The doctor in training remembered telling one of her patients that, come July of this year, she would no longer be her physician. Martinez had been treating the patient for months at a local health care center for a variety of physical and psychiatric health issues.
*****
Lisa's doctor (Jenifer, AKA LadyDoc) is actually a Nurse Practitioner, and is as knowledgeable as any doctor I've ever seen. The biggest problem around here is our local hospital's emergency room is basically a large Urgent Care Center - they'll stabilize you for transport to a larger and better equipped hospital in the Nashville area.
That and testing. Other than X-rays and blood work, any testing that Lisa needs done is down in Gallatin, an hour's drive from here.
One HUGE difference between our care here and California is wait time. Here, we're in and out whereas in California you'd wait for an hour or more for a scheduled doctor's appointment.
Same thing with the emergency room - when I drive past the hospital in Portland TN, they've got a sign at the road telling you how long the wait is, and it's typically under 10 minutes. A trip to the emergency room in California was an all fucking day or night ordeal, and that was just sitting in the waiting room amusing yourself by counting how many languages you'd hear.
Don't worry major universities are gonna solve the Doc shortage. There's lots of little disadvantaged victims of systemic white supremacy imps from inner city schools that are getting priority appointments to the medical schools.
ReplyDeleteThis is sadly 100% true. Gonna be hell to pay if you are sick in the future.
DeleteGovernment MUST be removed from ALL involvement in medicine and healthcare. That is the ONLY WAY our nation will again be healthy.
ReplyDeleteJune, July and August I was with an elderly relative in a Portland ER. Hours to half day wait.
ReplyDeleteI assume you're talking about Portland, Oregon and not Tennessee?
DeleteShades of Northern Exposure.
ReplyDeleteBefore I left San Diego in 2014 I had to go to the ER twice over the years and took a few friends for their issue.....place was packed with illegals....unless you were bleeding out, the average wait was 3 hours. On time it was over 5 hous.....That was at Kaiser.
ReplyDeleteBack in November, my wife fell and the corner of a table caught her in the inner corner of her eye and damaged the tear duct. The local, very competent, hospital didn't feel that there was anyone available locally to handle it. I don't remember if it was a matter of who was on call or what. So after four hours, at 18:00, mostly spent with the locals trying to get someone at Grady in Atlanta who could take the case, Grady being the only Level-1 Trauma Center in northeast Georgia. I was asked if Grady was ok. I said, well, they killed my mother but I know where it is, which was really what they were asking.
ReplyDeleteGod help us, we got there at 19:00 on a Friday night. The emergency room was packed. We provided some diversity. The intake person didn't have a clue, regardless of the package we brought.
At 23:00, they were kicking all family out. I asked the person doing the kicking if I could ask a question before i left. She said sure. I told her the story, she sent us to a person of non-diversity who handled it. The director of emergency said we should have been sent to Trauma immediately.
They took my wife back and kicked me out. I spent until 0600 Saturday morning sitting in my classic '02 Durango on the street. Give 'em credit. When my mother was there the sidewalk in front of the entrance was full of homeless and other scary people but now, the Grady and Atlanta cops kept it swept of any suspicious loiterers.
Maybe it's Fascist but the street was clean. I was panhandled once and the the guy was sent on his way, not because he was caught panhandling but because he didn't look like he belonged or maybe the cop knew him.
My wife said she was worked on in a hall on the stretcher. It turned out that there wasn't a specialist called in as we had been told but the on-duty trauma people were up to the job.
The big lesson was that our dog can go 24 hours without going out.
Glad y'all found a good NP. With all due respect though NPs are not nearly nearly as knowledgeable overall as a physician. There is almost no pathway to that equity of knowledge given the time and education invested. Years invested with a relatively narrow scope of practice can yield good results though.
ReplyDeleteI bring it up not to be a dick, but to make sure people understand the difference, many do not. I have known talented NPs and PAs, and I have had to bat cleanup behind many more that did not know enough to know what they didn't know, because they are told essentially they are the same as a doctor. The results have ranged from annoying to catastrophic.
It has become big business to send folks through midlevel programs, and even bigger business for hospitals and clinics to replace seasoned doctors with mid-level practitioners and tell everyone they are just the same. Corps and govco pay them less, but charges are essentially same as if seeing a doctor. Makes the bottom line look very good.
Before someone tears me a new asshole I will reiterate I have worked with a select few I considered colleagues, and on occasion even peers. They did not represent my experience with the masses though. All that being said, if they are good at what they do, and are willing to recognize their limitations and access help when needed, God bless and keep them, especially those providing rural/underserved areas care. It is a tough row to hoe for those of us that commit to it.
LadyDoc's very good at what she does to the point that I wouldn't have known she wasn't an MD if somebody hadn't told me. Hell, she's kept my wife running for 7 years now. And no, she has zero problems with sending my wife to a specialist if she feels it's necessary.
DeleteEven as distrustful as I am with doctors (even before the covid bullshit) I'd go to her if she was a man. That's my issue though - I just don't feel comfortable with a female doctor, especially a pretty one, examining me.
All good stuff Wirecutter, and y'all are blessed. I guess part of my point was some patients "would never know" the difference. I do. When "Dr Jason" the PA played around with a patient for a year or two getting fluid drawn off his abdomen with no work up, he ended up in my office. By this time the renal failure and liver failure were so far gone we went straight to hospice, too far gone to attempt intervention. Or "Dr Britttany" (NP) working the chest pain unit in ER...who after my call warning her that my patient on the way to the ER had changed from stable to unstable angina and needed a deep work up...did the EKG and bloodwork and discharged him after a few hours. He had his heart attack 3 days later and arrested on the cath table. Keeping him for a stress test would likely have averted that, but she knew better than the old doc, and treated the numbers, not the patient.
DeleteWhen you get a jewel like y'all have it is indeed a blessing. People just should be aware of the differences. The beast system serves to run as many widgets through the system as possible. Putting less educated and experienced people in place that sometimes blindly follow treatment algorithms without being aware of the hidden missteps is great for the bottom line, not so great for patients.
I will sign off with that, appreciate you letting me ramble a bit.
Manufacturing a doctor shortage so foreigners can be brought in.
ReplyDeleteagree 100%
Deletethis has been gonig on for awhile and was obvious to anyone who cared to look
also lawyers, insurance companies, hospitals made it very difficult for a solo practitioner MD to earn a living outside of a large group practice (mostly run by insurance cos)
Bingo!
DeleteWhen was the last time you saw a actual DOCTOR, not a PA, or something?
ReplyDeleteAnd if you did, was they born here?
Or imported because they have their degrees from a mud hut school, and their residency served in a “hospital” where a wheelbarrow was used as a ambulance?
Me?
DeleteThe last time I saw a doctor or any other medical professional was in 2016, before I moved here to Tennessee. I haven't needed to see one in all that time and I'm not a whiny li'l bitch that has to run to a doctor because I have a sniffle. And yes, Doc Warwick is an actual doctor, American born.
Been more than 40 yrs for me, except for the retired guy I shoot with sometimes.
DeleteI am glad you have found a good nurse practitioner. But I have seen them 3 times here in Texas, and all three times they misdiagnosed me, and I had to go see a regular MD a few days later when I got worse from what was really wrong with me all 3 times. I have to pretty much be at death's door before I will see another one.
ReplyDeleteWhat really scares me is that there are no young white male doctors anymore in general practice. Medical schools have been so busy pushing "wokeness" that it's all females and minorities getting accepted. The few white males that do get accepted excel so much that they always go into specialties instead of general practice.
Haven't been to a doctor in about 5 years. Probably won't go ever again. Told my wife if I become incapacitated, let me die and bury me out in the pasture. Gonna cut the undertaker who is a big time donor to democrats out as well. The neighbor has a backhoe. I don't want any drugs or anyone else's blood in me. To each his own tho. I just don't trust any of them anymore. Too many of our local ones are pill pushers.
ReplyDeleteYeah, it's a sad state.
DeleteMy local doctor runs the hospital as well. I believe he he told me he is Syrian Christian and he was a surgeon there. He is a good doctor and does not argue with me, which is great. When I got hit in the head, I was in the ER for 5 or 6 hours, of which about 15 minutes I was lucid enough to remember what went on. The laceration on my head was to the bone and covered the crown from the hairline all the way back. I do remember being stitched up, it was two layers of stitches and he seemed to be happy to be practicing. My wife says the scar is barely visible.
ReplyDeleteMy wife had to go to the ER on a Sunday morning for a bad wasp sting. We were in and out in no time at all. We saw a competent doctor in a few minutes and the longest time we had there was waiting to make sure she did not have an adverse reaction to the medications.
All in all, I am happy with the medical care we get here. We used Vandy a couple of times for eye issues that needed specialists and their vision folks are good. They caught and repaired a retinal issue with my wife that has made her sister and brother blind in one eye each.