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I live in a small town that has a major doctor shortage. We moved here 3 years ago and are still without a primary care physician.

I saw the other day that there is a new doctor as well as a nurse practitioner that are moving to the area and accepting new patients (each will have their own practice).

I'm not opposed to a Nurse Practitioner, I don't think. SO and I are both young and healthy and we only need to see a doctor a few times a year for regular check ups and the odd thing here or there (let me tell ya, it would have been nice to have a doctor for the back to back UTIs I had in the spring instead of having to sit at the walk in clinic for hours on end).

I guess I just don't understand the difference between the two? Should I be looking for anything in particular?

My 2 cents the difference is the doctor attended medical school.

I live in a large area if I am unable to get in to see my doctor and it something routine then I will see if the nurse practitioner is available. Most work with a doctor directly who is there in the background.

If it was anything of major concern I would wait to see my doctor. That being said if it was extremely serious I would look at the best on the East Coast.

Nurse practitioners can vary and the level of what they see can be different.

You may depending on personality like him or her better than the doctor. They are traditionally not as loaded with patients in most practices.

[This message edited by fireproof at 11:54 AM, November 2nd (Saturday)]

My personal experiences with several NP, from prenatal, routine, and now complex care for migraines has been excellent. They treat the whole PATIENT, not just conditions, are good listeners, tons of empathy, and know their science.

[This message edited by scaredyKat at 11:57 AM, November 2nd (Saturday)]

LOVED MY NURSE PRACTIONER. I am so upset that she will no longer be in practice after the first of the year.

I never had a problem with her referring me to another physician when I had things that were outside of their scope of practice. Look up what the educational requirements for a licensed NP in your area are. They are generally quite stringent.

Medical school or not, NPs generally receive a great deal of advanced education as well as nursing school. They have to pass rigorous licensing requirements in most places.

I have had mixed experiences with NP.

Most have been excellent.

The one at my OB/GYN's office leaves a lot to be desired... but then so does my OB/GYN... The whole practice has gone to sh*t since my beloved GYN retired and then died.

Looking for a new office.

http://www.healthforceontario.ca/en/Home/Nurses/Training_|_Practising_In_Ontario/Nursing_Roles/Nurse_Practitioners

Here's an overview for Ontario, Canada. They have been in practice a long time here.

I don't think med school can be held up as the gold standard. It's going to depend on the competency of the individual, their particular education and moreover their experience.

Our medical office has at least 4 on staff. None of them are any less competent than the Dr's. They all have extensive experience and education, I get longer appointments with them, and I feel the practice benefits from them greatly.

[This message edited by SI Staff at 1:01 PM, November 2nd (Saturday)]

My knee-jerk reaction has always been to prefer MDs over. NPs. However, DD has serious medical issue and for the past several years has been treated by a team of NPs in different disciplines at a teaching hospital affiliated with a medical school and her care has been really really great. Best of all, these NPs will communicate with me and each other by e-mail, so the right hand always knows what the left hand is doing and I can quickly and easily get in touch with them about any questions or concerns I have. Together these two women diagnosed and treated DD's rare medical condition. So, my opinion of NPs has changed, though I still would be reluctant to see "just any" NP without knowing his or her credentials.

I've had good luck with a NP at my dermatologists office. I see the MD every other visit, but have actually liked the NP more, just because of her personality.

I think it depends on your situation and experience.

I've had nothing but excellent care from NP's. They have always been affiliated with clinics that also had doctors.

Thanks for the replies.

I guess we'll see how things go. They're doing intake calls next week. The doctor I spoke of in my last post is opening her practice slowly, by taking 150 patients at a time until she reaches the number of patients she wants. They opened up an intake line last month to get her first 150 people and, from what I heard, that phone line received 250 000 calls. So, if I get through, I think I'll take what I can get. Any primary care health professional is better than none, I guess.

I am an MD and I supervise about eight nurse pracs and they all do a very good job. If and when they aren't sure what to do they will consult with their supervising physician. They often have the opportunity to spend more time with their patients.

purplejacket, could you give me an example of what a nurse practitioner WOULDN'T be able to do?

Like I said, SO and I are young and healthy, so I'm assuming that barring a major medical crisis, a nurse practitioner would be more than capable of handling our needs?

In the US CNP's are fully licensed and degreed at a minimum level of a master many are working in a doctorate and yes that makes them Dr Nurse. All new NP's from this point forward have to be doctorally prepared.

Most do a fabulous job and do look at the whe picture. Not just one issue. They work under the direction or as we say blessing of an MD. They can prescribe most common meds, or have the Dr they are under prescribe them.

Nursing is based on the philosophy of keeping patients well and acting as their advocate so the approach to treatment may feel different. They are working for you to help you.

Just like with any profession you will run across some that are awesome and some that just suck. I see an NP for acute things through my PCP. And I see my PCP for yearly physicals and major issues.

You do need to pay attentiOn when you see an NP at specialists a lot of time they do all the work come up with the treatment plan and so forth then the actual specialist sees you for 30 seconds and will then bill you for a high complexity visit, when the truth of the matter is the specialist did none of the work.

We see my daughter's pediatrician's NP. We can't stand the pediatrician, but we LOVE the NP, and choose to only schedule appointments with her.

She's in her 60s, very knowledgeable, and absolutely lovely. Our DD is 4, going on 5, and never have we had an issue that the NP was unable to diagnose/treat.

In a primary care office setting my nurse pracs do everything they and I feel comfortable that they can do.

I have some who love to do procedures and others that don't. My main job is giving advice.

An example this week was a 25 year old female with four years of fatigue. This patient had had normal outside labs and CTs and MRIs that didn't reveal anything. While my nurse prac did the lab work to rule out pregnancy, hypothyroidism, mono, anemia and diabetes she next was thinking about ordering some very expensive (even with insurance) lab work looking for a chronic Epstein Barr virus, CMVirus and Lyme disease.

My nurse prac asked me to see the patient and give a second opinion. On my examination I think that the antibodies looking for myasthenia gravis are the next best bet. That's a diagnosis that wasn't on my nurse prac's radar.

When a patient comes in with a symptom a mid level should be able to diagnosis and treat 90% of the time (the top 3-5 diagnosis for that complaint). When the diagnosis is something more obtuse that is where I'm supposed to come in to assist.

Hope this explanation helps.

Love my NP!

When I went in with something that COULD have been serious, she ran and got the Doc right away.

I love her.

I see a NP - she is a Doctor in her own country but not here, she is considered a NP here.

She is the best doctor I have had since I came to this country 16 years ago. She takes the time to listen, she is thorough, she has called me after surgery hours to give me test results.

Thanks for all your replies.

tushnurse, I'm in Canada, so I'm not concerned with billing.

The intake line opens tomorrow at 5:30. Fingers crossed that I can get through to someone...anyone...tomorrow evening.