Need your opinion of nurse practitioners and rural health care

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go to http://www.gadsdentimes.com and click on past issues and then look under April 7th for my article "Nurse practitioners serving Altoona patients: some insurers aren't paying."

I'd like your opinion of nurse practitioners in rural areas where they can't recruit doctor's. would you go to one with routine health problems? what about emergencies, etc.?

I've written this for the daily, which is the website you just looked up, and also for the weekly paper here (a slightly longer version) and I'm sure we're going to be writing more about this.

Thanks for any in put!

-- Suzy in 'Bama (slgt@yahoo.com), April 08, 2001

Answers

I did not go to your site but routinely see a pa .A nurse practioner is who found the hole in my daughters ear .She had been to at least 5 doctors before this. A pa read my tests results correctly for Lupus , when a top Dr in CT could not .Hats off they are great.

-- Patty {NY State} (fodfarms@slic.com), April 08, 2001.

My daughter and I usually see a PA or NP when we go to my doc's office for whatever reason. For emergencies, I'd go to whoever was available - PA, NP, MD, Paramedic, Witch Doctor - whatever - an emergency to me means EMERGENCY! )Loss of lots of blood, MI, system shutdown, resp failure, etc.. It doesn't mean an ear infection that I've ignored for a week or so...) My co-pay is the same either way - don't know what my insurance co. pays. In a nearby Amish community, there is a NP who is very popular with the Amish (who do not have insurance). I have spoken with her on the phone in the course of my work and have listened to her patients talk about her and they seem to think the world of her - and she was very, very nice! I don't feel near as rushed with my PA as I do my MD. The NPs and PAs I know don't seem to have the inflated ego attitude of some (not all, but some) MDs. Maybe they only teach that in med school?!

-- Polly (tigger@moultrie.com), April 08, 2001.

I've seen several Nurse Practioners, I was only unhappy with one. There is only one way to put this--she was a twit. As long as NP and PA's are closely monitored by a physician I think it's great. They do seem to spend more time listening to you than physicians do.

I'm not surprised about the insurance companies balking at paying for NPs and PAs, they'll try *anything* to get out of paying.

Stacy Rohan in Windsor, NY

-- Stacy Rohan (KincoraFarm@aol.com), April 08, 2001.


Most of my experience with NP's and PA's has been good, some are better than any doctor I've been to. When we lived in Tok, AK, the nearest doctor was a hundred miles away, so all we had locally was two PA's, and they were great. They were supervised by phone from Fairbanks, but for the most part didn't need it. We haven't had too many emergencies, but have gone to both NP's and PA's for all kinds of routine problems and gotten more accurate diagnoses from them than from most of the doctors we've seen. All the really stupid (and I do mean stupid) "diagnoses" we've gotten, or being rushed and not listened to, have been from doctors. Ditto for bad medical advice (like the doctor that wanted me to only gain ten pounds with my first pregnancy because I was a little overweight -- not much, just a little). Doctors -- specialists -- didn't diagnose my daughter's autism, a special ed. teacher spotted it when Juniper was almost six. Doctors didn't diagnose her celiac disease, either, even though I asked at least two children's specialists about her symptoms. A doctor told me my abdominal pains were either constipation or lack of exercise (LOL!!) -- it was celiac disease. I could add a bunch more things to this list (doctors only found one of my middle daughter's broken collar bones after her bike accident -- she'd broken both of them), and I know other people on this forum could add to it, also, but you get the idea! I trust the family doctor I have now, within reason, but I also don't go to her very often, and do tons of research myself (she's learned to research stuff, too!! ).

-- Kathleen Sanderson (stonycft@worldpath.net), April 08, 2001.

Several years ago I went to NP for routine physical exam. That was the most thorough medical exam I ever had, consumed a whole hour! She is allowed to write 'scripts but have to be countersigned by MD. I stopped going to her because she can't admit to hospital or care for patients there and as I didn't think very highly of her "supervising" MD, I found another MD, another hospital. Had no trouble with insurance paying her--quite a bit less than MDs, I might add.

-- ruth in s.e.Illinois (bobtravous@email.com), April 08, 2001.


I just switched to a practice that has a nurse practitioner that is spoken very highly of in our community. I wasn't finding satisfaction with our GP (he was an awful doctor, actually). I have worked with some excellent NP's, too, so I have no problem with them. As with any field, there are good NP's and bad NP's. I say if you like the person and feel they are a good listener and an equally as good diagnostician, that they know when to refer you if they cannot handle your problem--go for it!

-- amy (acook@in4web.com), April 09, 2001.

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