Well that does seem to be a national trend. I had same at urgent care here in Colorado recently, and my parents in NY have mentioned they usually see PA/NP at their pcp’s office. Also I have friends have praised their beloved PA.
Until the last few years we had never seen an NP nor a PA, but now we see them except for the regularly scheduled checkups. The medical centers have filled gaps in their schedules and personnel with them.
The quality of the NPs/PAs can vary but many are much more responsive than the MDs/DOs.
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Fwiw, DH LOVES the PA, and requests all regular visits with her rather than the MD in his office. Finds her to be less rushed, a better listener, and well aware of when something needs to be passed off - often not to the doc in their practice but to a specialist.
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One of the reason for the growth of PA and NP is the debt load that physicians have, the desire to make money and that medicine is now highly specialized.
No one wants to be a family practitioner when they can make more and sometimes much more as a specialist.
Sad but true.
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My nephew’s fiancée was going to be family practice but has switched to nephrology. I’m sad because she would have been wonderful to have as a primary doc but I’m sure she’ll great in her chosen specialty.
One niece is a podiatrist and works for Kaiser. She’s urging other (family practice DO) niece to strongly consider working for Kaiser too because hours/benefits/work life balance.
H just got a new internist mid-year and now will be losing that one (she’s moving back to mainland—I think our cost of living too high) and getting a new one who is grad of local med school. It’s like a revolving door! I’m glad I’ve had same internist since 2016—it’s the same one my lung doc sees and he referred me to her. She’s been very selective on patients she accepts since.
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My friends who are a MD (H) and RN (W) encouraged their kids to become PAs. Both did and are happy in their profession. They said it would offer them a better work/life balance and pay well but not have them be in school/training so long. So far, both seem happy with the choice they made.
My nieces/nephews & their spouses became MDs/DOs/podiatrist but not APRN/PAs. Their parents were often MDs as well. It’s a long & expensive route to becoming a medical professional, especially a MD or DO.
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I have seen PAs and NPs for primary care, urgent care, and OB/GYN care. My husband has even seen one for his oncology care. I have always been happy with them - no complaints. I honestly don’t really differentiate them from the MD I might see, since I feel like I get the same treatment. I don’t even pay attention to credentials (NP, PA, MD, etc.) when I am booking my visit.
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An internal medicine specialist has 4 years of med school and a 3 year residency. A nurse practitioner has much less training approximately 2 years. As long as they are closely supervised…but.
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Also, the days when you could decide which type of doctor you wanted for primary care - an internist, a geriatrist, family medicine specialist, etc. are long gone. Now you are lucky just to get one that will see you in a year from now (accepting new patients).
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The education divide is correct. However think how many things you see an MD/DO for that are simply diagnosed and treated - common ailments or injuries, routine annuals for generally healthy people. Are 7 years of post bachelors needed to diagnose and treat your poison ivy or interpret your normal lab results?
It could be said that an MD/DO’s time is better managed by having support staff like competent NP/PA - who also went through rigor, clinicals and medical exam testing to become certified?
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And this has been my experience. A group practice where there are a mix of MDs and NP/PAs and although they all see patients, the MD can be called upon when needed for trickier stuff.
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Several DNP’s in our family ranging in age from 27-69 working in the areas of neurosurgery, oncology, gastroenterology and family medicine. All spent time as floor nurses, obtained various certifications within their fields, sit on professional boards, taught classes/written parts of textbooks. One also has a PhD. They are all deeply passionate about their careers.
Saying all this as it’s not just an undergraduate degree and then 2 more years of school.
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My eldest daughter is hoping to become a PA down the road.
I see a PA every year for my annual post-cancer check up. The PA is great.
Post-mastectomy, the weekly ‘tissue expander’ injection appointments were done by a PA. She was amazing. She also assisted the surgeon in the OR for my surgery.
Eldest daughter sees an NP for primary care & a nurse-midwife for her OB/GYN needs. Also sees a PA for a different specialist appointment.
Daughter is choosing the PA route instead of MD/DO because of:
- 2-2.5 yr of grad school instead of 4.
- Less grad school student loans you have to take out.
- As a PA, you can change your specialty. Whereas with MD/DO, if you want to change your specialty, you have to go back and do another residency all over again…so you basically start your career over.
- better work-life balance for PAs compared to MD/DO.
- doesn’t want to still be in school when she’s in her 30s.
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The last two times I was in a situation where I normally would have seen a doctor I was scheduled to see a NP instead. Both were very good.
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I have seen my NP regularly for years now. She knows me. Takes time and is good at explaining things. I prefer her to the doctors in the office. I also get my regular post cancer skin scans done by the PA. She’s great.
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When I was FINALLY able to see the only cardiologist in our state who treated Postural Orthostatic Tachycardia Syndrome (POTS) after being postponed for nearly a year due to having to complete several tests & wait for an available appointment, he told me he was moving to TX and highly recommended his APRN/PA (I can never keep the two straight). I’ve been under her care since and things seem to be going pretty well. She seems quite competent and confident. Ideally, it would be nice if a cardiologist trained in POTS could supervise, but I guess she can always reach out to the MD she had worked with for years before he moved to TX. Between the 2 of them, they managed a clinic treating over 300 POTS patients for several years. The medical center isn’t bringing in a new POTS cardiologist so it’s choice or her or no one trained in POTS.
My lung doc often has me see his APRN when he’s unavailable. She’s very nice and has more flexibility in her schedule than him. They communicate so it works OK.
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my PCP runs a family practice. She is the only doctor, and she has NPs and PAs on her staff. I always saw the doctor for annual exams and med checks, but I saw one of the PAs for more urgent visits. A couple years ago, the doctor was unavailable for my scheduled annual exam, and I was rescheduled with a PA. I have been seeing her ever since, and I really like her. It’s clear from talking with her that the doctor has regular meetings with her NP/PA staff, sharing important information and setting clear guidelines for her practice. I feel very comfortable with my care.
My MIL has an NP as her primary care professional - this is the person who works with the AL facility where MIL resides. The NP has been excellent.
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The surgeon who did my DIEP reconstruction has PAs who were in surgery with her. I saw both the surgeon and the PA in the hospital and in follow-up appointments. Sure, there are times when I’ve had to see the PS, and I’ve been able to make that happen, but I can’t discount the care I received from the PA.
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I’ve had the same primary care doc for 25 or more years. I had one of her PAs as “my” person for a couple of years, but then she left the practice. I was shifted to another one or two, but kept requesting to have appt with my doc. Eventually she said she was going to keep me as her patient, even though I think most of her patients aren’t as healthy as I am. I don’t mind seeing the PAs, but I have liked the continuity of the same doc for decades, and it seems like PAs move around more. Now my doc’s dr is practicing with her, and she’s my husband’s doc (his last one retired a couple of years ago so he moved to my practice). I think I’m going to as my doc if I can be switched to her D when she retires.
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I read an article -can’t remember where- that discussed some problems with the NP and possibly PAs. Some of them are getting online degrees from for-profit colleges for their RN degrees…situations where they get only a limited amount of practical inperson training…and then they go straight on to the advanced portion of the degree, again with very little inperson training. They are very much less than qualified.
I have no problems, seeing a nurse practitioner who has had experience for several years as a nurse before getting an advanced degree. But the idea of having a nurse practitioner who has almost no experience is scary!
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