Finding a good doctor

[AlanMeyer]

After reading the title of this posting, you probably thought I was going to tell you how to do it. Unfortunately, I don't know either and I was just hoping to start a conversation in which anyone can pitch in. If we get some useful replies, I'll try to post a summary of them.

One thing I've recommended is looking at the teaching and research hospitals, for example as offered in the US National Cancer Institute's list of designated cancer centers that I keep posting ad nauseum: cancer.gov/research/nci-rol.... I think that can be very helpful for finding capable oncologists, but I don't know if it helps with finding good general practitioners, finding local doctors, or taking your particular insurance situation into consideration.

Interviewing doctors to find a good one is of very limited help for people facing immediate problems. If you have to wait a week or a month for an appointment, have to pay a significant copay, and then find that the doc is useless, you've lost time and money. If the doc is not useless but not ideal either, probably the most common case, you've then got to decide how much further to look. If we could line up six doctors in one building and interview them all in one day, that would be great, but it's a pipe dream for hiring doctors.

So, if anyone has some good ideas, or knows the URL of a truly useful web page that discusses it, please share what you've got.

Alan

[paulofaus]

Alan, I've had trouble finding a good specialist (Medical Oncologist and Urologist). I met with three Urologists. I wasn't overly impressed with any of them, but the most recent Uro, seemed the most well balanced. I've been through two Medical Oncologists and had a second opinion from a third. All the med-oncs in my area stick to the standard of care. No discussion about 'radical treatments' like BAT/Testosterone etc. I also made contact with Dr Steve Tucker in Singapore, based on his associated with Dr Bob Leibowitz in LA, I have also found it difficult finding a GP (Primary Care Physician). My historical GP is OK, but not really very knowledgeable about Prostate Cancer. I look forward to hearing from others.

[herb1 in reply to paulofaus]

paul, what do you mean 'you met with three urologists". Did you schedule an appt with each, have an actual exam, bring records from previous doc, ask them how readily they will move off protocol, etc? Did you have THREE DREs in a few weeks--just for fun?

Herb

[paulofaus in reply to herb1]

Hi Herb, The Uro who diagnosed me was about 5 minutes from retirement and he said that surgery had no place for me because the cancer was outside my prostate. The second uro reviewed my records and he said that he could remove my prostate. I found him super cocky and decided not to proceed with him. I met with a third Uro, at the suggestion of a friend who is a doctor. He basically gave me an option that he could remove my prostate, but he was unconvinced that it was a good idea. Only the diagnosing Uro gave me a DRE.

[herb1]

It's a strong union! Talked to a doc about interviews; he says docs hate it, just make an appt and be done. But that's hard if you're in the midst of ADT. You've got to schedule the new doc in the right week and if you don't like him, you've blown your visit to the old doc. I know, I'm in that decision-making situation right now.

Also, I'm finding that almost all (90%) of the urologists in my area (about 20) are part of one uber-gruppen and I don't like that gruppen! (Yes, I'm back to that second visit to get shot!).

Word of mouth from your other docs might be best avenue.

herb

[Hidden]

I was on the cheap Medicare advantage plan when diagnosed. Network to deal with. I picked my GP for convenience, a good rating, and he was at a nearby University. Urologist is just what the GP picked. URO was OK but annoyed that I chose HIFU instead of the radiation he recommended. He seemed glad that I developed some early post surgery problems which have since gone away. I made sure to bump my insurance up to Medicare Supplement (plan F) so I don't need referrals. I still have the difficulty of picking an oncologist. I don't have the answer to actually selecting doctors or specialists.

[diller]

Since this is an older post, don't know if this will be that visible,but wanted to reply anyway.

For people like myself, who can't travel outside their area for whatever reason, it can be more challenging to find a dr if there are not that many doctors in one's area, am referring to medical oncologists here since I had IMRT and not surgery and have seen med onc ever since imrt.

As someone above mentioned, there are these giant practices, and at least in my area, one cannot change a dr within a practice. And its not always easy to get referrals from others since one does not know usually who other pca patients are, and support groups often do not have the time for that kind of discussion or even allow it.

Thus one I think has to be careful of the critieria they are using to accept or drop a dr, unless they are able to travel outside their area, and even then they would need to know in advance which doctors outside the area would be a good match, which is hard to do unless one has spoken with them.

Since bottom line, one needs a dr to prescribe the medicine, and hopefully expertise - one who

changes drs often and who can't travel outside area, could soon run out of doctors. sorry to be so negative, but often read that one should just change drs if not happy with them but its not easy to do for all of us.

and while on the overall topic, one of the things I'm amazed to read on corporate or other medical sites in general, is about one's healtcare team - and articles imply that they are all in communication with each other, and that each one is an expert in their field, and so on.

I've never had such an experience that one dr communicates with other ones, unless in an HMO plan where pcp needed to make a referral to specialist, but that was extent of communication.

Maybe I'm being too literal here and its more about the patient building their own team, which I guess just means finding a bunch of drs as needed, which we all do all the time.

Again, am not trying to come off sounding so negative, just wanted to share own experience.

[cujoe]

Alan

Way late to be posting to this topic, but I agree on your initial comments re: teaching/research hospitals - since most (if not all) of them have review teams that look at incoming patient histories and periodically discuss treatment protocol(s).

I go to two such centers, one for each of my unrelated cancers, and do so for that reason and also because I expect them to be abreast of new developments that might help my treatment.

My current medical oncologist at the Pca center was "assigned" when my PSA rise returned after surgery + adjuvant IMRT. (I looked up his credentials and curriculum vitae and found he is the most credentialed MD I have even seen. In essence, that made him out to be a very smart doctor, but said very little about how good he is. So far, so good.) I did the RT and incontinence PT at their facility because I wanted it all "under one roof", so to speak. My experience has been exceptional and I attribute at least some of that to doing everything there. My oncologist's specialty is not on the research end of the spectrum, but based on comments he has made during my visits with him, I know that there are those types on my review team.

(Before I retired I worked in the design field, most often on inter-disciplinary teams. The end products always reflected the synergistic "whole is greater than the sum of the parts" that excellent teamwork creates. I'm hopeful that the same sort of interaction is guiding my healthcare.)

My original referral to the surgeon who did my robotic surgery was from my brother-in-law who had had the same surgery several years prior. Knowing someone who has had a positive experience with a doctor/practice/medical center is a very valuable tool in finding a "good" doctor.

Be Well - cujoe