My wife was a Cardiac nurse at a Houston Hospital noted world wide for heart expertise. The cardiac staff, when asked who they’d go to, or send their family members to for heart issues, mostly recommended a cardiologist originally from Pakistan. He became my doc as well. One of the best doc I ever had. Educated in England and US.

Just to clarify again - I'm okay w/ foreign born but educated in a first world country at a tier 1/2/3 school. UK (Oxford, Cambridge, etc) would be okay - comes down to the individual doc.

I'm a little wary of foreign (or even US born) docs from a school in the carribean (ie - grenada) or other third world country. This would include india, syria and similar.

The saving grace would historically have been passing the US boards. However, I'm skeptical of that with DEI.

This is not to say that the opposites can't occur - can get a great doc from syria or a terrible doc from US. But when all you have is a name and school of education to help you pick a doc, I'm a little averse to the non-US educated. And this is largely for any specialist referrals I may need in the future - anybody can treat a cough. I hope.

quote:

Originally posted by MelissaDallas:
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.

Thanks, this is a start. Still learning the differences. When did all this get so complicated?

Thanks jer - I'll check out the mbc site.

I think the demographics in medical institutions around the BA has changed a bit since 2017. In that time period, I think when I looked for a replacement PCP, most docs were US born, US educated. In fact, I think I picked one but she left during covid.

What I see now is not how I remember it 10 years ago. I could be wrong.

quote:

Originally posted by Rey HRH:
It all hinges on the person.

Bears repeating.

My PCP is a local guy, not an AMA member, just an a good old shooter, hunter, fisherman, not a fan of the Dems. 4yrs ago when I had to shop for a heart specialist, I couldn't find one that was not a foreigner in my area. The doctor that I saw in the hospital was Asian, I could not understand half of what he said. I ended up with a Middle Eastern doc, and I can understand most of what he tells me, he is very competent, but why can't they teach these people to speak English we can understand?

quote:

Originally posted by oddball:
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.

This thread made me want to see how my last PCP in the Bay Area was. She's the Nigerian doctor who took over the practice of my German doctor when he retired.

I found out she's the Medical Director now in UCSF. Apparently, not only was she personable, she must be pretty smart. Before this, she launched her own primary care group. I guess she sold the old practice.

Maureen Mbadike-Obiora

quote:

Originally posted by konata88:
Just to clarify again - I'm okay w/ foreign born but educated in a first world country at a tier 1/2/3 school. UK (Oxford, Cambridge, etc) would be okay - comes down to the individual doc.

One mitigating factor is that foreign educated doctors still have to pass the same requirements as US educated doctors in order to practice.

I think you can get a feel in the first few times you see them whether they're competent and whether their personality jives with yours.

Part of the problem is government-run medical education.
Numbers of medical students in US schools, numbers of residency slots are limited by the government, based on an old and failed theory that doctors demanded a certain standard of living; if we could limit the number of doctors we could control the cost of medicine.
Yeah, that worked, didn't it?

Another part is discrimination against whites, especially white males. Wasn't really a problem (much) in my days in training, but it definitely has become so. The son of my cardiology department chief and a professor at UCSF School of Medicine was turned down by all UC schools, had to go to SUNY Buffalo. Of course the chief still voted Democrat.

I had a good friend and colleague in cardiology who was trained in India, he was a good man and a great doctor. Likewise I've had male and female colleagues of all races who were excellent; and others of various ethnicities and either sex who were mediocre.

In general, I also look for the med school and residency training program, and if they were major programs in the US I would definitely give them a try.

But here we have another problem: many of the physicians who trained in good places went into specialty care, not primary care; and if in primary care they often chose to practice in big metropolitan areas. That left small town and rural areas as places not considered as desirable to practice, but because they needed docs...they let pretty much anyone practice there.

There's also been a demographic shift, with many more Asians choosing medicine than in the past. They had to be smart to get in, and they had to work hard, because--as we know--places like Harvard discriminated against them.

My bottom line is probably: I'll try to find someone who is mid-career, not just out of training--I'm worried about DEI in recruitment and training.

I'll stop my overly long rant here.

Good luck!

If finances allow, consider a Board Certified Internal Medicine MD in a “Boutique” practice.

Both my wife and I are alive today because we chose an MD-VIP Physician.


These practices limit the number of patients, allowing for MUCH MORE time with the physician instead of the 15 minutes, in and out, per usual.

They guarantee 24/7 availability and same or next day appointments.

I had an emergency cardiac issue on a Sunday afternoon, was met by the doctor at a hospital, diagnosed immediately with viral cardiomyopathy , treated and have lived happily ever since!

I can send an email/voicemail on a mundane issue and receive medical advice in a few hours.

The absolute best part is the in-depth knowledge of you as an individual!

One mitigating factor is that foreign educated doctors still have to pass the same requirements as US educated doctors in order to practice.
^^^^^^^
True. Cultural compentency however is not taught. Imagine speaking to a foreign physician who barely spoke English. It is unpleasant and at times borders on malpractice.

In my state (AZ) PAs work under a doc.
NPs have their own license and do not work under/with a doc unless they want to. My wife’s primary is a NP.
I had a DO for 25 yrs but he retired. Yes, a DO is a real doctor.

The biggest part to me is finding a foreign born doc I can understand. Being mostly deaf and having a very American set of ears, a heavy accent doesn’t lend itself to easy communication.

tagged of sorts,

need one myself,
my primary care doc went Concierge, then disappeared,

his Nurse Practitioner/ Physicians assistant left the practice for some other type of medicine

practice refused so see my during the cootie times cause I had not been in for a couple years,


so needing a checkup, and eval, to make sure I will live for a bit longer,

but need to find one

A friend said that Taiwan will do a full, comprehensive checkup, including MRIs, for about $3500. Top notch facilities and docs for that price. He was happy with the service. Said it would cost multiples of that if done here.

If I’m not satisfied here, may give that a try.

I’ve had some bad experiences with PCP’s, the end result being that my Cardiologist now serves as my PCP.

quote:

Originally posted by konata88:
A friend said that Taiwan will do a full, comprehensive checkup, including MRIs, for about $3500. Top notch facilities and docs for that price. He was happy with the service. Said it would cost multiples of that if done here.

If I’m not satisfied here, may give that a try.

Highly doubt that. Also, you're talking about flying to Taiwan to have all that done? Well, then tag on the costs of air travel plus hotel.

…AND what if there is a problem that requires a procedure? You have no insurance for it. And how do the results get back to a medical practice in the States?
You’re better off NOT getting such a “comprehensive” exam in my opinion: here’s an example: my spinal MRI shows I have severe spinal stenosis, and it’s gotten worse since the previous one. Yet I’m doing fine, no longer require epidural injections several times a year.
Another example: cardiac CT for calcium score: if it’s abnormal, you need follow up, at least something like a stress echo or nuclear stress test.
I spent part of my career developing and implementing preventive medicine guidelines for adults based on evidence-based medicine. For much of what you would consider a comprehensive exam “including MRI’s” there is no evidence of benefit, and potential costs, including finding something you can’t do anything about.

Thanks docs. Noted.

My gastro dr. Is from India but I am very pleased with him. I care more about getting a doctor that hasn’t bought into the idea that medicine and vaccines are the cure for everything than I am where they are from.

I guess I should be more explicit.

I'm not really questioning the competency of any individual doc. What I'm seeing is, in the USA, 90% of my choices to pick a doc is not born or educated in the USA. Why is that? Coupled with DEI over the past decade or so, I'm concerned about docs with foreign education with unknown accreditation quality in aggregate. These seems like DEI and cost moves, not competency. Where are all the US docs - born and educated in the US (race/ethnicity agnostic)?

Yes, perhaps intern and fellowship and board certifications help normalize to meet at least some minimum bar. But what about, in the PCP case, referrals to a specialist? I don't want a referral to a specialist just because he's of the same culture (for whatever reason). I want a referral to a specialist based on merit and competency. This is not a behavior I've seen demonstrated in my experience with those foreign born/educated and not assimilating into America.

So, again, my concern is not w/ any individual doc per se, regardless of background. This is a concern of the aggregate, both direct and indirect.