Another neuro may be in the future, if this guy really did say that.
Insist on talking with the doc. If he won't talk to you
(or the PA is running interference) you definitely need another neuro.
The PA is a real A-whole Doofus!
(I've got a better term, but it would be censored)

I wonder if that PA got the fentanyl patch confused with the lidoderm patch...not all of them are 'bright'.

I also wonder if you have an HMO? There are kickbacks to doctors to prescribe less expensive treatments at HMOs.

IF you are NOT in an HMO? Get another appt w/another neuro ASAP! And we all know how long that can take!
IF it IS an HMO? Find and contact 'patient services' and get thee a 'patient representative' ...to plug into plans experts and thus report such can I say? What appears to be blatent ignorance of PN and meds for PN?

That PAsst is really a PA? I'd check w/the state licensing board about that too...I've done it...you'd be surprised what you mite find? In one instance the 'PA' for a doc wasn't a 'PA' at all. Another 'nurse' had lost her license and was 'practicing' as a 'nurse' in one practice. Same w/pharmacists and PA's and PT's...
Now, I don't condemn all PA's at all! My only true encounter w/one was delightful, and I'd found they listened to me and actually paid attention to brewing medical issues.
It does depend on how well you 'communicate with' this individual...Some folks work well with others? Some don't.
I agree w/all senior posters have said! Go do what you feel you must do to get what you SHOULD have in the way of treatments! Don't have a
it's not productive...let us know how you do and are doing! Hope always! - j

I would call and ask why you at least deserve a reason. The PA I have dealt with seemed clueless. I am not saying this is all of them. I just feel many of us are too complex and we need someone who had more experience and higher degree.

Update: it's not quite as bad as it seemed at first, but still not great. The neuro called me later and explained that he's just never prescribed the lidocaine for PN before (the PA said "he just doesn't", which sounded to me like "because I said so") and wasn't sure what was the correct dosage. He told me he would consult with other neuros in the practice to see what they say (he's very young BTW) but also said that I might want to ask the Dr. who originally prescribed the patches for more.

Then we had some other frustrating go arounds including his multiple deflections of my point that most people with PN have more than one medication because they are more effective that way. He didn't disagree, but he didn't suggest a second med, either. Arggggh!

He wore me down for now.

Oh, two other things:

I'm not in an HMO.

And what about the claim that a neuro-muscular specialist is the same as a PN specialist--that's bull isn't it?