Doctor Passing Me off to Assistant

[jess9395 5,449]

Studies show patients who continue with follow up visits are more likely to keep their weight off long term.

Clearly that isn't an absolute, many people have surgery in Mexico and never have a follow up visit and do fine.

For me that statistic keeps me going back though. It was one week, two weeks, one month, three months, six months and 1 year follow up appointments and now I will go once a year for life! I pay the higher specialist co pay but feel it's totally worth it (and I often see a nurse instead) because I want to keep that weight off!

[OutsideMatchInside 10,166]

I don't have any sleeve issues or sleeve specific questions. I am d ping great and I have a clear plan on what to eat. My primary can track my blood work. If I have any sleeve issues or questions. I will either suck it up and go back or I will choose another doctor that is closer. They don't seem interested in resolving the billing issues though and I won't go back until they do. I have spent enough money out of pocket this year without a doctor office hustling me out of co-pays they are not entitled to

[WL WARRIOR 692]

I just received a reminder for my one year follow up in the mail. The name of the bariatrican I will be seeing is, once again, someone different (or new). This will be the third time I've switched bariatricians within the same clinic. Maybe it is like you mentioned, a Missouri thing. As for my surgeon, I only met him briefly when coming out of surgery and never got to talk to him. These things don't bother me too much. However, it did bother me when I wasn't allowed to meet or speak to a bariatrician at my clinic while experiencing a complication a few months ago. They kept referring me to the ER at the hospital I had my surgery. I ended up just going to my PCP. In fact, I may skip my one year follow up and see my PCP instead.

[drmeow 323]

@sennypoo You will likely get more answers to your questions if you make a new topic rather than posting in a thread about doctors vs NPs and PAs in the Rants forum.

You don't mention which surgery you're having - sleeve, bypass or band? There are forums for each one, with specific pre-op threads.

No, you won't be only on chicken broth for 12 weeks. Try reading through some of the threads in the forums for your particular surgery. While there can be some differences from doctor to doctor, no one (to my knowledge) has you on 12 weeks of chicken broth alone (and if that's what they are recommending, find another doctor) good luck!

[VDB 800]

I am trying to plan for my surgery. Went the seminar. Have had two out of three weight loss management with my regular GP. cardiac appointment done now I just want to try to eat some of the foods that I can. I heard you only get chicken broth for the first 12 weeks . after that I'm not sure what you can eat and after seminar the doctor said something about following the South Beach Diet? has anyone else been told that? any comments will be greatly appreciated on little hints on what to expect and do. thank you.

After surgery, I did the liquid diet for 2 weeks, as prescribed... then to soft and mushy food for 12 weeks (including soft cooked turkey, veges, fruit such as bananas), now am on regular food but no beef, Pasta, starches etc. This phase will last until 12 months out.

[FocusOnMeNow 599]

@@OutsideMatchInside - I just wanted to chime in that I totally support you in determining the level of care that you need. It is obvious that it is the overall business practices within the office that are off putting rather than the MD vs PA thing. The sales analogy does not work though, you are not in the middle of a deal. You already bought the car and you are now taking it in for maintenance. Most surgeons will round on you day of, day after surgery, and sign your hospital discharge, and they're done. I agree that the way they are going about it is all wrong. It sounds as if they have done a poor job with following up with you. I met with both the NP and my surgeon at least twice prior to surgery. My surgeon left for vacation in Greece the day after my surgery, and I haven't seen him since.Of course, I did know about this in advance though, so it did not come as any surprise that left me feeling uncared for. My surgeon and one of his junior colleagues (also a surgeon) rounded on me day of and day after, and he left me in good hands. I also would like to thank him, and will likely send him a card to do so. I'm really sorry that you are having this bad experience and hope that you find a better place to get care that knows how to treat people like informed shared-decision makers. Good luck and all the best!

[sennypoo 1]

Thanks for the information I appreciate the help

[TammyDTM 391]

I am fortunate that mine is a Center of Excellence. I knew beforehand that it was a "team" of professionals. I paid a one-time program fee before surgery and I will never have a co-pay or out-of-pocket fee for follow-up visits.

I saw my surgeon twice before surgery and twice after surgery. Subsequent visits were with her PA. I also see the nutritionist at each visit. So, it goes, nurse, PA, nutritionist (and once with the exercise specialist for assessment).

I am happy with my surgical team. They are very professional and knowledgeable and they are keeping me on track.

[OutsideMatchInside 10,166]

This is a well known bariatric center of excellence.

[Dream4tc 192]

Have you tried requesting a different appointment so that you can see your surgeon?

Doctors now rely heavily on Press Ganey scores for reimbursement due to patient satisfaction scores. You can try escalating this to the office manager or higher. You can also argue the bill for the office visit. The only other option, is to change doctors.

Edited August 31, 2015 by Dream4tc

[Timeforme15 15]

I agree its hard to look at is as a business deal. Think of the women that prepay for OB and delivery care only to have the nurse end up delivering......do you get a refund because a nurse delivered and not your OB? nope.....medical care and billing is a whole different world.

[sennypoo 1]

I have a high respect for NPs and PAs. My mother went to a good doctor that got so busy with patients thay HAD to see the Dr. He never had time to spend with them. Therefore th NP found the cancer in my mother. I was a nurse for many years. I know nurse practioners are very thorough and schedule 20-30 per patient where a doc only schedules 10 min. and can be dounle booked.

[Beachbum2017 108]

I'm just going to weigh in with my experience - My surgeon was part of a highly regarded Center of Excellence - pre-op care was amazing - I have never been treated so well at any doctors office. However, once my surgery was completed - I only saw my surgeon once after my surgery - the rest of the visits were with nurses and PAs - like the original poster I was charged a co-pay everytime that I went in just like if I had seen the doctor. Got so ridiculous that I quit going after 2 years and only see my PCP now. I was still only eating 800 calories per day after 2 years and started gaining weight. PA suggested that I start running every day. I'm a 58 year old woman with rheumatoid arthritis - that was the clincher for me - I haven't been back since. I have great respect for PAs and nurses - I have many, many in my family and I know how hard they work and how dedicated to their jobs they are but when you're expecting to be treated by a physician and you get a PA or a nurse that can't answer your questions and doesn't seem to care about finding out the answers then it is time to move on.

[OutsideMatchInside 10,166]

I agree its hard to look at is as a business deal. Think of the women that prepay for OB and delivery care only to have the nurse end up delivering......do you get a refund because a nurse delivered and not your OB? nope.....medical care and billing is a whole different world.

Where do nurses deliver babies? The worst that usually happens is you get the Doctor on call not your doctor.

And they don't bill the same. At the previous healthcare system I was in NP/PA do not bill at the same level as a physician, that is why you don't pay a co-pay. The office visits are cheaper. That creates a higher demand for NP/PA because people can save by seeing them and most of the time they provide more caring care. GPs and Specialists don't bill at the same level, why would a Dr and a NP/NA bill at the same level.

The attitude of most people posting in this thread is that medical professionals are doing them some kind of favor. There are plenty of Doctors, Physicians Assistants and Nurse Practitioners. They all have student loans and they all have bills to pay. Patients choose the one they want, patients have a choice and they are doing the service providers more of a favor than the service providers are doing them.

I had a couple years I paid for concierge doctor services and it is far preferable to insurance based healthcare. You get treated with more respect. Because of the law I am stuck buying and insurance plan, but next year I am going back to concierge level and just buying the most basic of insurance plans.

[CowgirlJane 14,259]

While I see the logic of seeing a PA or nurse practioner, on an emotional level, I wanted to see my surgeon. I did in fact at the first follow up and then shifted over to the PA. when it was time for my 1 year, I wanted to see the surgeon again, I suppose on some level so that he could see that I "dun gud". I don't know why it was important, but it was.