflygardyn@reddit

If you need to see a doctor you need to go to the ER. I have a husband with a bad back and it takes 3-4 days to recover every time he puts it out. There is nothing that can be done to help. There is no shortcut. He either lays flat on the floor with his legs up or he hangs over the ottoman. For 4 days. Because that's how long it takes for swelling to go down and the disc to slip back into place.

But he keeps emergency pain meds on hand for when it goes out. Talk to your GP about pain meds/muscle relaxers and physical therapy if this has happened before. You have unrealistic expectations of what a doctor could do to help you. But seriously, if you want to be seen by a doctor, you have to go to where the doctors are. In an emergency, that's the ER.

Urgent care is always NPs and PAs. Doctors don't work there.

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DramaticErraticism@reddit (OP)

Urgent care is always NPs and PAs. Doctors don't work there.

They used to! Times have changed tho, sadly.

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butterflygardyn@reddit

Not where I live. Urgent care places have always been NPs and PAs. Since the 90s at least. You're sounding like a boomer. "Back in my day..." 🤣

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Minute-Actuator-9638@reddit

I’m going out on a limb to say it’s probably related to the historical issues with pain meds in the US. Pain medication prescriptions dropped off in 2010. There was a problem of over prescribing from 1990-2010 that led to the opioid crisis. Urgent cares played a big part in this because people would visit different urgent cares to get prescriptions and not disclose their history. 2010ish there was a major pushback from officials stop the prescription of painkillers. 2016 the fda issued radical new guidelines. I had massive neck surgery in 2018 and was prescribed 4 (yes FOUR) pain pills.

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hlmoore96@reddit

I PREFER my NP. She listens better than any doc I’ve ever had. She writes Rx, but certain ones she needs me to take a drug test. I think it may be a state issue? She also works with a doctor in the practice that she can run the info by while treating my long term, serious illness. But while the doc knows of my cases, I never see them. I think a lot of practices are going that way.

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delightfuldillpickle@reddit

Same. I love my NP. She is a gem. I have not found a doctor who will spend more than 60 seconds with me.

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Cattailabroad@reddit

I've had far better experiences with NPs or PAs than most primary care doctors. They actually talk to you and get to know you and LISTEN. Personally I think they are the people providing the most consistent primary care in this effed up healthcare system we face right now

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SGFCardenales@reddit

Hmmmm. You are either a PA/NP or related to one.

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Massive-Insect-sting@reddit

Hmmmm you are either a primary doctor or related to one

See how fucking stupid that sounds?

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SGFCardenales@reddit

Nope. Reread your response…see how stupid that sounds?

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buddytheelf2023@reddit

I feel like more than half the time np’s or pa’s have no idea what they’re talking about. They never really help me even if they take the time to listen. We need MDs to solve the problem. That’s who I’d rather see as someone who has to pay up front for all medical issues. I’m at the point where i just don’t even go to the dr anymore cuz i can’t afford it or they are useless

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Cattitoode@reddit

This has been my experience as well. Most of the PA's I've had did not rush me through the exam and actually listened to my concerns. I have had doctors who did this in the past, but not in a very long time, and certainly not since they began bringing computers into the exam rooms and spent the visit looking at the monitor instead of the patient. I feel like my PA's spend more time with me.

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dirtygreysocks@reddit

NP can write prescriptions, though. Are you sure you didn't see a Medical Assistant?

My main PCP is a Nurse Practitioner, and is amazing. She has written all of my prescriptions for a decade.

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Toldyou42@reddit

I believe schedule 1 drugs are narcotics, they could be restricted at that level.

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DramaticErraticism@reddit (OP)

Yes, almost every state blocks NPs from prescribing schedule 1...but no doctor is going to prescribe schedule 1. I believe schedule 1 simply means that the drug is highly abusable and there is no medically viable use for the drug...i.e. its only use is to get f'd up for fun.

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notevenapro@reddit

But you needed schedule 2 drugs which are legal for NPs to write an order for in 48 states.

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dirtygreysocks@reddit

Must be a state thing. I've had everything prescribed by her. Best medical care I've ever had has been by NP.

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Relative-Accountant2@reddit

The problem is that almost everyone in healthcare is heavily scrutinized for prescription pain meds. I was sent home from an extremely painful ER run a Tylenol prescription. Tylenol. Thank dog for friends with prescriptions. The opioid crisis is what led to all this. Everyone is a junkie. Ppl with real pain are screwed.

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Cattailabroad@reddit

Can they? I thought they still needed a physician to do final approval.

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DramaticErraticism@reddit (OP)

It depends on the state where they practice and it depends if they work under an overseeing doctor, so it can vary greatly from place to place.

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MaybeLost_MaybeFound@reddit

I prefer my nurse practitioner. They’re given more time with the patient and they have access to the same things through their supervising physician.

I went to four different MDs to get help with my midlife stuff and was dismissed and/or lied to be all of them. Thanks to my NP listening, I now know I was iron deficient, deep into perimenopause, have hypothyroidism, and I feel amazing after getting the right treatment.

For managing my everyday care, I’d pick a mid level over an MD every day of the week.

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PrairieMaths@reddit

You can partially thank Managed Care for this, effectively everyone is funneled up to more expensive practitioners and facilities only as a second or third resort after the initial cheaper filtering.

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Oxjrnine@reddit

The amount of paperwork that family doctors are general practitioners have to fill out has almost tripled in the last 30 years.

Fewer medical students want to be general practitioners. The appeal of being a specialist is too great.

So your hit with a higher demand due to an ageing population. Fewer people choosing to be a general practitioner. And the ones that do are only spending about 1/3 of the time with their patients than they used to.

One of the benefits of adding nurse practitioners to general practice is that they can be trained and put into the healthcare system much faster than producing a new family doctor. They are also capable of handling a huge percentage of the routine things that family doctors deal with every day, which frees up more of the physician’s time for the areas where their additional medical training is most valuable — things like more complicated diagnostics, unusual cases, and patients with multiple overlapping health conditions.

That means nurse practitioners can often handle medication renewals, blood pressure checks, mild infections, follow-ups, and routine chronic disease management, while the doctor focuses more on the patients who require deeper investigation and more advanced medical decision-making.

What I don’t understand in your case is why the nurse practitioner didn’t go and get the doctor.

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aksf16@reddit

A big reason the appeal of a specialty is so great is that many students are going on loans and specialists make a lot more than GPs. My daughter is, and her student loan is 100k PER YEAR. Her school is 88k and they don't allow you to have a job. Not that anyone would have the time.

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Conscious_Damage8678@reddit

I have had great experiences with nurse practitioners in general medicine, gynecology and oncology.

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Sitcom_kid@reddit

if you are very fat, the doctor will talk to you. don't ask me how I know.

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Fluffymanolo@reddit

And ignore anything you complain about because it'll go away if you just lose weight.

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JJQuantum@reddit

I have a regular doctor. I see her twice a year but can message her through the app when necessary. A nurse will see the message as well and if they answer then my doctor likely won’t but if she thinks more is needed then she will. Get a regular doctor instead of going to urgent care.

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SnowblindAlbino@reddit

My primary providers have been NPs for 20+ years now. Hasn't been an issue really. There just aren't enough doctors at the practices in my area to cover all the patients, and the NPs are backed up by a huge network of specialists. I feel like I've had good care from NPs and they at least have time to talk to me when I go in.

The whole US healthcare system is a steaming pile of shit, but not because of NPs.

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Mugwumps_has_spoken@reddit

I'd rather have a NP than a resident who is moving on from the facility in a few years.
Esp for specialties. My daughter has many specialists, and for her Neuro we alternate between the Attending and the NP. When she was in peds (she has only moved to adult in the past year), I LOVED her NP. Like, seriously, I adored Lyndsey. She could always fit us into the schedule if something came up. She always had more time for us at appointments. Now, I loved her peds Neuro attending as well.

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48north@reddit

Look into direct primary care. You pay a monthly fee and have direct access to the doc. I spent an hour and a half with my doctor at my last physical.

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Cecil_B_DeCatte@reddit

And for those who can't afford that?

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Signal_Glittering@reddit

Laws have changed in the past 15 years dramatically with controlled substances. It’s not the NPs fault. I love a good NP. I think they are more thorough than an MD. I don’t get my care at urgent cares though. Stay away from those.

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DramaticErraticism@reddit (OP)

I don't blame the NPs at all, but prescriptions aren't the only issue I have. I don't want to be charged doctor prices to see an NP, I also want the vast education and hospital experience a doctor has.

You can get a nursing degree and then take online classes for two years to become an NP, there are no fellowships, the level of education is far less stringent etc.

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TopFuel9-8@reddit

A nurse practitioner literally saved my life 3 times from idiot MD's and 3 specialists who blew me off...because she took the time to LISTEN which MD's no longer do.

She personally called a surgeon at HOME to convince him to do a surgery a specialist said I didn't need because my numbers were borderline. When they took out the offending organ, the surgeon said it was full of a tar like substance that would have made the organ stick to a wall if he threw it that was going to be bad for me in extremely short order. After 2 years of bouncing around Drs and specalists and living in a mostly horizontal position, she correctly diagnosed a form of epilepsy, (our local neurologist blew me off as a complaining woman) got me to Mayo clinic, and Dr's there were stunned at the audacity of the neurologist and inability of the other Drs to figure it out. She correctly diagnosed celiac disease before it was common, after 7 months with a GI finding nothing wrong with me even tho I had 💯 lost control of my system after my 3rd kid, lost about 45 lbs in 3 months 15 more than I gained which put me about 10# under weight & couldn't even keep broth in me. (At the time swansons chicken broth had wheat in it & thats what I was eating on my clear liquid diet) The GI gave up and told me I just needed fiber. She didn't and when I went back to her she figured it out.

I won't see another MD unless I end up w something horrible like cancer or need a heart specialist or something.

Nurse practitioners specialize too, and other than the quality you can get at Mayo, 98% are far better practitioners by leagues.

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mediaseth@reddit

I have a pretty good nurse practitioner, but the extra appointments to get to the right kind of specialist gets annoying. It used to be that your doctor could figure things out and you'd leave with not only a prescription but a few sample pills from their closet until your prescription could be filled. It used to be that if you had to be referred to a specialist, they weren't booked months out. You just got in, somehow. I remember arguments against single-payer/socialized medicine mentioning the exact same scenario we have right now with private health care and multiple insurance companies.

I don't know how to fix it. I just want it fixed.

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FawnLeib0witz@reddit

I love my PCP and almost always see her. She spends plenty of time with me and has never rushed me. I saw the NP at her office once as an urgent issue and was misdiagnosed. Also saw an NP at urgent care once and was misdiagnosed.

I will stick with my PCP.

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beetlejuicemayor@reddit

This is the current situation in healthcare. I see a PA at a urogynecologist office because you can only see the doctor if you are having surgery. It’s so damn frustrating because I have a chronic condition. I need to find a new provider.

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b5wolf@reddit

I am on maintenance meds for my PMOS/T2D plus some cholesterol meds. I have been on them for about 10 years. Unfortunately, one of them can build up potassium so I have to have blood checks every 6 months. Half of my appointments are with the PA although most times my Dr pops in.

Scheduled drugs have became such a topic, most providers won't prescribe them unless you have an active, on going relationship with them. I had to go to the ER after getting hit in the head by a 4x4 during a remodeling project. Concussion, orbital fracture, 16 stitches and a script for ...Tylenol 800mg

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earinsound@reddit

I live in a major city in CA and see my doctor each time I go. My parents live in a small town in AZ, it’s mostly NPs. Although the median age is 65 there they can’t attract doctors and when they do, they don’t stay.

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Environmental-Gap380@reddit

I see my PCP every 3 months. I’ve been with her since 2011. She is slowly retiring. She stopped taking new patients a while ago, and as patients leave, she has reduced her hours. To get an appointment. You need about a month’s lead time. She is great, and I don’t know what I’ll do when she fully retires. Our only issue is her long time nurse left, and the replacements have not been as good with keeping the prescriptions with the proper refill frequency. Original nurse kept up, and I never had to request a refill.

My dad was an MD, so growing up, I rarely saw someone else. It made me have a hard time with going to other doctors.

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This-Assumption4123@reddit

It took months to get in to see the “cardiologist” and when I got there I saw a PA but paid like I saw the doctor. My follow up after starting medication for POTS and low blood pressure I was supposed to see the doctor but again I saw the PA. I am still blacking out with blood pressure dropping to 53/37 in the evening and morning so he doubled the dose and I was scheduled for a six week follow up. He mentioned the next time “it has to be with the doctor per insurance requirements” and I advised I had only wanted to see the doctor from the beginning and I waited to see the doctor and didn’t get one. He seemed annoyed but so was I. I could die before I see him and the PA honestly has no clue what he was doing. He looked fresh out of school. For my GI doctor he only works two afternoons a week, one doing procedures and the other reviewing his Pa’s notes so it’s not even possible to see him without getting a procedure done. Like how am I going to let you put me under if I don’t know you enough to trust you. It’s ridiculous. I work in healthcare myself and I work with surgeons so you always meet the surgeon we don’t have PA’s so it’s so frustrating.

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DramaticErraticism@reddit (OP)

Jesus christ, this is exactly my point, NPs are great for small things and common issues, but when it comes to serious problems or seeing the symptoms of something greater, you really want a doctor with the experience to understand and know about such things.

I'd rather deal with a bit of a cranky doctor who is really good than an NP that holds my hand and listens to my problems.

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sherrib99@reddit

It’s so frustrating! I made an appt w a doctor, got there and they only let me see a NP….who promptly told me I needed to see the doctor and to make another appt. So now I paid twice for one issue, which I knew needed the doctor….thats why I made the appt with the DOCTOR. Bait & switch

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TeaGlittering1026@reddit

Shit, I can't even schedule an appointment. If you don't need an appointment for something major or are not actively dying, Kaiser doesn't want to see you.

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WalnutTree80@reddit

All the urgent cares in my area are just nurse practitioners.

And as someone whose family has a lot of people in the medical field, I'll tell you that the ones who work at urgent care aren't usually the cream of the crop among nurse practitioners either.

They are either fresh out of school or have been there for years because they can't get hired anywhere else.

At my regular family doctor's office, I always see my regular doctor. But if she's out and I need to be seen quickly, there are two nurse practitioners that are very good. In fact, I like one of them better than the doctor.

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drtdraws@reddit

They're cheaper to employ, that's 100% of the reason they are everywhere. Soon it will only be an AI on zoom, so I guess at least it's still a person.

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B52fortheCrazies@reddit

Don't go to a place that is staffed by NPs/PAs. Also, NPs can absolutely write for controlled substances. They likely just told you that so you would leave.

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DramaticErraticism@reddit (OP)

Also, NPs can absolutely write for controlled substances. They likely just told you that so you would leave.

No dude, it depends on the state, my state does not allow. I'll just click this block button here, it's like asking you to leave and never come back.

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notevenapro@reddit

Might have thought they were a drug seeker.

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attorneyatslaw@reddit

I have had prescriptions for controlled substances written by NPs before. They definitely though he was drug seeking.

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boringcranberry@reddit

In 5-10 years it's going to be a lot worse. The fed government has reduced all financial aid for healthcare degrees. Whether you agree with it or not, people used to be able to fund their entire cost of their medical education with financial aid. As of July 1, the govt has split aid into two categories. Standard and professional which insulting in and of itself and their all "professionals."

Standard degrees will be eligible for 20k a year. That's for tuition AND living. Professional degrees are eligible for up 100k yr.

The problem is that doesn't cover the cost of tuition. People will not be able to afford to go to nursing or medical school without private loans. Many will just decide they simply can't afford it and we will have a massive shortage of nurses, NPs, PAs and all sorts of specialists and mds.

It will be a profession only for the rich and we'll have to wait months and drive hours to go see a doctor.

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Entire-Order3464@reddit

You're so far off the mark I don't even know where to begin.

NPs can write prescriptions for muscle relaxers and other pain pills (including opioids) for back pain.
None of them went to devry or any other similar schools. NP schooling is rigorous.
Couldn't physically find the issue? Back pain is usually a complex issue you wouldn't expect a physician to find the issue without an MRI.

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notevenapro@reddit

You are so far off the mark. NP schools vary widely and some are basically diploma mills.

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B52fortheCrazies@reddit

Agree with #1 and #3. However, there are lots of diploma mill NP degrees so you missed the mark on #2.

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Massive-Insect-sting@reddit

More and more these Gen x posts end up being some person just shouting at the sky. We are clearly becoming the embarrassing generation at this point

"I remember in my day we went and saw doctors for everything, and we liked it that way"

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DramaticErraticism@reddit (OP)

You should do your research before you try to put someone else on blast. Are you married to an NP or something? No need to take things so personally

That isn't true, it depends on what state you live in and what the local laws are related to NPs.
While DeVry may not offer NP, there are many online programs that do, I don't understand your point. If you're trying to compare NP education to that of a doctor, they are a billion miles away from each other and only an idiot would try to equate them in any way.
Wtf do you know about it? You have no idea about what issue I had, how doctors identify back issues, the circumstances that caused my back pain...or anything else! Its ok to just keep your mouth shut sometimes mate.

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DynastyZealot@reddit

Also: chiropractors are quacks. Do not go to them unless you want to risk paralysis.

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Secret-Function-2972@reddit

My family's primary care provider is a nurse practitioner and he's great. Also a rural neighbor and is super helpful answering texts outside of office hours. The clinic we go to only has one doctor, but we'd rather see this NP.

I also think it's the way healthcare is headed, maybe especially rural healthcare. There just don't seem to be as many primary care physicians.

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DramaticErraticism@reddit (OP)

For sure, the days of every small town having their local doctors office is dying. Im not sure why that is, I'd assume there would still be enough patients?

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Secret-Function-2972@reddit

Docs don't want to live in small towns, Docs spouses don't want to live in small towns, there are fewer Docs anymore compared to the population, people spending that kind of money on med school don't want to go into primary care but rather specialize where the $$$ is, etc. Likely a multitude of reasons.

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aksf16@reddit

Health care is a mess. It's very difficult to become a doctor because of the expense as well as programs not wanting to expand the number of students (they want to stay "exclusive"). Look up the numbers, it's crazy. Meanwhile our population is growing larger and older. Their solution? Push people towards NPs and PAs. In many routine situations this works. However, more complex health conditions require the significantly increased amount of education and training a doctor receives. I've been going to a neurosurgeon's office for spinal issues. I saw the actual doctor one time for about 10 minutes. Since then I've been sent to a PA who can't be 30 yet. She's nice, but she doesn't know what to advise. She just says things like, "We can do x" or "We can do y". I think she's scared to say one way or the other.

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the_real_MBAPROF@reddit

Always able to see my primary. If not he has several PA’s on staff. If that doesn’t work, off to the ER. Again probably seeing a PA.

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Whynot151@reddit

I went to an appointment at a pain management clinic yesterday, it was an introductory appointment and I was seen by one of the many PA's there. There were posters on every wall stating the order of operations there, the only time you see the Doctor is for procedure, all other things are done by the PA's. I spent an hour with an actual salesman, in the exam room, being pitched an electronic implant for my pain. This appointment could have been handled with a text giving me instructions for imaging, instead they collected my copay and the payment from the insurance company for letting a salesman pitch their product. Looked it up online and it is a shit product embroiled in lawsuits and controversy, no way.

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DramaticErraticism@reddit (OP)

Yeah, I am not sure there are any pain clinics that are on the 'up and up'. They are for-profit institutions that try to make money out of addicts and people in severe chronic pain.

I remember when I lived in Florida, they were everywhere.

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Glum_Manufacturer232@reddit

All of our PCPs are switching to concierge business model. $1200 a year per person on top of insurance bullshit.

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rcook55@reddit

I talk to my Doc every time I go in. I also go to a teaching clinic so that might be why. I haven't not talked to a Doc in decades.

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notevenapro@reddit

Go over to the nursing sub reddit. There are nurses who move to NP with little nursing skill.

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hapster85@reddit

You don't want to offend, but basically just said they're uneducated, with worthless degrees, and bring no value to patient care. I'd hate to hear what you had to say if you did want to offend someone. Lol

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AnnieFlagstaff@reddit

My primary care provider is an NP now and I am convinced she is going to save my life someday. She is so much more thorough than most doctors I’ve seen.

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Informal-Gene-8777@reddit

My migraine specialist is an NP and she is the bomb. I also had one for birth control/gyne care when I was younger who was a fucking gift.

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OBB76@reddit

I've had so many different doctors over the years who either just threw drugs at the problem, dismissed it, or just sent me a 100 referrals without really doing anything.

I just found a doctor, close to my age and he has been amazing. Really listens to my concerns and provides viable options instead of doing what the previous doctors have.

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Rearrangemetilimsane@reddit

Mine uses webmd. I have less confidence.

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CapitalBluejay7619@reddit

My doctor told me that he got offers from Canada to practice there, he said the paperwork was included in the most 50 hrs a week. He told me the amount of paperwork that has to be done is ridiculous. I see him each time I go but he talks about how he would never tell someone to go into medicine, unless it is for a specialty.

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MaximumJones@reddit

There is a shortage of doctors due to all the unnecessary hoops they have to jump through now.

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TertlFace@reddit

The problem is that it used to be that you had to have significant bedside experience to even apply to NP school. You had 10, 15, 20 years at the bedside before out-competing your peers for a slot to grad school. The idea was to take an experienced professional, add advanced education, and come out with a competent midlevel practitioner.

Now you can literally go direct-entry to NP school. You can come out of high school, do five years at a diploma mill, and come out with the same license as that grizzled vet and DNP after your name. The dilution of quality has led to a whole host of problems.

Source: Me, respiratory therapist x20 years turned RN

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freakymack@reddit

I have never had this problem. I am chronically ill and in all sorts of pain. And as far as an opiate…no one is writing scripts for that no matter what. I believe certain cancers can get them but that’s it.

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attorneyatslaw@reddit

I always talk to my doctors when I go to the doctor. They definitely have less time to talk to you than they used to, though, but it greatly depends on the doctor and how busy a day they are having.

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Freeflying_Dragon@reddit

I see a NP for my annual ckeck up every other year. There is a clear difference between NP and meeting with a Dr. The NP seems to be running through a check list without looking at my physical health records with me. Was out of there so fast, had 45 minutes left on my Parking meter.

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kermitsfrogbog@reddit

When I go to my PCP I am seen by the doctor. Actually talking to him is another issue. Lol! He used to be much better. Not sure what happened. Now he’s just a source for referrals to other doctors who don’t take my insurance.

My previous PCP, who I unfortunately had to leave, was awesome. But he went to a concierge medicine business model and also stopped taking my insurance.

I’ve also had some great NPs.

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DramaticErraticism@reddit (OP)

I love my doctor PCP. That being said, she is a black woman and I get the feeling that she is extremely aware of what its like to not be heard and seen. She's the best.

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sunnypurplepetunia@reddit

Very few medical prescribers are prescribing controlled medications anymore. The laws are very strict & very few want to lose their medical license.

Next time go to an orthopedic walk in clinic, not an urgent care.

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Sasquatchmas@reddit

I love my NP. She takes the time to sit down with me and really talk. She has helped me way more than any doctor has since the early 2000s. The opioid crisis ruined everything.

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Sasquatchmas@reddit

And what I mean is that crisis was the exact point where doctors stopped listening. I know this because I had a standing script for T3 and suddenly I was treated like a junkie. My doctor disappeared from her practice. She always told me I was responsible with my script, which was why she kept refilling it. It was a very confusing time.

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buddytheelf2023@reddit

Urgent cares suck. I would rather just die than go to one. Waste of time, waste of money, at least for me

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NotYourScratchMonkey@reddit

I have only personally been to urgent care one time and it was because I cut my finger pretty badly and I felt they did a pretty good job with getting me in, treating my injury, and giving me post injury advice. I think it was a much better experience than I'd have received if I went to a hospital emergency room.

My wife has only been to an urgent care once and, again, she felt it was a good experience. She actually injured herself on a boat in Honduras. The local urgent care clinic was terrific but short on supplies (but the doctor was great and he did the best he could with what he had on hand) so when we got back, she went to an urgent care to follow up because it was the weekend and she couldn't get into to see her doctor until later in the week.

When she finally got to her doctor, her doctor said that both the Honduran doctor and the urgent care doctor did absolutely the exact things she would recommend.

I'm not discounting that you had a bad experience. Just saying that not everyone has bad experiences at those places.

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MaximumJones@reddit

I never see an NP, always my doctor.

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egret_society@reddit

I never go to the doctor so no.

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Melvinator5001@reddit

My PA moved on and I was passed on to a doctor who has been my doctor now for two years. She is leaving the practice in August. I have never seen or laid eyes on this woman. I have had 2 physicals and a minor medical issue which resulted in 3 appointments none of which did I see her. Got another Dr once and a nurse practitioner the other 4 times. The last visit they asked do you know Dr. so&so is leaving. My response was “She was never here”.

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butterflygardyn@reddit

NP are wonderful. And highly educated. I would rather see an NP or PA than a doctor a lot of the time. I have found that they will actually listen and answer questions while doctors are often rushing to the next patient.

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aksf16@reddit

Their education isn't even close to a doctor's, and for ccomplex situations that matters. My current pup is an NP who's been pushing the wonders of nicotine at me.

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Massive-Insect-sting@reddit

Get off drugs if you're going to respond

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DramaticErraticism@reddit (OP)

Found the person married to the NP lol

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Fantastic_Golf_7154@reddit

I saw my clinics NP for years. I actually liked him better than my primary. Then back in May/June of last year I started having more and more serious issues. As he would go through my records and talk with me, he would tear up (I've known him for 15 years). He finally sent me to an internist at the clinic because he didn't want to miss something that might be going on. Honestly, I miss seeing my NP

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Breklin76@reddit

I talk to me doctor every visit.

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AshDenver@reddit

NPs begin as Registered Nurses (RNs) with a BSN, then complete 2–4 years of graduate study to earn a Master's (MSN) or Doctorate (DNP) in Nursing.

For routine care, NPs are fine.

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WilliePullout@reddit

Yeah I don’t visit them. So I’m moving on with my cancer treatment and I get it my doctor is busy and I’m doing well. So she sent me to the np. Well I’m not driving an hour to go see him. I requested a video chat and my blood draw be on my own. They want to save money by using a np but want to still charge specialist prices. They have 1 doctor and the rest are nps. Hospitals and networks are fucking slimy. It’s all greed.

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Cattailabroad@reddit

You are paying OOP for cancer treatment?

It's FAR better to see a NP than to not go at all. I'm sorry, but this is a terrible decision.

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WilliePullout@reddit

No I’m not paying out of pocket. Not sure where that was gathered from but good day.

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DramaticErraticism@reddit (OP)

Totally, if they want to give you the option to pay 1/4 of the price for an NP, that's a nice option to have. Just don't try to tell me you're giving me gourmet pizza and then show up with little caesars.

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WilliePullout@reddit

Fucking Torino’s lol

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Ray_The_Engineer@reddit

We relocated, and my current dude is a NP. That said, he seems pretty sharp and willing to give me the time I need during a visit. Prior to that (3 years ago), I had always had MD's.

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HighJeanette@reddit

Yes you are.

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Badrear@reddit

I had really bad bronchitis bordering on pneumonia 20+ years ago. I called my Dr’s office, and they said he could see me in two weeks or I could see a NP that afternoon. I’ve actually had better luck seeing actual doctors since then.

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DramaticErraticism@reddit (OP)

I guess if your option is to see an NP instead of a doctor or just dying of pneumonia, Id probably want to see the NP.

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discgman@reddit

Urgent cares are not hospitals. You don't get to see a doctor unless its serious, even then its by zoom.

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WAstargazer@reddit

If you look at it from a nursing perspective, the rise of NPs means higher wages, status, and regular schedules. And let's face it, most of what is needed by a majority of people can be handled by a Nurse Practitioner. However, I also agree with what is said here- I miss talking to a doctor as my PCP. I feel my NP is not thoughtful enough to look big picture and see what is actually going on with my health. Even if you can afford healthcare in the US, you are getting less and less care. Enshittification is happening, but we cannot pin this one on the nurses.

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squishygrapes585@reddit

Noob here. Yes, I've noticed that unless you have an appointment with an MD, you see a nurse practitioner, physicians assistant, and medical student doctors. Granted the hospital system I go to is a teaching hospital.

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usingbadnamesabunch@reddit

15 years ago they were handing out oxycontin like it was candy. Purdue pharma was sued. This was kind of a big deal.... You might have heard about it.

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digawina@reddit

Well, there's a horrible doctor shortage, so this is the result.

Maybe if people didn't have to go into a lifetime of crushing debt to go to med school, we could have more doctors.

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KurtStation68@reddit

In our healthcare group, NP acts where a physician doesn't need to be there. Maybe at an initial visit, but routine is followed up by NP. I think about 20 years ago I first started seeing NP.

Now you can go down the rabbit hole as there's a lot of specialists within in NP community. I get the need to help provide relief for physicians and other healthcare providers.

Without getting into politics or societal changes/culture - like most things nowadays it's definitely conveyor belt care. It's not what it was like 10 years ago, doubt it's gonna change.

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Frequent_Cut_1251@reddit

My primary health care provider is a NP, I love her, she’s far better than the doctor in the office. My wife sees the doctor as her primary, and I used to, but she’s a better fit for me. I’m not missing out on anything.

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GroovyGmaIvy@reddit

I was in healthcare for almost 30 years, but a nurse practitioner almost killed my now ex-husband so I don’t trust them anymore.

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DramaticErraticism@reddit (OP)

I imagine a lot of them believe that they're just as smart and educated as any doctor. I suppose when hospitals are using them like doctors, to save money, it's an easy jump for them to start believing they are doctors.

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Educational_Bid_5315@reddit

I go to a PA and I love her. I’ve also had positive experiences with doctors at urgent care. Maybe it’s just the area I’m in

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DramaticErraticism@reddit (OP)

Im sure things vary a great deal between facilities and states.

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theblisters@reddit

I always see the doctor I made an appointment to see

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No-Top-883@reddit

Healthcare is a mess. Doctors are retiring early as they are fed up with dealing with insurance and corporations are buying hospitals and health care systems. I am friends with a lot of people in medicine and the NP Is bridging the gap. It all sucks.

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StankyBassFace@reddit

I see what you mean, but I’ve actually begun to prefer my doctor’s NP over my actual doctor. I’ve had the same doctor for a very long time, but it seems she’s just not giving much of a shit about what’s going on with me these days. I started seeing her NP and realized the NP was far better at giving care. And this is coming from someone who was a paramedic in the same health system.

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Honeybee71@reddit

Hmm I always see my doctors

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CCHTweaked@reddit

It’s more complicated than just enshittification. A lot of doctors have left the field of work because of COVID. This is effecting care for everyone as there are simply less doctors in practice.

This means that in la,Des where a doctor’s level of care isn’t required you get a NP for triage.

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boybrian@reddit

Sounds like you need insurance and a PCP. You did not follow up with a specialist and go to PT?

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DramaticErraticism@reddit (OP)

Why are you trying to turn this around and blame it on me? Such a boomer thing to do.

I have a PCP but I wasn't going to wait a week for them to see me for a problem I needed help with immediately.

I'm just picturing you with blood everywhere, using duct tape, while you wait for your PCP to have an open appt to see you lol

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DramaticErraticism@reddit (OP)

Ah yes, forgot about that word, perfectly stated.