My local GI has 'downsized' and I am being reassigned to --- a nurse practitioner. Very disappointed, as it took 21 years to find this guy, who was recommended by my Cleveland Clinic CRS.

I explained my situation over the phone (jpouch) but apparently all the GI's patients are being reassigned to NP - it doesn't matter how special I am Wink

I'm trying to be open-minded about this, and am willing to see her, but am having a bit of trouble adapting to the idea. I am curious as to whether anyone else here is seeing a Nurse Practitioner in lieu of a gastroenterologist, and if so, can you report on any benefits, downsides, etc.? The scheduler told me that the NP can do about anything the GI can do, except for procedures, which she can schedule.

I mostly have a local GI on hand for emergencies, scripts, etc. I also have seen Dr. Shen and a CRS at Cleveland Clinic - mostly for fistula issues.

Also, on the off-chance, does anyone know a GI doc who works with j-pouch patients in the Columbus, Ohio area?
Original Post
Would your scopes still be with the same GI? If so, perhaps this is not such a bad thing, as the NP would be working in tandem with him and would be more accessible. NPs do need physician oversight. If this NP is good, she will listen to your input and not try to change any established protocols you have in place.

Jan Smiler
I rarely even see my GI here. All frontline is done through the "huisarts" (GP). They schedule the procedures and needed tests at the hospital, and that's when I see my GI and/or her team, but otherwise the huisarts does everything. There is a GREAT NP on staff whom I love; he seems to have more time to listen and delve into things.

Wow! What a concept! I think it is a great idea because if you are contagious, you keep it at home. Here, with my provider, Kaiser, they utilize and encourage email-your-doctor and phone appointments. When I was in the hospital last time, they even had a pilot program of a remote specialist visit, using a mobile "robot" with a two-way video (like FaceTime).

I think that they are realizing that much of good diagnostics are based on a good history. Anybody can order the appropriate tests.

Jan Smiler
I can understand your trepidation. I think I would feel the same way. There are some really very good nurse practitioners; however, you have a history that she may or may not be equipped to deal with. I believe that nurse practitioners are a good alternative in some situations but her training is not nearly as thorough as a physician who then specializes
. It would not hurt to meet her, and see where her level of experience with j-pouches falls. But I would not hesitate to seek out a few names of docs. Maybe check with your local support group for IBD.
Thanks phoenix08 - throughout the years I've become used to the feeling of being - let's say "unwanted" - by my local doctors, including my original surgeon and GIs. I believe it's just a matter of them not knowing what to do with a jpouch patient. We will see how the NP works out, however, when I was working with the scheduler and mentioned my jpouch, they didn't know what one was. Granted, it was just the scheduler, but did not make me feel very confident.

I will be going in with an open mind, and will update this post when the time comes.
The scheduler at my GI's office never knows what a j-pouch is either, but she isn't even there for the scope. My GI now just writes "patient knows how to prep" when he orders the scope, to avoid all the discussion about it. I am sure that a lot of patients try to tell them that they don't need to do the standard prep...

Good luck with the NP, and I hope she's working with the same GI.

Jan Smiler
I use my GI like a primary. Every time I have tried to be understanding and compliant. I am horribly disappointed! I have had numerous doctors do that poke all over your belly thing and you seem fine thing. Yhen they look at my file and say oh looks like you've had some surgeries. No that huge scar is for fun!! And really I feel as if its getting worse. My insurance changed this year and I'm constantly having to justify why I need things done. Absolutely ridiculous. But it could just be where I'm located.
OK, I saw the NP today. I went in with a positive attitude, was looking forward to working with her. Disappointment! She asked me about 6 times whether I was having stomach pain. When she asked whether I had any procedures done in the last year, I answered I had an EUA done in April. She stared at me ... E...U...E? A? ME: Um, yeah, EUA. Exam under anesthesia. She nodded.

She has only seen 1 or 2 jpouch patients. She was in her late 60's - "not that there's anything wrong with that", but it was like she wasn't all there.

Thankfully, she said the doctor was going to come in and talk with me for a few minutes, since she had so little experience with jpouches. So it was not all for naught.

I'm sure (very hopeful, anyhow) that this is not the typical GI NP. I did get what I went in for, some answers re. canasa, anucort, butt burn, etc. - from the doctor. Had he not shown up, I would have had to call the offices and express my disappointment in the appointment. Will not be meeting with her again, although I can use her for script refills...


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