an infection in my hand. Two days later I had to go back for a new Rx because I was having an allergic reaction. The nurse practitioner offered to look at my body's rash (hands, armpits, crotch) and I refused, saying I knew it was a reaction. She wtote me a new RX. They billed my insurance $300 or more. I fought them on it, saying I didn't have or need an exam, just a new script.

practice drive-through medicine.

If the doctors who audit our charts ask why we didn't examine a patient for an acute complaint, we have to have a better answer than "The patient didn't want me to."

Ask questions and then sends me to a specialist. Has never done more than listen to my chest. Never seen me with my shirt off. Thinking about finding a DO again. They seem more hands on.

who's now 70 .... was a child ... the doctor used to take your tonsils out right in the office!

Everything's so complicated now, especially when insurance is involved.

If they refer you out, it's usually because their schedules are too tightly packed to be able to do them.

I do a number of procedures in clinic; ingrown toenail excision, incision and drainage of an abscess, removal of subcutaneous foreign objects (B-B's are the most common. Point that B-B gun somewhere else...), excison of skin tags, etc. I usually consult on the case first, then schedule the actual procedure either for the last visit of the morning, or the last visit of the day. That way, there are no other patients waiting, and I can take my time with it.

Anything more time-consuming than those simple procedures gets referred out to a specialist who can make a living seeing no more than ten or eleven patients a day.