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Ask the Dr . . .

Feb 10, 2015

Ask the Doc…..

“Whenever I call to make an appointment with a doctor I end up seeing someone else. In some cases I have never gotten to see the actual physician.

What are your thoughts on this?”

Often, patients don’t get to see a physician initially, and at times at all. Many patients question the credentials of a PA or nurse practitioner because they are obviously not the same as the physician they want to see. That said, today’s medical assistants have training that is quite extensive. In addition, you may find one that has greater concern, compassion and time than the doctor you may have hoped to see.

But this issue goes far beyond actual credentials. It involves choice or perhaps more appropriately…the lack of choice you have. If you booked surgery with a particular physician and found out someone else was going to do the surgery, even if they had the same credentials, you might not be too happy…….and rightly so. This becomes even more important when problems develop. Many patients that have had knee replacements done and develop problems never get to see the surgeon again but a PA or other associate. In such instances you should certainly see the person who actually did the surgery. That would also most likely be the individual with the highest level of training and experience. Unfortunately, this is becoming the standard in medicine today and frankly, I think it is disgraceful. Other patients that have had cataract surgery and developed problems were sent to an optometrist for after care. These doctors may be well qualified for many things but in most instances have never done such surgery nor have they had an ophthalmic surgical residency program. All of this is done for no other reason than to save the surgeon or their group money.

In medical practices of any type, ethics, patient care and office or hospital finances most be balanced but only one can be primary. Either you run the highest level practice based on quality care and concern and try to make a profit, or your primary goal is profit, and you try to provide the highest level of care you can within those profit margins.

I’m old fashioned. I hate to see what has happened to personalized, quality medical care. All patients get my cell phone number and call me directly. There are no gate keepers at all in my practice. Patients are all shocked when I answer and begin by apologizing….”I’m so sorry….this was the number I was given.” My response…. “Well didn’t you want to speak to me?” Laughing, they most always respond by saying, “Yes, but I certainly didn’t expect to you to answer.” To which I reply, “Well if you feel more comfortable I can put you on hold for 20 minutes and then come back with a foreign accent and then disconnect you.”

All too often policies and procedures are advocated for others that the policy makers honestly don’t really want for themselves. Our representatives in Washington would never, ever settle for the health care system they advocate that will supposedly be so great for us. Ask any physician if they had a personal problem and booked an appointment with a particular physician whether they would settle for seeing a practice associate or even another physician with similar training. Lincoln said, “Let those who believe in slavery, be one first.”


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