Doctor Passing Me off to Assistant

[OutsideMatchInside 10,166]

I am 6 weeks post op. I am suppose to go for a doctor visit next week. The office has called a few times to reschedule. I returned the call today to learn that my Surgeon will not being seeing me, but an Nurse Practitioner or Physicians assistant will. I am still required to pay the same $50 specialist co-pay.

I do not have any complications and I am doing very well. I just commented to my friend recently that I don't even feel like I had surgery at all until I eat and feel the restriction.

I would still rather see my surgeon at this point. I understand, seeing patients for follow up isn't as profitable as surgery, but as a patient I wish I knew this information before selecting this surgeon. I could have made an educated decision and maybe selected a different Doctor or program.

I end up cancelling my appointment and I guess I will make one with my primary and save myself the 1.5 hour drive to my Surgeons office.

[Miss Mac 6,262]

I am 21 months out and have seen my surgeon once since my operation. I see a bariatrician for my follow-ups every three months. My last one will be in December for my two year anniversary.

When it was time for my six week check-up we had blizzard conditions in Chicago, and they cancelled my appointment. So, a week later I went to my primary for a post-op check-up. No problem.

[BigViffer 3,544]

My wife has worked around surgeons and doctors for so long that she passed some knowledge down to me. There are certain things that people just firmly believe that are wrong. Many people want the doctor to give their child a shot instead of "just a nurse". But what they don't realize is that the doctor doesn't give shots that often and is really bad at it from lack of practice. Nurses to many a day and therefor are better at it.

Same thing applies to surgeons and their assistants. Many times the assistants have better bedside manners and they are more familiar with complications and questions post-op. Surgeons are good at what they do, which is dealing with people when they are knocked out. The assistants are the ones that are going to be giving you the real information and dispensing it as well. They also can translate what you are saying to what the surgeon needs to know and vice verse.

[OutsideMatchInside 10,166]

My mom is a nurse and a lot of my friends are doctors. I wouldn't want a shot from a doctor, I'm fine with having one from a nurse.

My appointment was originally with my Surgeon then they changed it. He has been seeing patients post-op normally. This is a new change.

My biggest issue with this is, I am still paying the same co-pay for someone that doesn't have the same credentials. And it requires a long drive on my part. I don't like the bait and switch.

It just isn't worth it when my primary is literally across the street from where I live, a 2 minute walk, and is experienced with WLS follow up.

[toasty 371]

I gotta agree with @BigViffer. I realize you feel your specialist payment is not worth it for seeing a PA or NP. However, I would look at it this way. The PA or NP will probably understand the issues you are facing much better than the surgeon (they see bariatric patients all the time and know the after-care issues, where the surgeon spends most of his time in surgery). By the same argument, the bariatric PA or NP will also know much much more about bariatric issues than your primary care doctor will, at least that would be true for mine.

[OutsideMatchInside 10,166]

I don't have any issues though, this is just a routine follow up visit. I can have my primary order blood work.

If I was having any issues, I would suck it up and go, but I am not.

There are a few other things that have happened that I am not going to post, but overall. I am not pleased with the follow care, and the office management. There are other bariatric doctors covered by my insurance in the area, so if I need specialty care I will just switch.

I posted this in rants for a reason.

[Elode 8,093]

Being that I'm in school finishing my masters for my nurse practitioner I will try not to be bias but I will say a Nurse Practitioner is HIGHLY educated as are physicians assistants. There's a reason why your surgeon trust his patients care to them. A smart surgeon isn't going to do anything to hurt his license or practice. That's all I'm going to say about that.....but you do what makes you comfy.

[OutsideMatchInside 10,166]

I have seen nurse practitioners in the past, I especially like them in ob/gyn environments.

I have never seen a nurse practitioner or physician assistant and still had to pay the same co-pay. I asked some questions about the billing for this visit and previous visits and I didn't like the answer I received.

Without going into detail, they are cheating me out of money and when I asked to speak to billing I was sent to a voice system, that keeps going in the same loop.

It is more than just this one thing, but this is the final straw. I can just find a Doctor in BJC healthcare and not have to deal with this BS.

[KChelper 42]

Being that I'm in school finishing my masters for my nurse practitioner I will try not to be bias but I will say a Nurse Practitioner is HIGHLY educated as are physicians assistants. There's a reason why your surgeon trust his patients care to them. A smart surgeon isn't going to do anything to hurt his license or practice. That's all I'm going to say about that.....but you do what makes you comfy.

I felt this was unfortunately very condescending. I understand the original posters issue. I would feel the same way. It's feeling like your expectations arent met. You expected the surgeon. In my 1 week follow up I had specific questions about the surgery. I was told about a couple small things post op/recovery & wanted to ask my surgeon. The PA that visited with me didn't know me, didn't know what happened during my surgery, etc. I was never told post op visits would not be with the surgeon.

[muzical1 85]

I haven't seen my surgeon since surgery. His assistant handles all appointments. I think this is a common practice.

[Babbs 14,681]

I saw my surgeons assistant first 6 weeks, and like you, wasn't happy with the treatment plan he was giving me (complications from GERD), and a couple of other things I didn't agree with ( one being I hadn't actually seen my surgeon since surgery) so I made the decision to also cut ties and be seen by my primary from there on out. I feel it hasn't hindered my health or success at all. WE are THEIR customers. If we aren't happy with the service given, then it is our RIGHT to go elsewhere. As long as health care in this country is for profit, you're darn right I'm gonna go where I feel I'm getting the best care for my money.

In other words, I COMPLETELY agree with you taking control of your own health care and going elsewhere.

[OutsideMatchInside 10,166]

Thank you for understanding. I am sick of medical professionals acting like they are doing patients/customers a big favor. They are service workers. We are paying them for a service. If they aren't providing that service, then it is our right to find someone else to provide the level of service we want.

I select my Doctors based on their educational background. I selected my primary because of the schools he attended, just like I selected my Surgeon based on his education and experience. I am not going to switched to a provider I haven't researched just because they feel it is an okay trade off.

It is poor patient care and bad customer service. The person making the appointment wasn't even sure who would be seeing me. I don't know why people think that is okay, but it is not in my book.

[gowalking 10,790]

I see my bariatric surgeon at every appointment. I've never seen a PA. Same thing for the orthopaedic surgeon who did my hip replacements.

[VSGAnn2014 12,992]

This isn't addressed to the OP -- but to others who are reading this thread.

I adore my surgeon. Really love him. He also operated on my husband who was diagnosed with cancer after my WLS. He also removed my gallbladder 4 weeks after VSG surgery. All his surgeries for us were perfect.

But he's not nearly as qualified to advise me on post-surgery care as his bariatric P.A. is. It's her job to guide me with regard to food choices, Vitamin / mineral / other supplements, behavioral issues, etc. She attends bariatric post-surgery care conferences often and reads all the latest studies. This is her job, and she does it brilliantly.

She also guides many of the bariatric support group meetings that the bariatric surgery group provides to its WLS patients. She has knowledge of and offers the context of (literally) thousands of WLS patient behaviors. She's a walking research database of what works and doesn't work post-WLS.

It's illogical to imagine your bariatric surgeon knows more than anyone else in her/his practice about all the topics you need consultation / guidance about post-WLS. It's also simply not true.

[OutsideMatchInside 10,166]

She also guides many of the bariatric support group meetings that the bariatric surgery group provides to its WLS patients. She has knowledge of and offers the context of (literally) thousands of WLS patient behaviors. She's a walking research database of what works and doesn't work post-WLS.

It's illogical to imagine your bariatric surgeon knows more than anyone else in her/his practice about all the topics you need consultation / guidance about post-WLS. It's also simply not true.

There are other practices where the PAs are known and deal with patients Washington University is like this, the PA is on the website as part of the team. This isn't that kind of practice.

If I had been introduced to the PA before hand I could have included the PA in my decision making process. Adding someone new to the equation and not even providing their name is highly unprofessional.