Nurse Practioner Are Seeing Patients Instead Of Doctors

[tmoe]

The previous post was closed.was told to start over,anyway I ask the question about NP as being my primary doctor. Is this going on at all

VA medical center or just in Augusta Ga.Carlie says its been going on but in my seven years as seeing VA doctors this is my first with a

NP.She is doing good so far even givin some pain meds. I think it maybe a good ideal stay on her good side,because they are the one

that does C&P exams mostly. I guess you see the doctor when dying only.I know a lot of MH doctors quit at Charlie-Norwood but looks

like regular doctor also

[Stretch]

I had a female doctor that was very good. She got married and moved to San Diego VA. I changed doctors twice. VA told me I could only change only once in a year. I told them that I did not change and that the Dr. had moved and that one just disappeared. They told me that they know what happened to him. They wouldn't tell me about this guy. The change was allowed.

I got a new Older Male Doctor that I am pretty happy with him. I requested a male doctor. I don't see any NP's except for intake for my doctor.

If a Veteran doesn't have a preference who knows what they will through at you.

I thought everyone knew that you could change. Why there are so many female doctors (maybe 80% in AR.) in a mostly male enviornment is beyond me.

Edited February 13, 2013 by Stretch

[Notorious Kelly]

Wow - hot topic- hope we can all remain comrades thru this.

My solution? Shut down the VA.

it's incredibly wasteful & expensive to run a health care system parallel to the civilian world.

Veterans could then receive care in their own towns isntead of crossing the state.

Let VA employees compete for jobs in the private sector if they can pass muster. If they are not up to par, why should only veterans be stuck with them?

SHUTTER THE VA!

[71M10]

I think we can all remain comrades.

I think presently I would prefer to fix the VA instead of shutter it. I am not so sure I want to be at the mercy of the Affordable Care Act and the IPAB. IPAB actions will eventually filter into the VA but it will not be automatic so we will at least have a chance to lobby against drastic changes.

I would whole heartedly agree that some intelligence should be applied to Fee basis. Why does the VA pay me round trip mileage of 251 miles to go to my VAMC to have a INR (blood couagulation test done)? The answer is they think they are saving money because by doing the test in house, it costs them $17 to do the INR test compared to $20 if I went to a local lab (dollar amounts are estimates not actuals). they don't factor in the mileage reimbursement on the cost analysis.

Again I was tying to point out that being allowed to do something (request another provider), and having a right to something are entirely different matters. Maybe this legalism is not important, but I keep hanging on to it like a pit bull on a mailman, because we have legislated changes in the health care industry that no one knows what the ultimate results will be.

We have a doctor shortage and it is going to get a whole lot worse in two years with about 30 million more people getting set up with primary care physicians through the subsidized insurance provided by the Affordable Care Act. It would not suprise me to see the IPAB mandate the use of NP's and PA's (again it would not suprise me - I am not saying this will definately happen).

If you are a Pit Bull lover - I am not a hater. I just recognize that some idiots allow or encourage poor behaviour. If the use of Pit Bull offends you please feel free to substitute Poodle or Mastiff!

Edited February 13, 2013 by 71M10

[Teac]

Lately It appears I ruffled some feathers... which of course was not my intent.. and for that I am sorry. I realize that some of my opinions are out of the mainstream.. ( but they are not out in left field either). I actually am surprised that anyone would think they are stuck with a provider simply because they use the VA system. I am equally surprised that some really took offensive postures concerning my opinion. I know sometimes I come of as a wisenheimer and it would look better if I just reply once to a thread rather than to go on and on. I really don't use this site to rile anyone, and if I am a distraction maybe I ought to stop logging in. I really actually come to this site to assist and at to fill in the time,but if I am not enjoying my time and if have to prove everything I say, then it just seams that my time is not well spent....

[71M10]

Teac,

When I was sworn in, I agreed to defend the consitution of the United States. That constitution codifies the right to free speech! I took nothing in your postings as a personal attack and I hope you did not think my disagreement was a personal attack or affront to you. Clearly we see some things differently, but we are looking at the issue from two different perspectives. Your perspective is influenced by current conditions that you are encountering. My perspective is looking at the situation with the knowledge that changes are happening and trying to understand/discuss the implications of those changes.

Your contributions, my contributions, Carlie's, Jbasser's, Tbird ...... all of these contributions are what make this board work for veterans. Thank you for sharing and participating.

Best regards,

[carlie]

Lately It appears I ruffled some feathers... which of course was not my intent.. and for that I am sorry. I realize that some of my opinions are out of the mainstream.. ( but they are not out in left field either). I actually am surprised that anyone would think they are stuck with a provider simply because they use the VA system. I am equally surprised that some really took offensive postures concerning my opinion. I know sometimes I come of as a wisenheimer and it would look better if I just reply once to a thread rather than to go on and on. I really don't use this site to rile anyone, and if I am a distraction maybe I ought to stop logging in. I really actually come to this site to assist and at to fill in the time,but if I am not enjoying my time and if have to prove everything I say, then it just seams that my time is not well spent....

teac,

If you mean me - heck no my feathers aren't ruffled and you are fine in my book.

Healthy discussion and hashing out what we are supposed to receive versus what

we don't receive is how we all continue to advance in our VA benefits knowledge base.

My only point is that - we can only make a choice from the medical providers that the

VAMC's have employed.

Say a specific clinic only has one "Doctor" 3 RN's and 4 NP's -

most of the patients in that clinic will in fact NOT see the "Doctor" but they will see

one or more of the RN's or NP's and the "Doctor" will supervise and sign off on the treatment

plan.

Then again the clinic could have 20 "Doctors" but if they are all female or non-english speaking /

understanding, etc . . . you are still left in the same boat of only having a "Doctor" available to you

that is not within YOUR standards - they only have to provide medical care by their standards.

Now certainly the patient has the legal rights to say - no, I don't want to be treated by a

RN or a NP - I want a danged "Doctor" and nothing less than a "Doctor".

We are limited to what's available and there are simply not enough "Doctor's".

That's why they have slew's of lower pedigree's - bottom line is the bottom dollar.

I have in the past had a couple of fine providers that were not "Doctor's", but I swear

they were better than some of the "Doctors" I had in the past at a VAMC.

After a huge problem with a VAMC / ENT surgeon that had done two surgeries on me

and 5 years to win a FTC and get his license pulled - I stay away from most medical

providers in general.

Yet - this evening I am having someone take me to the ER at my VAMC because I've

been sick since Christmas and am fairly sure I'm back into CHF.

This link was an interesting read.

http://www.uthscsa.edu/gme/documents/HS%20MANUAL%202012-2013.pdf