I've searched for threads on here about finding doctors, and none of them apply to me. I can't search the BCBSNC website, since I'm looking for a specific kind of doctor: the one that has a very small practice, and if they use a "nurse" at all, it's just to take your vitals before the exam. My wife's family in Western NC has a doctor like this--do they exist around here? If so, closest to Cary would be best, but I'd be willing to drive as far as Fuquay, Clayton, Wendell, Chapel Hill, or Wake Forest.

I'm sick of these huge-ass practices where you see a different person every time, and even if it's the same person, it's some kind of nurse or P.A. No offense, I'm sure they're great, but I prefer to put my life in the hands of a doctor.

6/7/2010 11:39:41 AM

yes, they exist.


in the country.

--


Seriously, though I used to see Dr. Michael Karam when I lived in raleigh. He was a one Dr. practice. He still shows as being in the same location, so I imagine it's the same.

[Edited on June 7, 2010 at 11:43 AM. Reason : although I don't think your concerns are valid at all.]

6/7/2010 11:42:27 AM

Find a MD at your practice and request appointments with ONLY them. I was even able to get decent care at student health by finding the best MD there and requesting only her.

6/7/2010 11:43:29 AM

Quote :

"you see a different person every time, and even if it's the same person,"

[Edited on June 7, 2010 at 11:45 AM. Reason : a]

6/7/2010 11:44:59 AM

a friend of mine works at Dr Horton's office. his office is near rex. seems like it may be similar to what you are describing, but i only went in for a physical.

here is the info (from a biz card i have)
Robert M Horton MD
3124 Blue Ridge Rd
Suite 101
Raleigh 27612
919-782-2333
http://www.roberthortonmd.familydoctors.net

[Edited on June 7, 2010 at 11:46 AM. Reason : as far as i can tell it is dr horton, a nurse, and a woman that does billing/reception]

6/7/2010 11:45:07 AM

Dr. Robert M Horton. His office is over next to Rex Hospital.

He's the only Doc, and there's maybe three nurses.

Horton Robert M MD?Ste 101, 3124 Blue Ridge Road, Raleigh, NC 27612-8041
(919) 782-2333?

6/7/2010 11:47:05 AM

lol

6/7/2010 11:55:58 AM

Quote :

"Seriously, though I used to see Dr. Michael Karam when I lived in raleigh. He was a one Dr. practice. He still shows as being in the same location, so I imagine it's the same."

Cool, I'll check him out. As far as my concerns, that's not the only thing. I just like getting to know my doctor. Guess it's different down here, but where I'm originally from, people have a years-long relationship with their doctor and you rarely see practices bigger than 2 doctors, and no "nurses" to take vitals etc.

I also respect them more because I know the amount of education and work it takes to be one. P.A.'s are approaching that level of education these days, but sorry, I know too many people who are not very bright and became nurses.

Quote :

"Find a MD at your practice and request appointments with ONLY them. I was even able to get decent care at student health by finding the best MD there and requesting only her."

I loved Student Health; I miss it! But yeah, I always saw a female MD who was very good (dunno if it was the same one).

^^^Huh? Makes sense to me. Either you never get to see the same person; or, if you do, they're not a doctor.

^^ & ^Cool, will call them first since 2 people posted it. I did see about Access Health Care (http://prosites-bforrest.homestead.com/) in another thread. Some guy said the doctor was "the most brilliant guy he ever knew" or something. They only have 2 doctors and a nurse.

OT, but I obviously need to move to the country though. Getting sick of homeowners' associations & want to find a place where I can do some shooting without the cops getting called.

[Edited on June 7, 2010 at 12:01 PM. Reason : ;]

6/7/2010 11:58:16 AM

Burton Family Practice in Wake Forest. It's a tiny practice, short wait, and you pretty much always see Dr. Burton or the Nurse Practitioner

6/7/2010 12:00:56 PM

^ that doesn't sound like what he wants at all.

6/7/2010 2:06:35 PM

^Heh, yeah, +1 for small practice, -1/2 at least for RPN/FNP.

6/7/2010 4:07:42 PM

my doctor is in a fairly large practice, but I only see him. There are nurses who take your blood pressure, height, weight, temp before seeing him. But that's all they've done in my experience. And they take blood and what not on site. Which is a plus imo.

I also hate seeing a P.A. or not seeing a doctor during a visit. I've only seen him a few times (don't get sick too often), but he's spent as much as like 45-60 minutes in the exam room with me. And I've never felt rushed with him or anything like that at all.

I'd recommend him, but he's in n. raleigh (near crabtree). So, I'm not sure you'd be interested. If you are, pm me and I'll send you his info.

6/7/2010 4:14:44 PM

I forgot to add, Dr. Horton doesn't take credit. Cash or check.

6/7/2010 4:17:56 PM

Does Dr. Horton hear a who?

6/7/2010 5:05:44 PM

brian forrest in apex - he doesn't take insurance though

6/7/2010 5:46:14 PM

^Oh, crap. That's the guy I linked. He doesn't take insurance? That sucks -_-. Well, guess I could save $185/mo by dropping it and be able to afford going there lol. I was hoping to keep it till at least November and see if the Repubs actually are able to repeal the new law.

6/7/2010 6:06:47 PM

depending on your insurance copay, dr forrest might not be that much more. an office visit is fifty dollar bucks.

6/7/2010 6:21:45 PM

i have never gone to a practice where i have seen a different doctor every time - there are plenty of small practices out there.

i see a nurse practitioner and she has caught some things that i saw doctors for previously. so. whatever floats your boat.

i'd recommend my place but do you want a place without FNPs AT ALL? i mean you don't have to see them...

[Edited on June 7, 2010 at 7:09 PM. Reason : .]

6/7/2010 7:08:14 PM

^It's not so much that I don't want nurses to be there period, but that them being there makes it a bigger practice. I just don't like big things ("that's what she said").

Maybe I should have been more forceful. Since I'm only ever used to going to one-doctor practices, I never needed to demand things out of them. So could I have demanded that I only see one doctor at these bigger practices?

Either way, now that I've got all this advice, I'd rather just go to a smaller practice.

6/8/2010 12:22:53 PM

i dunno i've never been to a practice with more than 3-4 doctors.

is that "big"? when i think big i think of like 20 doctors.

http://www.schmidtandcatchings.com/
1 MD and 2 FNPs. but you can request ONLY to see the MD if you want. i go there and i only see one FNP. but any other doctor i've had, regardless of practice size (i've never been anywhere with just 1 doctor though) i've always seen the same doctor. EXCEPT perhaps emergency situations.

6/8/2010 2:03:49 PM

I think regardless of who you end up seeing, an MD, FNP, PA, you should feel comfortable with them, and make sure they take time to listen to you. That should be the key.

I honestly dont go to the doctor enough to even expect them to remember me, even if they only have 10 patients. You obviously go a lot more often.

6/8/2010 2:46:01 PM

^^It's big to me. Before I moved to NC, I had only ever been to one with 1 doctor, although I had heard/seen some with 2. Even when I lived in FL ~10 yr ago I only went to one-doctor practices. Thanks for the link. I saw them when I was googling around, maybe on City-Data or something.

^I only go once every month or 2 to get refills on prescriptions. Is that a lot? All my previous doctors, even at Student Health remembered me.

I've been going to Cary Healthcare Associates since graduating and I hate it. The practice is already extremely impersonal but then they closed early and tried to tell me I was lying when I said that the lights were off when I went by.

http://www.caryhealthcareassociates.com/meet-the-providers.html

6/9/2010 1:57:09 AM

did you decide on a Dr.?

I can't believe a Dr. only charges $50, that is super cheap.

6/9/2010 2:04:25 AM

http://www.countrydoctormuseum.org/

6/9/2010 2:50:16 AM

Quote :

"depending on your insurance copay, dr forrest might not be that much more. an office visit is fifty dollar bucks."

Forgot to respond to that. Mine is $15, so that's prob a bit too much unless none of the others work out. Thanks for the info though.

^^No, I need to get on it though. Going through withdrawal .

^Cool, may go see that when I'm bored one day.

6/9/2010 6:38:51 AM

YO I WENT TO THAT COUNTRY DOCTOR MUSEUM ON THE SATURDAY OF MEMORIAL DAY WEEKEND AND THE SHIT WAS CLOSED.

NOT PLEASED.

oh also, it sounds like you'd love my family doctor in pennsylvania. he's in pennsylvania, however.

[Edited on June 9, 2010 at 9:13 AM. Reason : .]

6/9/2010 9:12:13 AM

^LOL

Also, ask him to move, pl0x?

6/9/2010 10:17:07 AM

Quote :

"I also respect them more because I know the amount of education and work it takes to be one. P.A.'s are approaching that level of education these days, but sorry, I know too many people who are not very bright and became nurses."

YOu may not think they are bright, you may think you are so damn smart, they may actually be "not smart", but i promise you they are learned in their field. Have you sat in on them and watched them practice? Have they been repeatedly fired or something?

6/9/2010 12:11:53 PM

^Unless you have something to contribute, please GTFO. I was just responding to someone asking why I prefer doctors (if you bothered to read his edit, which said he "didn't think my concerns were valid"). It's a preference, get it? It's personal. But--since you had to ask--seeing as many of them don't understand basic biochemical or physiological processes when I bring them up (they give me blank stares), unlike Doctors and most P.A.s, I don't trust them to make the connections between cause and effect (disease and symptoms, respectively).

For LPNs, I'm sure they're "very learned in their field," if by "learned," you mean they've finished a 2-year community college program to be an RN and a 1 yr program to be an LPN (i.e. they don't even have a bachelors-level education).

NPs learn how to do physicals and what signs to look for. They never take advanced biochemistry, immunology, etc, and the intro classes they do take are a joke compared to even undergrad-level versions. So for NPs, I'd say they're equivalent to a mechanic, whereas a doctor is equivalent to an engineer. When it comes to my car, I'm happy to take it to a mechanic; when it comes to my body, I'd rather take it to the person who's more knowledgeable about the entire body, from a biochemical, to cellular, to organismal level.

6/9/2010 1:16:51 PM

^ I am not sure what you are stating right there, but I would like to make sure you are clear on a few things...

you do realize an LPN is not a NP, right? Its not even on the same trail. You do know that to become a FNP you have to go through 6 years of university education, right? You have to have a Bachelors of SCIENCE in nursing, not some associates degree. If you didnt know this, then your background of medical knowledge to even be in this discussion needs revisiting.

I'm not going to get into a debate, but your analogy of comparing a FNP to a mechanic really is more wrong than you know, and is completely disregarded and proven incorrect in numerous scholarly studies. The field of nurse practitioning is now well established, and well regarded, and these people easily make nice 6 figure salaries. I know NPs that approach 200,000 a year, and I can assure you they dont think they are a mechanic, or are second class citizens to doctors.

I'm not going to say there arent lousy NPs and PAs. There are. There are also plenty of crappy doctors.

ALSO: Your GENERAL doctor or PA or FNP is not a SPECIALIST. If they see anything odd, they are going to refer you. You pay a specialist to deal with complicated issues, because no general doctor is going to be the end-all be-all for diagnosing everything in the human body.

Chosing your provider and being more comfortable with an MD over an FNP or PA is a personal choice, but choosing an MD is not proven to be any better than a FNP for general care, and that is the type of doctor you are seeking.

[Edited on June 9, 2010 at 2:28 PM. Reason : .]

6/9/2010 2:17:32 PM

^Thank you for all that lol. Yes, I do realize they're different, that's why I separated them into different paragraphs and said that a LPN has next-to-no education and compared the NP to a mechanic (not necessarily unfavorably, just not for me). A BSN is pure shit; I have friends that gave up on chemistry and biochemistry as degrees so they could do a BSN and make "the big bucks," because they hated gen chem or organic (which are obviously easy compared to upper-level classes). Wow, $200k/yr? They're outliers then, because if you look at salary.com or some other salary aggregator, you'll see the 90th percentile is making ~$100k.

Yes there are crappy doctors, which is why I'm asking in here about doctors people recommend; and yes, I know the difference between a PCP and an internist and other specialists.

Other than the school nurse, I had never seen a nurse for anything until I moved to NC at 21. You're not gonna change my mind, k? Why do people have to try & convince others to change their minds about things? Can't I just like doctors better? Sheesh!


Source: http://hrsalarycenter.salary.com/salarywizard/layoutscripts/swzl_salaryresults.asp?hdSearchByOption=0&hdSearchByOption=0&hdKeyword=Nurse%20Practitioner&hdJobCategory=HC05&hdZipCode=27695&hdStateMetro=&hdGeoLocation=Raleigh,%20NC%2027695&hdJobCode=HC07000008&hdJobTitle=Nurse%20Practitioner&hdfte=&hdCurrentTab=&hdNarrowDesc=Healthcare%20--%20Nursing

[Edited on June 9, 2010 at 3:53 PM. Reason : ;]

6/9/2010 3:52:30 PM

I didn't say all np's make 200k. The salary is very dependant on where you work and what you do. In this area, the common range seems to be from 80k to 120k, although I know people that get 80 an hour (they work more than 40 a week).

6/9/2010 4:06:10 PM

yikes this is crazy

for the nursing programs i've looked at biochem and organic chemistry are prereqs. i realize this isn't true for all programs so don't get all bent out of shape.

i think that PAs have biochem and organic as prereqs for their program too. at least at ecu. if i remember correctly.

as a sidenote you better hope you are never hospitalized with a serious illness - because in those cases the nurses are the ones that see you on a daily basis and know you better than the doctors (often a team of doctors) who see you on rounds. so the nurses are the ones providing the continuity in patient care. i'd watch what you say about them - karma, you know.

[Edited on June 9, 2010 at 4:16 PM. Reason : .]

6/9/2010 4:15:17 PM

bringing up nurses is like the lounge equivalent to bringing up tipping.

6/9/2010 5:01:51 PM

^^^Well, then it's just as easy to say that I know people with bachelors degrees who make millions (like that asshat Jeff Zucker at NBC).

^^lol, yeah, that's part of where my viewpoint comes from, although those are obviously RNs so even less educated than even LPNs. When I had surgery last summer, they were pretty clueless. I had to look up on my phone what the CO2 they pump with was actually for, which incidentally, was pretty awful. I have a pretty high pain tolerance and didn't need the vicodin I was prescribed for that (appendicitis) or my wisdom teeth (tylenol 2), or when I got my leg caught between 2 pallet jacks (also vicodin), but turning into a CO2 balloon was pretty painful.

But I don't really believe in karma. If it were real, all these Wall Street scammers like Dick Fuld would be in prison.

^lol sure appears like it. I guess next time I'll just pretend I didn't see people asking me if nurses were okay instead of doctors

[Edited on June 9, 2010 at 5:17 PM. Reason : ;]

6/9/2010 5:11:08 PM

Quote :

"choosing an MD is not proven to be any better than a FNP for general care, and that is the type of doctor you are seeking."

It is this type of attitude that I think separates nurse practitioners and physician assistants in the mind of physicians. From the beginning, physician assistants have taken a specific and supporting role, always under physician supervision. On the contrary, from the beginning, nurse practitioners have always been interested in independent practice. I'm not saying that this is the goal of every single nurse practitioner, I'm just saying this is a major difference between the two fields, from the physician point of view. Where physicians really start taking issue is when nurse practitioners are purported as equal to physicians for primary care purposes. This is patently false. A new primary care physician, those physicians with usually the least amount of post-graduate training, has literally ten times more hours of training than a new nurse practitioner. The only way such a statement can be construed as true is if the nurse practitioner-level of education is accepted as the standard for primary care, therefore deeming physician-level education useless, irrelevant.

[Edited on June 9, 2010 at 6:01 PM. Reason : ]

[Edited on June 9, 2010 at 6:02 PM. Reason : ]

[Edited on June 9, 2010 at 6:03 PM. Reason : ]

6/9/2010 6:01:20 PM

Quote :

"statement can be construed as true is if the nurse practitioner-level of education is accepted as the standard for primary care, therefore deeming physician-level education useless, irrelevant."

That is actually not true. The proof is in the studies. Many many studies have been done that directly compare the quality of medicine practiced by clinics that are run by only NPs compared to clinics run by MDs. The findings are that NP's spend twice as long talking to the patients compared to the MDs, that patients end up with the same percentage of referrals across both clinics, and that independent verfication has found that the quality of the diagnosis were also equal. The only negative thing is that NPs test more, which could also be a pro depending on how you look at it. It is more likely due to a cover your ass attitude they are forced to have because so many doctors have it out for anyone that pratices medicine besides them.

http://www.acnpweb.org/i4a/pages/index.cfm?pageID=3321

PAs are different for the fact that they could have had any degree before going to PA school, not related to the medical field at all, and then essentially get masters degree to work under a doctor under direct review of the medical board. NPs report to the Nursing Board, and their powers are directly derived from that board's power which is beyond the review of the medical board. When the DNP program is a requirement in a few short years, NPs will essentially have the same education as MDs, and will have close to the same clinical hour requirements as well. There will be even less difference from the front line MDs and front line NPs.


Instead of the MDs being concerned that NPs are able to practice and not have to report to the medical board, they need to be looking at their studies, and figuring out how the nursing board is putting out graduates with less education and less training that are performing at the levels of their new graudates and try and find out what they can do better. And as I see you stated at the end, try and determine if MDs need to be the primary frontline supplier of medical services.

And FYI: newly minted doctors dont have 10x the hours of NPs when they come out of school. That is absurd. If you are going to try and make an argument, lets at least keep the facts straight.

Sorry, ibnuts, I didnt want to hi-jack your thread. I hope you find that country doctor you are hoping for and he/she does a great job.

BTW: I have had good luck at Duke Family Medicine out in Briar Creek. Its obviously not small, but I get to see the same doctor every time. So does my wife (we both see the same). Nurses are obviously involved, but I have never felt pressured, and she spends as much time as I need.

[Edited on June 9, 2010 at 9:28 PM. Reason : .]

6/9/2010 9:05:23 PM

I have been to NPs before that told me to only see MDs. NPs can do as well as docs for the easy patients that a monkey could treat, but I want to have a relationship with a practitioner that can still help me out when the crap gets deep. MD or DO only for me. Even then, I am extremely picky about my docs and at present drive an hour to one. I am considering giving up on that office and driving 3 hours each way to the one I used to go to. Finding an open minded doc that doesn't have a HORRIBLE office staff is not easy. By open minded I mean that they will put up with me trying alternatives when what they are trained to do doesn't work.

6/9/2010 9:51:44 PM

Quote :

"I have been to NPs before that told me to only see MDs"

What? haha, you went to an NP that told you shouldnt be seeing them? Did you go to a minute clinic or something?

Hell, my wife does spinal taps Do you think a monkey does those?

I'm officially out of this, anyway. People are going to feel the way the want to feel, and they have every right to choose their provider, MD or NP. Personal choice.

[Edited on June 9, 2010 at 10:04 PM. Reason : .]

6/9/2010 9:59:54 PM

if nothing else, there is the fact that it is much harder to become an MD than an NP, and therefore the standard MD will be a smarter person than the standard NP. that's good enough for me, truth be told.

6/9/2010 10:26:40 PM

Student health NP told me to stick with MDs the one time I forgot to tell them that I wanted a MD only. I wasn't pregnant, sick with the flu, or depressed so it was outside of their comfort zone, basically.

Medical schools select for people that are good followers so finding a MD isn't easy, but in my experience finding an exceptional NP is impossible. Sure a NP might be able to do a spinal tap, but knowing when and what to test for I have had much better luck with MDs or self diagnosis.

6/9/2010 10:51:37 PM

Quote :

"if nothing else, there is the fact that it is much harder to become an MD than an NP, and therefore the standard MD will be a smarter person than the standard NP. that's good enough for me, truth be told."

are you serious? Carribean medical schools will take anybody who's willing to pay the outrageous tuition. I have friends in undergrad who got in with a 2.5 gpa and subpar MCAT score.

6/10/2010 9:33:24 AM

Wow this thread blew up! lol

I think alot of people don't realize how fast the medical world is changing and have an old view on NPs and MDs. You can easily see a NP for everyday stuff, but the OP doesn't want to. He wants one of the old style doctors and there is nothing wrong with that.

In fact my father's practice would rather take a dumber down to earth MD, that pts were comfortable with than super duper smart foreigner. It's called capitalism and it's all about what the pt. wants. The people in this area want someone they can connect to and understand, and a dr. like the one they had growing up. The funny thing is it is almost impossible to find a southern laid back younger Dr. (Cardiologist) so they keep searching. (Their last partner was Egyptian, but grew up in the states)

ok back on track. There are still a few good old Dr.s out there that are in a single practice.

(although it is looking like not for as long as we would like with the way things are going )

ok end rant.

6/10/2010 10:39:12 AM

^x6. No problem I got a lot of good recommendations. After I try them, I may or may not revive this (assuming people aren't still arguing about doctors vs. nurses).

^^There are horror stories of people paying tons of money and showing up to find that classes aren't even going on, so I hope your friend is going to one of the 3-4 schools that is actually any good and has U.S. hospital rotations or acceptable residency placement rates. As for whether simonn's statement was accurate, IMGs still have to do their residency at a U.S. hospital, and for that, they will need to pass the boards (USMLE). In fact, if you're going to get into a U.S. residency (which will look down on even the best of the Caribbean schools), you'll need to do better than comparable applicants from even bottom-ranked schools like ECU. Even then, you're going to be faced with the stigma that anyone who sees your diploma or asks where you went to school (or sees it on the "about us" section of your web page) may be turned off by it.

I'd still be more apt to choose an IMG because they went through the U.S. residency program, which even with recent reforms to reduce rotation hours, is far more stringent than anything nurses have to go through. It's nice to be "progressive" and inclusive and say that nurses are doctors' equals, but when it comes to my body and life, I'm going to go to the best doctor I can find that meets my other preferences as well (small office, friendly, etc).

^Yeah it did blow up!

That's exactly what I'm looking for. Down-to-earth, but in a small, old-style practice. My wife's doctor was her grandmother's doctor and oversaw her pregnancy; then was my MIL's doctor growing up, oversaw her pregnancy; and was finally my wife's doctor. I don't know that he'll still be practicing if/when we have kids! This in in Western NC in a small-town, but I was hoping I could at least get that around here (which seems surrounded by small towns and is a small city itself).

Time's are changing. I'm originally from Canada, so used to true socialized medicine. I'm not sure what this new system will bring, seeing as it seems destined to make the insurance companies even bigger. Eventually it might switch to socialized as that system becomes untenable as well--who knows. Not trying to get into a health care debate other than to say, at least in Canada, doctors had complete freedom to be in the types of practices they wanted to be, and by and large, that turned out to be one-doctor practices where they could set their own hours and do as they pleased. My doctor got to where she'd only work 2-3 days a week and close up early.

It's a lot easier to find a doctor here, but a lot harder for me to find one that I like.

[Edited on June 10, 2010 at 11:13 AM. Reason : ;]

6/10/2010 11:12:32 AM

6/12/2010 9:32:33 AM

^I had to use the filen ame on that to even understand it--I don't have cable

6/12/2010 5:53:06 PM

i find it hard to believe you can't find a practice in the raleigh area where you aren't able to see the same doctor everytime. at my doc's office they only give you appointments with your primary care physician, unless it's an emergency.

6/12/2010 8:31:50 PM

yeah every place i've ever been has asked which doc i want to see when making an appt. for most things i'll ask for the one my family has used for 30 years but for something like strep throat i'd just take whoever i could see quickest since it was pretty basic

6/12/2010 8:58:50 PM

Quote :

"Robert M Horton MD 3124 Blue Ridge Rd Suite 101 Raleigh 27612 919-782-2333 http://www.roberthortonmd.familydoctors.net"

yup. the only thing is he will not prescribe relenza. does not believe in it.

nurse is vw nut.

6/13/2010 8:18:19 PM

http://www.doctorsmakinghousecalls.com/

6/21/2010 6:15:35 AM