cardiologist visits

I had a Biotronik Edora 8-DR-T installed a year ago, and it is wonderful! Not a single vasovagal attack. However, my cardiologist will not see me unless I have a problem. I am 91, on lisinopril and atorvostatin. I see a PA (physician assistant) once a year. This does not seem to me to be sufficient attention to my case, but maybe I am wrong? I am curious how often others are seen by their cardiologist?


11 Comments

once a year

by new to pace.... - 2021-09-15 17:16:45

Seen once a year , along with an in office pacemaker check once a year, quartlerly remote pacemaker check.  If the EP sees a problem  with the pacemaker check. Asked the Cardiolgist what she wanted to do.  Then she called me in an told  me the problem was fast heart beats .That was in June 2021, since than have had yearly pacemaker check Aug.2021 and was not called in.  Guess problem dissapeared on it own.  Well i would like to think so.

Gardiologist frequency

by AgentX86 - 2021-09-15 17:52:07

I see mine four times a year and my EP once, though he just told me that I didn't need to come back unless I had a problem.  He knows my cardiologist well and trusts him to refer any problems (my cardiologist referred me to him).

I have structural problems, though.  I wouldn't need to see him so often (likely once a year) if the only issue was the PM.  Though I like my cardiologist a lot and he spends considerable time with me, even some small talk, I wouldn't mind seeing a PA some of the time. 

Last week I had an appointment with my neurologist and his PA filled in.  His PA spotted the problem that I'd been complaining to the neurologist about for a couple of years.  Not that he did anything about it but at least he knew enough to look for and find the cause.

BTW, PAs aren't someone who just walked in off the street.  They're doctors who haven't done a residency for some reason or another (often they just ran out of money).

Haven't seen a cardiologist for over two years

by crustyg - 2021-09-15 18:15:06

But my case is fairly simple (like the owner).  I have a remote PM monitor (connects to PM every night, only sends back to base if there's a problem), I have to attend EP-tech clinic annually, and if I want to ask for an adjustment I just email the Boss's sec and EP-techs do the necessary.

I think the EP-docs are experienced enough to know who needs frequent in-person follow up and who can be left alone to live their lives, and who will call in if there are problems.

Cardiology Visits

by Marybird - 2021-09-15 18:18:48

I'm back to seeing the interventional cardiologist I saw before I had my pacemaker implanted, as the EP's I was referred to ( at my request) for diagnosis and management of sick sinus syndrome/pacemaker management have left the practice. The cardiologist took over my pacemaker management/ remote monitoring and afib management after that, and I alternate seeing his PA, and then the cardiologist approximately every 7-8 months or so. I'm just as happy to see the PA as I am the cardiologist, as he's very knowledgeable and excellent at what he does, and he also works very closely with the cardiologist. He also spends as much time as needed to address issues that come up, and answer questions. 

Then, of course, there is the every 90 day remote monitoring of my pacemaker, and  these guys have been vigilant in addressing issues that have come up on those reports. 

 

 

Couple Times a Year

by MinimeJer05 - 2021-09-15 18:55:14

I was once a bi-yearly visitor and then more recently it's been once or twice a year. It can be hard to see my cardiologist as she's usually booked out 2-3 months, but her nursing team is pretty top notch and can get me in within a few weeks. 
 

I prefer NOT to see any of them though as that means things are going fine. :-)

 

hope you're able to see your health team as much as you feel you need to.

 

jer

Visits

by Julros - 2021-09-16 10:48:50

My previous office wanted me to come in twice a year, alternating between the nurse practioner and the electrophysiologist. I objected, mainly because I saw no need to go in just to be weighed and deny any symptoms.

Plus, after the last visit I read in my report that the nurse practitioner documented assessments he didn't do. I have since switched offices. 

I don’t see a Cardiologist

by Shaun - 2021-09-17 16:43:36

I have a regular pacemaker clinic appointment once a year but I don't ever see a cardiologist. I assume the pacemaker clinic would involve the cardiologist if they felt it necessary. Otherwise I think the only other route to seeing a cardiologist would be a referral from my GP.

Year between appointments

by AgentX86 - 2021-09-17 17:21:56

I believe, in the US, if you haven't see a physician in over a year, you are no longer considered a patient.  The doctor, then, can't prescribe  or even refill medications without another appointment. 

Referrals, in the US, anyway, is an insurance thing.  With my insurance I can go to any provider, in-network, without a referral.  Some insurance requires a referral and it must be to a doctor they specify. 

Some Medicare (government sponsored insurance for seniors) plans allow one to go to any physician, anywhere, that takes any money from the government without a referral. Some are like the second, above.  Pays your money, takes your choice. Plan wisely.

Reply to Eight Comments

by qfzbvg - 2021-09-18 13:30:00

Thank you all for your comments. I appreciate your time and the information.

Not important but:  where I am, a PA is NOT a doctor.  And I never heard of an electrophysiologist (EP) before. (I think I can figure it out, though.)

I don't see much of a pattern to the frequency of cardiologist visits. Some are more frequent, but some are less, or like mine: "Never unless there is a problem". Seems like I should stop fussing about it. I can probably get used to the idea that, if I ever do have problem, or the PM does something wierd, then I will be a stranger to whoever gets the call.

PAs

by AgentX86 - 2021-09-18 13:52:44

In the US, PAs are indeed doctors.  They have graduated from medical school, so are doctors.  They have not completed their internship or residency so can only work under the supervision (license/insurance) of a licensed doctor (who has survived his internship).  This is very close to the relationship of an intern to the resident/supervising doctor in a teaching hospital. Interns are doctors, too, but have to work under another's license until they've done their internship and passed the tests.  IMO, PAs are doctors without the attitude, found in so many MDs.

NPs are similar,  though they've come through a different educational path (and aren't doctors, obviously).  They, too, can prescribe meds an do pretty much everything an MD can do but must work under the license of a a licensed MD.  For most things, I'd just as soon see an NP, too.

PAs

by Marybird - 2021-09-18 19:38:38

I wouldn't be surprised to learn that *some* PAs had gone to medical school but for some reason had not completed their post- medical school residencies, fellowships, or other advanced training needed to take their medical board exams, obtain specialty board certifications, etc. They'd have the title of doctor by virtue of completing medical school , but couldn't practice as licensed physicians, so working as PAs would be a logical step, I'd think, in working in the fields they've trained for. I'd also imagine they probably take the state exams/certification exams to become licensed/certified PAs as this may be a requirement to work as a PA in many states in the US.

But they haven't ALL gone to medical school, there are specific Physician Assistants degree programs in many colleges and universities. These are most often, as I read, MS level programs, with the first two years of college to take the required core and preparatory courses for the last 4 years of professional study, including in field internship/practicum ( whatever you call it) experience. I'd say it's similar to the other healthcare fields requiring 5-6+ years of study, such as the pharmacists, physical therapists, exercise physiologists, NP's etc. The PAs completing these courses of study take the license/certification exams for PAs. These PAs don't include the title of "doctor" in their names, since they aren't doctors.

In perusing the various state laws regarding the scope of practice of PAs ( these can vary state to state), it seems they are required to work under the direct supervision of a licensed physician- direct meaning the doc is available either personally, via phone, or internet, to answer questions, handle issues that need a physician, etc., and the work of a PA is supervised ( ie, must be signed off) by a physician. The laws here in Florida state that the PA can perform pretty much any task that falls within the scope of his/her supervising physician, and for which the PA has been trained- and they can prescribe medications ( except for narcotics, IIRC), do minor office procedures, etc. But they can't set up an independent practice, as nurse practitioners can.

As I understand it, NP's CAN practice independently from physicians, don't require direct supervision from physicians, though this may vary from state to state. They can in Florida, where I live.

 

I've only run across one PA personally. That'd be the PA in my cardiologist's office. He's excellent, knowledgeable, personable, and willing to take the time and effort to address questions and concerns of the patients.

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