Physician Assistant instead of Doctor

9 years 3 months ago - 9 years 3 months ago #40975 by warrentug
Physician Assistant instead of Doctor was created by warrentug
I have been getting a little "irked" that I never see the doctor when I go in for appointments, I only get the PA. Is this normal? I have been in for three office visits, and in for three procedures,(cystoscopy, and two TURBTS). I only see the doctor for 2-5 minutes before the procedures and have never had a sit down talk about treatment or choices.....this doesn't seem normal to me. He just explains what he is going to do at that time. He always asks me if I have questions but when you have the tubes hanging out of your arm it's hard to have a long talk!

Maybe I am suppose to be then talking with my Primary Physician, which I really don't have one. What is normal on this? I have started looking around but in a small town there is only five to chose from and four of them work at the same place.
Thanks, Warren.

Please Log in or Create an account to join the conversation.

9 years 3 months ago #40976 by sara.anne
Replied by sara.anne on topic Physician Assistant instead of Doctor
I guess that each office is handled differently. Even when I have a nurse doing the procedure (BCG) my uro stops in to ask if I have any questions and just to "chat" for a minute or two.

I have found, however, in other (not the urological practice) that I get more information from the PA's!


Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator

Please Log in or Create an account to join the conversation.

9 years 3 months ago #40977 by CatherineH
Replied by CatherineH on topic Physician Assistant instead of Doctor
I would suggest next time you make an appointment ask specifically for a meeting with the uro to discuss your treatment plan.

When I went to Vanderbilt for my initial consult, I spent about 10 minutes with the doctor who was going to be my surgeon. After he had looked at my CT scans and reports from the TURBT I had at my local hospital, he drew a little diagram on the paper that covers the exam table showing what he planned to do.

Since then, I have been back 8 times and I see him when he comes into the procedure room for my cysto which is about 3-5 minutes.

I have started writing down any questions I want answered because it's hard to think in that moment during the exam. And, if you're going to be getting BCG, the PA may be very competent to answer your questions in the meantime.

Best wishes... Catherine
Forum Moderator Team

TURBT 1/21/10 at age 55
Dx: T2aN0M0 Primary Bladder Adenocarcinoma
Partial Cystectomy 2/25/10
Vanderbilt Medical Center
Nashville, TN

Please Log in or Create an account to join the conversation.

9 years 3 months ago #40979 by upnorth
Replied by upnorth on topic Physician Assistant instead of Doctor

I see the same thing happening at my doctors. The PA dose a very good job of answering most of my questions, but if they can't they do consult the doctor for me, or bring him in to talk things over with me.

I wish my doctor was the one I was always talking with too. But then I feel that some of my questions are so basic that the PA will do. I wouldn't want to take the doctor away from someone who has a real tricky one to answer, just to make me feel a little more personaly cared for.

I guess we all wish we could be the only pateint so the doctor could concentrate more on settleing our nerves. But we know that its not possible. I just wish they would take more time to talk to us one to one.

I posted about a new book I'm reading "The End Of Illness" in another Catagory. The book touches on this subject, and how to deal with it. You might want to look into it.


Age 55
Diagnosed BC 12/20/2011 Ta No Mo 0a Non-Invasive At age 48
"Please don't cry because it is over..... Smile because it happened!" {Dr. Seuss} :)

Please Log in or Create an account to join the conversation.

9 years 3 months ago #40980 by DougG
Replied by DougG on topic Physician Assistant instead of Doctor

The urologist office that Doug goes to does not have any PAs. He has always seen his urologist when going for cystos or follow up appointments. His doctor is always very willing to discuss options.

When he went for BCG, he always saw the same nurse, who he nicknamed "BCG Betty" until we learned her real name.

I like Catherine's suggestion of making the appointment specifically with the doctor you want to see...maybe that will work.

I don't think the primary care doctors would be the ones to talk to about bladder cancer. Just my opinion....

Good luck. Sounds like you want and deserve better attention.


Forum Moderator

Please Log in or Create an account to join the conversation.

9 years 3 months ago #40982 by mmc
Replied by mmc on topic Physician Assistant instead of Doctor
I never saw a PA or had my BCG or mitomycin treatments done by a nurse. In my case, the nurse did the prep (numbing gel, prep, etc.) and the urologist did the treatment. I always brought my notepad with my questions and my uro spent time with me to answer questions and I took notes on the answers (especially in the beginning).1 After I got referred to the bladder cancer specialist doctor and had my RC, he even gave me his email address and cell phone number. I never called his cell but when I would send him a question or report a concern (suspected intestinal block, suspected urinary tract infection, idea for a research study on bladder cancer) he would get back to me quickly. He's a professor at a university teaching hospital and we have great conversations when I see him. I am careful not to abuse the access I have had and he has even sent me email out of the blue now and then.

I would not be comfortable only seeing the PA for bladder cancer--but that's me.
At my GP I don't have a problem seeing his PA but he still always comes in and spends time as well.

Again, other people's mileage may vary but I want the doctor, in addition to whatever staff he/she has for various tasks, to be involved in my treatment when it comes to anything serious and in my opinion cancer is pretty darn serious.

If you are in a small town you may not have a lot of options so you may just try talking to your doctor about your comforts level and desired interactions with him and with the PA. Could be he explains things in a way that makes you more comfortable and it could be he makes some adjustments for you. Worth a shot.


Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

Please Log in or Create an account to join the conversation.

Moderators: Cynthiaeddieksara.anne