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Old 07-13-2022, 09:59 AM   #1
bigdog
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Default Doctor Referral ?

I'm in need of a new primary care doctor, as my current one is moving out of practice. Not necessarily a full M.D. but would be satisfied with a Nurse Praticitioner or Physicians Asst. MD's seem to be in short supply or retiring !

I'm in Gilford, so would like a professional on this side of the Lake.

Thanks !
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Old 07-13-2022, 10:19 AM   #2
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Originally Posted by bigdog View Post
I'm in need of a new primary care doctor, as my current one is moving out of practice. Not necessarily a full M.D. but would be satisfied with a Nurse Praticitioner or Physicians Asst. MD's seem to be in short supply or retiring !

I'm in Gilford, so would like a professional on this side of the Lake.

Thanks !

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Old 07-13-2022, 10:49 AM   #3
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Itís a problem in the area. My Endochronologist retired and they are not getting a new one til October or November by then my prescriptions will run out.


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Old 07-13-2022, 03:56 PM   #4
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Itís not easy. We were offered appointments in Manchester but thatís a bit far for primary care. We did get appointments in Concord Hospital Internal Medicine Department but basically it is with a team and could be MD, DO, NP,etc. We actually were there this morning. Well run, nice people who run on time trying to be helpful but the medical care system is clearly strained. Our primary care physician of 15 years in Laconia was outstanding but he is not seeing patients and only doing endoscopies.

I am a retired physician and understand the pressures involved and am glad I am retired. Patients will need patience and persistence.
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Old 07-13-2022, 05:10 PM   #5
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Trust me. You DO NOT want to be cared for by an NP. One does not learn how to practice medicine from a textbook. They do not have a residency that I am aware of. Therefore, some are extremely good while many are not. My experience was that I told one Dr. I did not want to see the NP. After she talked to me, the MD took over and it was night and day. My last experience a couple months ago when my primary care wanted the NP to check on my blood pressure was a disaster in my mind. Nothing done relative to BP. She was adamant that I go completely off salt. Period. Crazy. BP is in good range. Also not able to relate to me. Maybe she does not like men? Anyway I do not need to justify her existence. I have a NP in the family (by marriage) and she knows about enough to get herself in trouble. Thankfully my healthcare team is at Mass General in Boston. The last time I was admitted the other person in the room was from NH. He told me when they could not figure what the problem was they sent him to Mass General. He said it was often.

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Old 07-13-2022, 07:37 PM   #6
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It is very, very difficult here in the Lakes Region. Our primary care physician retired in December, and they have been unable to find a replacement. My endocrinologist retired in March and his replacement wonít start until October. My husbandís rheumatologist retired in May. His urologist is now only working limited hours.


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Old 07-13-2022, 07:59 PM   #7
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I'm with Woody--we've had multiple family members avoid medical disaster because we've had good PCPs. Especially if you've reached a certain age (all of us on the forum?), it's worth a long car trip to Manchester, Dartmouth, Concord, Boston, wherever...

Bring your spouse for his and hers appointments, get a nice lunch, make a day of it!
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Old 07-13-2022, 08:50 PM   #8
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Default Doctor referral & NPs

In general, a doctor is much more qualified than a Nurse Practitioner, however, in my humble opinion and in my medical care, I find NPs to be extremely patient-oriented, more so than a lot of MDs. Also, even though there is a level of independence accorded to an NP, if an NP gets in a situation pushing the limits of their practice, it is my 100% experience that the NP will seek advice from an MD. Now, as we all know, medicine is definitely a field where all patients are different, providers are different, and health issues don't all follow the same courses, therefore, it is up to you (the patient) to cultivate a relationship with your provider (at any level) for the best healthcare possible. A broad-brush approach will not be acceptable.
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Old 07-13-2022, 09:28 PM   #9
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Quote:
Originally Posted by Woody38 View Post
Trust me. You DO NOT want to be cared for by an NP. One does not learn how to practice medicine from a textbook. They do not have a residency that I am aware of. Therefore, some are extremely good while many are not. My experience was that I told one Dr. I did not want to see the NP. After she talked to me, the MD took over and it was night and day. My last experience a couple months ago when my primary care wanted the NP to check on my blood pressure was a disaster in my mind. Nothing done relative to BP. She was adamant that I go completely off salt. Period. Crazy. BP is in good range. Also not able to relate to me. Maybe she does not like men? Anyway I do not need to justify her existence. I have a NP in the family (by marriage) and she knows about enough to get herself in trouble. Thankfully my healthcare team is at Mass General in Boston. The last time I was admitted the other person in the room was from NH. He told me when they could not figure what the problem was they sent him to Mass General. He said it was often.

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This. an NP is not a doctor and donít settle for less. I did once and a misdiagnosis turned out to be cancer.
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Old 07-13-2022, 10:39 PM   #10
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Whole health system is mucked up. I live in NH for 8 months of the year but kept all my MA doctors. They are all part of Beth Israel/Deaconess/Lahey health system. Two weeks ago I needed to have a 5 minute MD appointment to schedule an every 6 month test....I already had the test results from my last tests and they were perfect. So I tried to avoid a 200 mile round trip for a 5 minute doctor's office visit by doing a Virtual Zoom call...we had done them numerous times in the pandemic. But the health system has now put up barriers....since we have a NH mailing address...our PO box..... we no longer can do tele-health. Must be in-person in MA. Such baloney, but I had no choice but to make the 200 mile drive. UGH....and yes, the visit was 5 minutes and involved the doctor just setting up the next test. He typed and I waited.
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Old 07-14-2022, 07:57 AM   #11
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Quote:
Originally Posted by SAB1 View Post
This. an NP is not a doctor and donít settle for less. I did once and a misdiagnosis turned out to be cancer.
Had the opposite happen. MD, and an ORthopedic did a scope on my knee and went through my tumor. Walked around with a large tumor in my knee for 7 years because MDs misdiagnosed it. It wasn't until my knee locked up and I had a PA investigate and got me to the where I needed to be.
So before people bash ALL NP and PAc, its all individually based. I am in the medical field and there are times that I actually send people to a certain NP or PAc because the MD tends to rush where the NP or PAc tends to listen and take their time to get all the info.
Is this every case? No, it is individual situations. Each clinician is a different personality.
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Old 07-14-2022, 09:50 AM   #12
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Had the opposite happen. MD, and an ORthopedic did a scope on my knee and went through my tumor. Walked around with a large tumor in my knee for 7 years because MDs misdiagnosed it. It wasn't until my knee locked up and I had a PA investigate and got me to the where I needed to be.
So before people bash ALL NP and PAc, its all individually based. I am in the medical field and there are times that I actually send people to a certain NP or PAc because the MD tends to rush where the NP or PAc tends to listen and take their time to get all the info.
Is this every case? No, it is individual situations. Each clinician is a different personality.
Exactly. To complicate the issue, requirements and limitations as well as names of ďphysician extendersĒ are different state to state.

Each of our personal experiences is helpful. But the big picture is complicated and now is a difficult time to make informed decisions.
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Old 07-14-2022, 09:56 AM   #13
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The NP and PA are not the same category. Yes the PA is a 2 1/2 year course accompanied by actual work in a hospital kind of like a residency. The NP may or may not have any connection with a hospital. Mass General has an NP program so on sight teaching goes along with class. However if doing an NP program at Boston College I do not believe a hospital is involved. Yes all md's are not perfect although they are supposed to be. Remember for any profession, Half of the class is in the bottom of the class. Sometimes some in the bottom half make better Dr's.

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Old 07-15-2022, 02:17 PM   #14
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The NP and PA are not the same category. Yes the PA is a 2 1/2 year course accompanied by actual work in a hospital kind of like a residency. The NP may or may not have any connection with a hospital. Mass General has an NP program so on sight teaching goes along with class. However if doing an NP program at Boston College I do not believe a hospital is involved. Yes all md's are not perfect although they are supposed to be. Remember for any profession, Half of the class is in the bottom of the class. Sometimes some in the bottom half make better Dr's.
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To piggy back on the above last sentence 'Half of the class is in the bottom of the class. Sometimes some in the bottom half make better Dr's.'

What do you call a person that graduates at the bottom of their medical class?
Answer ----------> DOCTOR !

IMHO, every NP I've had in the past has been more personable, conscience, dedicated to my personal health than most MD's I've had. I wouldn't hesitate using an NP. In most cases the NP in a medical practice has the ability to consult with an MD in the same office, should the need arise.
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Old 07-15-2022, 08:48 PM   #15
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Originally Posted by bigdog View Post
To piggy back on the above last sentence 'Half of the class is in the bottom of the class. Sometimes some in the bottom half make better Dr's.'

What do you call a person that graduates at the bottom of their medical class?
Answer ----------> DOCTOR !

IMHO, every NP I've had in the past has been more personable, conscience, dedicated to my personal health than most MD's I've had. I wouldn't hesitate using an NP. In most cases the NP in a medical practice has the ability to consult with an MD in the same office, should the need arise.
In NH, NP can actually practice on their own without MD backing. I know of a few private practices that are all NP and they are great location, always willing to listen to other medical professionals. PAc need to work under an MD. They, unlike NP, can actually assist with surgeries as well.
There are a lot of differences, and as far as I know, all the ones that I know all had to perform some kind of clinical (residency as you will).
As I've said in other posts, there are good, and there are bad. there are good MDs and bad, there are good PTs and bad, there are good dentists and bad. Can't make a general statement of ALL because of one personal experience.
As I tell all my patients when it comes to Orthopedics, or any MD. Sit down with them, chat, and if you have any kind of questions then get a second opinion. You have to feel comfortable with who you see or the odds are, you won't do well with them because you will always doubt them.
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