3+ yrs out (1st experience w/ WLS-prejudice NP)

Figured I'd share.

I'm over 3 years out and just had my first experience with one of "those" kind of medical "professionals" who is ignorant/prejudice against WLS.

I got a bad case of bronchitis that started late Sunday.  I waited until Wednesday to go to the DR hoping it would get better (and it's next to impossible to get an appointment w/ my PCP anyway).  So I went into the local walk-in clinic on Wednesday and saw their nurse practitioner.  

I went over my list of symptoms (pressure in my chest like I couldn't draw a deep breathe was my main symptom).  She didn't even conduct a real exam (no looking in my ears, nose, throat, etc.  She did listen to my chest and said it was totally clear.  Then she says, "Well, pressure in your chest is just one of the many side affects of gastric bypass surgery, so you'll just have to learn to deal with that."  (Yeah... I know.  I couldn't believe it either.)

I just sat there for a second or two, then said, "That is NOT a side affect of my gastric bypass surgery."  And she immediately responded, "Yes it is." 

Now normally, my red head would have been all over that setting her straight with facts.  But I was so sick physically (in addition to having had a couple of terribly exhausting weeks before that) that I just shook my head and let her prescribe me some Ru-hist.  The next day I called in and demanded to see my DR and ended up seeing a different NP at his clinic.  She was very thorough - did everything from a CBC to a lung xray to a EKG.  Turns out I had bad bronchitis in addition to a "nasty looking" throat - both of which are (thankfully) starting to get better now that I've been on antibiotics for a couple of days. 

Just figured I'd share my first experience with one of "those" medical "professionals". 

(PS - I certainly DID fill the main clinic's ears with what had happened.  I'm even thinking about writing the main office a letter about it, giving them suggestions on several places she can get educated regarding WLS - since she obviously does not have a clue what she is talking about.) 

LOL.  wow.

  Sorry, but this is yet another example why I just do not trust N.P.s..  We now have P.A.s, N.P.s, M.A.s, paramedics, etc. etc.  --  It's like the health profession is trying to allow everyone to be able to do a doc's duties in one respect or another despite not being an actual M.D./D.O.    

I agree. And they certainly don't hesitate to charge you just as much as if you had seen a MD/DO. I refuse to see a NP if they are charging me the same.

Obviously neither of you are very educated about the different roles that people play in the healthcare field.

A medical assistant (MA) and a PA/NP are seperated by YEARS of schooling and experience it's like equating a Little Leaguer to Derek Jeter. And the fact that you mention a paramedic, who would never treat you in an office/clinic/hospital situation but may very well save your life while getting you to one of those places really points out your ignorance.

And FYI, the billing/reimbursment rates for Midlevels and Docs are vastly different, so while your copay would be the same, what the office bills your insurance company is very different. And if you don't have insurance it's much less expensive to see a midlevel.

Perhaps you should both educate yourselves a little bit more on this topic before advising other people "not to trust" a practitioner who may very well have been working in their field longer than their supervising physician has been out of med school.

There are hospitals that employ paramedics to work in their ER's and Urgent care clinics. My local hospital has paramedics working in both. They also call a special team of paramedics in when the nurses have trouble getting I.V.s in.

So while I agree with everything you said I did have to point out that some hospitals/clinics do in fact have paramedics working in the hospital/clinic itself not just in the ambulances.

Given my choice I prefer to see the PA in my PCP's office.  He has had many over the years.  When I need to be seen I need to be seen now, not in three weeks and I can usually get an appointment with the PA the same day.  Once I'm at the office the PA is usually on time or close to it where I might wait for two hours for the MD.  Once in the exam room I find that the PA takes more time with me and really listens to what I'm saying instead of thinking about the next patient.

Each set of initials plays a vital role in our healthcare system.  And let me tell you, I'd rather have a medic start an IV any day!

Wendy (Proud mom of an EMT)

How awful for you! As if a post-op bypass surgery patient 3+ years out wouldn't know the difference between "that stuck feeling" of eating too fast or not chewing enough and something like bronchitis! I'm glad you let the clinic know about it. Hope you're better soon.

Connie

"That stuck feeling" wouldn't also have come on slowly Sunday night, lasting for days on end and accompanied by low-grade fever, swollen glands, pressure through the sinuses below my eyes and in my nose, as well as a sore throat that so "nasty looking" that the second/smart NP thought it was strep throat even though the fast test showed negative. 

But hey... what do I know?

As a fellow midlevel practitioner (though I am a PA) I am *SHOCKED* that you were treated, or rather not treated, the way you were. I would definately ask to speak with her supervising physician and explain that if they don't re-educate that particular NP they may quickly find themselves with a legal case on their hands.

What she said/did was not only idiotic, but malpractice.

I hope that this experience will not deter you from seeing a different NP/PA in the future because the majority of us are really very good at our jobs.