My Experience With a Physician Extender

Recently, I went for my annual check-up with my doctor. I scheduled an appointment online, and prior to meeting with the intake practitioner, I had made the decision not to be weighed. I didn’t want to know my weight, and I didn’t need documentation.

Where's the Doctor?

Source: Simone Secci/Unsplash

When I walked into the room the first thing the nurse did was escort me to the scale. I informed her that I was not getting weighed, and she suggested that I could turn around so that I wouldn’t have to see the number. I hesitated, yet she just stood waiting. A wave of emotions took over me and I felt pressure, and reluctantly got on the scale.

I hated myself for backing down. I had a choice, but the overall assumption that I must weigh myself or else I might not be seen for my examination kept me compliant.

Afterward, I watched her input the number and I couldn’t let it go. I asked her why it was necessary to get weighted and she proceeded to tell me that the doctor needed to know my BMI.

I replied, “If I don’t want to be weighed I should be legally allowed to respect my body and my choice.” However, I didn’t know my legal rights. If I did decline, would I have been asked to leave? Would I have lost my appointment? At that point, what was the difference? It was already done.

When I was escorted to the examination room I was informed that I only had to take off my clothes from the waist down. More confusion struck me. I had hoped to get an annual physical exam, as well as a pap smear.

A physician extender walked into the room. Initially, I was told that the doctor would see me, but a substitute affiliate was there to see me. I had never heard the term before and it sounded like a euphemism for a lower-level provider (they are similar to nurse practitioners or physician assistants, and I am sure there are reputable ones).

The physician extender confirmed that if I didn’t do the exam, I would have to rebook and come back another day.

I went through with the exam, and I added that I wanted lab tests done, to which the physician extender agreed. She also said that I would experience some spotting from the pap smear, which she claimed to be normal.

Later, I realized it was not simple spotting; it took three days for the hue of the blood to go from red to brown. That can't be normal. I phoned the office to see if I should be worried, again I was told that the spotting was normal.

The following week I called to find out the results of my lab tests, and I was informed that the physician extender didn’t request all the tests that we had agreed upon. It was too late to re-run the tests, and I would have to return.

I googled physician extender: "A provider specially trained and certified to provide basic medical services under the supervision of a licensed physician. Physician extenders may order tests and make referrals related to the member's medical needs."

I didn’t have a PPO; maybe I was forced to work with an HMO already in place. Or was this the result of a compromised health care system?

In the end, I felt awkward and ended up acting like an insecure teenager at her first appointment. I could have taken more responsibility in the matter. I didn’t advocate for myself, and I should have.