I'm looking for a primary care (internal medicine) doc - haven't had one for years (last one left / retired; probably couldn't take the system anymore as he wasn't too old. He was good too).

I'm searching through the health group provider list. It seems more than 90% are foreigners, largely middle east or (dot) indian. And not just foreign born but went to foreign med schools. For example, Grenada? I thought the joke awhile back was that you went to Grenada because you couldn't get into a real med school, but you had the money to pay. I guess these people had intern / residency in the US but w/ DEI, I'm skeptical of their actual competencies. This includes MD and NP. Is this typical now?

I'll pick one for now and see how it turns out. I'm not comfortable..... I found one doc that may be okay but it's a drive (1+ hour each way). That's the alternative if this one doesn't work out.

see if you can find an DO

I think osteopathy is hokum, but I believe all the schools are here in the US, and they have good bedside.

If you have to drive to get good medical care.....so be it!! It is your life we are discussing here. That is my opinion.

Consider a Physicians Assistant or a Nurse Practitioner if you just need a "family doc" and don't have any serious underlying problems. They work under the supervision of doctors, can usually see you sooner if needed, and many have more experience and knowledge that more recent medical school graduates if they've been doing it a while.

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Originally posted by konata88:
Grenada? I thought the joke awhile back was that you went to Grenada because you couldn't get into a real med school, but you had the money to pay.

Like anywhere, it depends on the student. St. George's is a fine med school. One of the best surgeons I've ever worked with went there as did a great friend and great anesthesiologist. Two brilliant people.

It makes no difference where your sheepskin is from, just that you have one and are driven to be good at what you do. Don't judge them by the diploma on the wall.

When I was going through my pre admission physical and post surgery, I was "attended to" by numerous "computer" Indians. My grandson in 2nd year Med student. I asked about how many of his class were foreign born...Many

The competition among east/south Asians for medical roles, and the huge population, mean that in general they are quite intelligent and likely extraordinarily good at their profession (generalizing, but broadly accurate).

The best neurologist I’ve ever interacted with is Indian (dot), the best PCP a Syrian (female).

Thanks guys. I'll look into D.O. - not sure what that is but if they can a PCP, then may be a good option. I see more on the list.

While I get that a good doc can come from any school, that's a large part is due to the individual and not the program, it just seems like a higher probability of mediocre docs from a mediocre school, especially if it's not relatively cheaper. But not all good docs can get into the "good" schools. And not all docs from a "good" school are actually good, especially with DEI admissions.

It seems like a crap shoot these days. But good to know that you guys have experienced good foreign docs (again, not just foreign born but foreign med school).

I'll try it out - if I'm uncomfortable after the first appt, I'll seek out a DO in another office.

BTW, this first overview visit seems very expensive ($600?) - more than an appt with a specialist. That's surprising as well. Doc visits sure are different than what I remember. What a difference 10 years makes?

quote:

Originally posted by reloader-1:
The competition among east/south Asians for medical roles, and the huge population, mean that in general they are quite intelligent and likely extraordinarily good at their profession (generalizing, but broadly accurate).

The best neurologist I’ve ever interacted with is Indian (dot), the best PCP a Syrian (female).

A lot of the foreign schools are just as or more demanding than those in the states. In my facility, ( smaller community hospital) the current crop of internal medicine residents ( about 20) all but one is Indian or middle eastern ethnicity. I have know lots of very good practitioners from all ethnic backgrounds. Bear in mind some of these “ foreigners” are 3rd or 4th generation doctors, heck some may have ancestors in this country longer than mine.

I am a PA and have been at it for over 30 years. For general care without a lot of complications NP/ PA is just fine. One thing I try to teach new PA’s is to know your limitations, and make sure you involve the appropriate people promptly when needed. Even an older primary care doctor I knew ( old school, did a lot of things as office procedures a lot of specialists won’t even try) told me if you have a seriously ill patient, make sure you are not the only one worrying- meaning get them specialist help ASAP.
Two great Docs I work with are foreign born one from Venezuela and another from Cuba.

I prefer an American trained physician due to the training but more importantly cultural differences. It is most important in psychiatry which currently is a specialty chosen by many foreign medical grads

I have no idea where “In the gilded cage” is, but here in San Diego I like the UCSD health group. My PCP is very smart, very perceptive, and easy to work with. I’ve been with her for for about 12 years. Her ethnicity is Chinese.

The specialists are generally good too. And UCSD has at least a dozen facilities within two miles of my home, including three hospitals.

I'm actually seeing the NP who works for / with a doc that is foreign born / educated. The NP sounds good (we'll see; it's who I chose w/o knowing who the guiding MD would be) but I just learned that the NP is somewhat secondary to the docs for final things (diagnosis, treatment).

For general treatments (colds, annual health check, etc), I'm okay with NP and, while not ideal, probably the docs being assigned. What I really want is a good, informed, networked PCP that can refer me to the "best" specialist for any given issue. Not just to some cultural / social buddy which in my experience is very common for the dots. At least in my prior profession. If a dot is best specialist, perfect and fine. But if the dot referral is just some dot buddy, not cool.

My Indian interventionalist cardiac surgeon saved my life in 90 minutes. He had up to date procedures whereas the experienced US surgeon was stuck in the 1980s.

Another limitation is the corporation the Docs and Np work for. Between the insurance companies dictating what procedures and medications and what order, the business head also likely imposes limitations on their ability to freely practice.

I rarely see my Doc. He is a specialist, runs his pod, works with the Pro Sports teams, teaches at university, and authored a book. I like him, but suspect he is too busy to be my Primary

My primary is a PA-C. She's the one that caught my renal failure and saved my life in March. She's pretty competent, nose ring and all. No issue with keeping her as PCP.

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PA-C.

Honestly, I've only been familiar with the term nurse or registered nurse. All these terms are new to me: NP, FNP, PA (and some of these have -letter suffix which I haven't figured out. Like what does the -C mean in PA-C?).

I'm still trying to figure out what all this mean but my appt is w/ a NP.

It all hinges on the person. A woman doctor from Nigeria bought the practice from my German doctor when he retired.

She was very personable and professional.

I moved to AZ. The doctor I went to for one, got sick more often than I did and when he had to cancel my appointment, it moved it out by a couple of months. The nurse would take my vitals. He would come in to check my vitals. Then he would go to the other side of this big spacious room, bigger than most operating rooms. He's sit and start talking. At first, I thought he was talking to me until I realized he was fucking talking into his dictation machine.

The nigerian doctor, if I had something going on, she would tell me to come in and they'd squeeze me in same day. The AZ doctor, I called and they said they can't see me and won't let me squeeze in.

I ended up going to a Nurse Practitioner instead.

If you’re in CA, go to the Medical Boards website (www.mbc.ca.gov)

You can check/verify licenses and review where they received their training. It will also display any disciplinary actions. It’s a wonky site so bring some patience..

I’d run from a DO and stay with an MD. PA’s are good for minor ailments but don’t have the training an MD has. Kind of like comparing a police officer to a community services officer.

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Originally posted by konata88:

quote:

PA-C.

Honestly, I've only been familiar with the term nurse or registered nurse. All these terms are new to me: NP, FNP, PA (and some of these have -letter suffix which I haven't figured out. Like what does the -C mean in PA-C?).

I'm still trying to figure out what all this mean but my appt is w/ a NP.

NP: Nurse Practitioner (has a Masters in Nursing Science).RNs, if they have a degree have a bachelors. All NPs have an area of specialty- Family Nurse Practitioner FNP, Acute or primary care gerontology, pediatric, psych, midwifery anesthesia and some are multi-speciaty. “-C” or “-BC” means board certified, which they are if they are practicing. Same with the PA-C Physicians Assistant-Board Certified.

Where is "the Gilded Cage"?

Before I left the Bay Area in 2017, American trained GPs I could hit with a feather. Everywhere. And all of my specialists were UCSF trained.