Asking for a doctor at urgent care

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    I was blind sided when a PA walked in at the urgent care. I am not very happy. She couldn’t really answer my questions. Like, she said if I have low grade fever that keeps coming back she would emperically treat me with cipro. When I asked what would she be potentially treating (hey, I am rusty on my GI stuff OK?), she looked at me blankly and said she would be emperically treating me. Sigh. Would it be super obnoxious if I asked for a doctor next time? Hopefully there won’t be a next time. My doctor retired and I keep putting off in establishing another one.


    I think I would go one step further and not even go to an urgent care or ER unless I had an assurance that I would be seeing an actual doctor. Wow.


    Yes, I would ask for a physician. People started doing this already. When I was doing orthopedics rotation, some patients did not want to see their PAs. You may or may not have success in the ER/urgent care setting with getting a physician to see you, however.

    Six years ago, I had a difficult c-section and my baby had neonatal RDS. The pediatric hospitalist intubated him but when they extubated him 2 days after, the baby was not ready yet. Guess who did the intubation this time? A pediatric nurse anesthetist. All this while I was under heavy sedatives post surgery. Also, I was not a medical person at the time. This RN did not paralyze before intubating and the child put up a huge fight from what I gathered. These mid levels are now treating you, me and our children. Too bad it has come to this!


    When I hurt my back so badly, my father-in-law called urgent care after urgent care looking for a doctor staffing one. Called about five places before he could find one staffed with a doc (it was a holiday). I went there and received excellent care and evaluation from the doctor who happened to also be a sports medicine fellowship trained guy. Fit my needs perfectly. I would not have been ok with a mid-level, and after conversing with the doctor – I still feel confident I would have only wanted to see an doctor. I really needed his expertise that day, because I had certain activities I needed to do, and I needed to be better by a certain day etc. He was able to really handle things the way I wanted.

    Don’t feel bad about only seeing a doctor!


    As a physician who works urgent care, I don’t blame you guys. A word to the wise. Some urgent cares are also staffed by NP’s. The front office staff may not know the difference of who is working so I would be sure to ask the MA or Nurse who works directly with the provider what their credentials are.


    There are very few PAs or NPs I would let touch my body. My med school had an NP dedicated for the med students and she was actually pretty good. But I got to know her over the course of 2 years before she was available to us.

    I would and have asked for a doctor. I don’t feel bad about it at all.


    If I go to UC, its because I’ve already decided that I or my child are not in danger, and I generally know what we need. If I feel we need physician care, I go to the ER, which is staffed by MDs. I live in a state that actively discourages treating family, so I just tell them what I want and don’t hesitate to let the PA know that I am a doctor. My family doc knows us and that is no big deal.


    I don’t think we can take one bad PA and extrapolate it to all PAs.

    My primary care provider is a PA-C, and I wouldn’t see anyone else unless I had a complicated problem/zebra. But, he knows when a situation is too complicated for him.

    I am an attending physician and former PA-C by the way.


    I completely agree. My PA is better than I am about finding the ‘zebra’ diagnoses-I would go to her in a heartbeat. And she definitely knows when something is over her head.


    Keep in mind that you can become a PA without even getting a bachelor’s degree. Just two years of college courses in basic and behavioral sciences, followed by 27 months of PA school. A PA is probably, at most, at the educational level of a 2nd-year med student when they graduate. Would you go to a 2nd-year med student for your medical care? Yes, some have been in the medical field for years before they went to PA school, but you don’t always know which ones they are.
    Most urgent care clinics are staffed by PAs and NPs these days. I agree with residentmom that I would only go to one if I had no other option and was already pretty sure what was going on and what I wanted.
    I once demanded (politely) an MD anesthesiologist when a nurse-anesthetist walked in the room before my son’s surgery. I got what I asked for.


    I saw an ED PA miss appendicitis and have the 19 yo guy sit there all day long bc he was trying to admit him to medicine for diverticulosis vs. IBD (seriously – I can’t make this up). Ended up with a perfed appendix and peritonitis. There was no need for that. Not to glorify myself, but I’m only an intern and I went down, talked to the guy for about 5 minutes and without even touching his belly, based on history alone – was quite convinced he had appendicitis. And that it had perfed, and I was able to tell my attending when I believe it had perfed based on hx.

    There is a reason we all go to medical school. I don’t think it makes me a rock star, but it is nice to know I spent all those hours studying and rotating to learn something.


    No way I would feel comfortable with CRNA for my kids. I might let them do mine, but not my kids. Not a lot of reserve, these little critters, you know? When things go south, they go south fast.

    So upon discussing OB’s and midwives, I found out that midwives of my mom friends handle all of genetic counseling and testing that most OB’s send to maternal fetal docs to handle. My friends’ reactions were why isn’t your doctor doing everything, and my reaction was why do your midwives think can practice in an area where docs feel is out of their scope of practice? Very strange.


    This is where healthcare is going. It really bothers me to see how people are talking about NP’s as if they’re clueless. They are practicing within their scope, a great deal of them have years of experience and training. Although my purpose for applying to med school is to be autonomous, I respect NP’s enough to have them examine my daughter at her pediatricians office. I’ve dealt with poor doctors in my lifetime, but don’t catagorize the whole field as being mid-level…

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