Time With Oncologist

[Stegosaurus37]

How much time does your oncologist spend with you at each appointment (and how frequent are the appointments)? I get to see the oncologist once a quarter and the nurse practitioner in the other two months for twenty minute appointments (if I'm lucky). Is this normal?

[YostConner]

I see my MedOnc quarterly for 30-40 minutes (with the knowledge he’ll give me whatever I need). In between I see the nurse practitioner twice for 20-30 minutes. I have access to my pain nurse (or any of them really) whenever I need it. My care is through Johns Hopkins.

[DSEE in reply to YostConner]

Please advise

You have a separate pain nurse?

[YostConner in reply to DSEE]

I do. She’s part of an integrated oncology team, but she manages my pain meds. I’m currently using fentanyl patches and oxycodone tablets.

[Hidden in reply to YostConner]

Great care.

[Tall_Allen]

It sounds like you don't feel like your questions and concerns are being adequately addressed. If you have a long list of questions or diagnostics to discuss, you can request a longer time slot at most places.

[Stegosaurus37 in reply to Tall_Allen]

It's possible to request double appointments, but that doesn't seem to do much good. My previous oncologist is no longer there. I think he got fired. Saw the new one Friday for the first time. He came out of retirement to pitch in for two days a week until they can come up with something else. 4 pm appointment and he didn't show up until 5 pm and then gave the distinct impression that he wished I'd just go off and die properly like I should.

Thankfully that's the last time I'll see him since we're changing health care providers starting Jan. 1.

I've said I have two diseases - the cancer and the treatment regime and I don't know which will kill me first. Now I have to add a third - oncologists who are just SOBs. I admit I got my back up a bit with him but I am sick of all these bastards who just ask "what do you want to do with the rest of your life?" If they don't have anything to contribute, then say so before I have to haul myself around for these appointments. I've already outlasted all their prognosises. And as a tough old buzzard I intend to continue to do so.

My cancer could have been caught - and should have been caught - while it was still possible to do something about it. But Standards of Practice dictated cession of PSA check at age 70. I've researched that and it is purely arbitrary - no scientific or medical logic behind it. Why would PSA be significant at 68 but not at 72?

Forgive the rant but I've always been in excellent health and aside from the cancer I still am. As I write this I've had a year and a half ripped out of my life by the therapies and I will die several years sooner than I would have otherwise. What is, is and you just deal with it. I've had a good life and I'm not afraid of death. But it's like someone stealing your wallet. I would be less than human if i didn't feel some resentment for those whose negligence got me in this situation.

Thanks to all my brothers here for your understanding.

[whatsinaname in reply to Stegosaurus37]

I completely understand and empathize with you, Stegosaurus37. This thing about turning up late (coming at 5pm or 6pm instead of 4pm), why do they do it ? Probably, because they just don't give a crap about keeping a cancer patient waiting ? I can understand the rest of your complaints, having similar problems myself.

The question is : What can be done, apart from changing quacks on a regular basis, until more by fluke one is lucky enough to find a relatively decent quack ?

[DaC00tie in reply to Stegosaurus37]

I understand how you feel. With my first oncologist I felt like I had to drag information out of him. He would ask me, what questions do you have? And since this was my first exposure to an oncologist since my prostectomy 11 years ago, I didn't know what questions to ask. But since doing some research and being on this blog page, every time I come up with a question I write it down. Even still, when I saw my oncologist and began reading the questions off my list (I had a piece of paper in my hand), he appeared to get frustrated, like he wanted to be done with the session, and asked me where I got my questions. I wasn't comfortable with him, or my radiation oncologist. And these people have my life in their hands so to speak. As a result, I changed facilities and I have a new oncologist which I definitely trust more. She sits down patiently and hears me out as I talk about my questions and concerns. And she responds to all of them. I get the same response from my new radiation oncologist. I'm so glad I made the move. I feel much better about my treatment. As far as how much time they spend with me in minutes during my appointments with my oncologist every 3 months, she'll spend as much time as I have questions for. It varies. And they are on time with appointments.

[Fitzbruce1 in reply to Stegosaurus37]

I can feel your pain since mine is so similar. I am doing a better job of not thinking about my quack family practice doctor these days. Resentment? Hell yeah!

[Hidden in reply to Stegosaurus37]

I recall waiting in an exam room over a half hour to get my biopsy results and I could hear my urologist chatting outside. Really? Then again, maybe that's his least favorite duty -- to tell another old guy that he has prostate cancer.

[ARIES29 in reply to Stegosaurus37]

Good one Stegosaurus37 & dont worry about the rant as i am sure most here have had the same experience. Untill you can find an MO that has had personel experience with PSA you will get the, im allright jack treatment.

[Hidden in reply to Stegosaurus37]

I hear you..

[MichaelDD]

I see my oncologist local/"regular" minimum every month. Now that my local introduced me to another at UCSF that one every 4 months currently . More if I think I need. Local always answers email or calls back within 24 hours. Most of the time within same day. Even with good attention there are times I'm lost. I explained that to my MO and he said don't call the front desk and leave him a message. Tell them you want to speak to me. Has helped me.

[whatsinaname in reply to MichaelDD]

You are fortunate to have a diligent, considerate doctor.

My quack told me that he cannot treat me over the phone

I found another quack, who thus far, is considerably better

The new quack is female, btw.

[DaC00tie in reply to MichaelDD]

I also have my oncologist at UCSF now. I very much like the service I get there. I was being treated at Stanford. Night and day difference. Everybody has their bad days, doctors included. But the service is so much better there. I have Dr. Borno

[MichaelDD in reply to DaC00tie]

I'm very appreciative of everyone at UCSF. I'm with Dr Rahul Aggarwal.

[PGDuan in reply to DaC00tie]

Yes, I also have had very good experience with Dr. Borno.

[Stegosaurus37]

I do have to empathize with them. They are much over-worked and it's going to get worse as the Baby Boomers age. But that's no excuse for the "wham, bam, thank you ma'm" approach. Poor time management is poor time management and if the health care admin can't figure it out that it's not working and devise a solution, a new set of admin folks are required.

[whatsinaname in reply to Stegosaurus37]

Yes, its not only a doctor/patient imbalance. It has to do with a lot of other things like incompetence in scheduling appointments, not bothering about patients, quacks getting stuck in "meetings", talking non-stop on their phones, etc, etc, etc.

The REAL problem is that very few people like you (and I) are ready to call them out. Most suffer in silence and that encourages the bloody quacks to lord it over.

[Hidden in reply to Stegosaurus37]

Is it true oncologist start out at $700k. ?

[erjlg3 in reply to Hidden]

:0

[charlesmeyers1964]

i call them maintance docs. i get the usual check the heart,lungs few questions for 200+ an out the door. they are useless over prices shit heads

charlie

[rococo]

I may be wrong but after doing my research, ithink I know moree what i need than they do. As long as they provide the meds, treatments and test want, not concerned with time spent with them. Rocco

[Break60]

I don’t have one. My two ROs and one Urologist have been great. I do about 2 hours of research daily. So far so good.

[Sherpa111]

My MO spends about 30 to 40 minutes with me once a month. Never felt rushed and he tolerates all my questions. He is a MO at the home town oncology practice with a DO, so he is fairly tolerant with my use of some supplements.

[chascri]

Every three months for follow-up appointments. I am to call for an earlier appointment if something comes up. Appointment usually last about 15 minutes and are usually with the doctor or nurse practitioner depending on whether there are new issues just follow up. Same with palliative care doctor and nurse. Of course always available by phone or email. My care is through Levine Cancer Institute, Charlotte, NC.

[cigafred]

The hospital organization limits visits to 15 minutes, in my case every six weeks while on ADT. During that time the MO is fully responsive, but goes so slowly/carefully that we cover little. If I send an e-mail he will slowly read it when we meet, thus using up most of the time. Tall Allen suggests requesting a double appointment, but I doubt insurance would cover (I have no basis for this belief, so I will try). Otherwise a great MO, at the forefront of what is happening, tolerates my deviations from standard of care, but no interest in supplements.

[leo2634]

As long as I have questions he will listen and advise. I have completely trusted this man with my life and he has given me hope as well as compassion and knowledge. You need to discuss your feelings with the Doctor and if you're not happy move on to better care.

[Consultjack]

I see my oncologist once a month and I refuse to see the NP. I am paying for the oncologist 🤡 Jack Cassidy

[RonL]

My oncologist quarterly, usually ten or fifteen minutes which since nothing has changed in the last 21 months is plenty ( stage 4 castrate resistant on Zytiga and Lupron undetectable PSA). Blood work and an Xgeva shot every four weeks. My family doctor will see me within 24 hours should I need him.

[JimVanHorn]

I see mine quarterly. I bring a list of questions that ask the physicians assistant and she answers them. Then he comes in and we all three of us talk about 15 minutes about my labs and anything the assistant does not understand. I was having a low hemoglobin (9.6) and he noticed my creatinin levels were increasing, so he was going to give me Procrit, but waited and sent me to a nephrologist anemia clinic. They gave me 5 bottles if iron IV for 1 1/2 months and now I am on Procrit injections. My hemoglobin is up to 12.4 now. That is the process we use. Now I am on active surveillance and see my oncologist every 6 months now. So I just keep truckin'.

[Shepard]

I am on the same schedule as you. I do not feel as though I am being rushed. I do prepare myself with a list of questions or items I want to report. I hold to my agenda and over the past several years I have gotten answers and we minimize the time in the cold exam room. I also receive a monthly "wellness" call from my Doctor's nurse who covers a check list and is open to my comments. I also have a patient portal that I can use at any time to ask questions. I have always had a response within 24 hours. I am pleased with interactions provided by my treatment team.

[alephnull]

Mine has been very good and has been willing to stay until I have all my questions asked.

[GoBucks]

I go every 3 months. Appointment lasts about 20 minutes. But I could keep him for 40 and he wouldn't flinch. That's why I never complain if he is running late. I know he is helping someone else just like he's helped me. Sorry for your troubles. Obviously time to shop around.

[j-o-h-n]

I've told this one before, but worth repeating (I think).

Guy comes home from work and tells his wife "let's play doctor". She says "that sounds like a good idea". Guy says "I'll be the doctor and you be the patient". She says "ok I'll be the patient". So he left her sitting on the couch for two hours.

Another one. Guy (not the same guy from above) goes to see a psychiatrist. Psychiatrist asks him "what's your problem?" Guy says "I don't know doctor but everyone seems to ignore me" Psychiatrist says "OK next".

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 12/10/2018 8:44 PM EST

[Stegosaurus37 in reply to j-o-h-n]

Too true! Thanks!

[Hidden in reply to j-o-h-n]

I finally told my psychiatrist that I’m having suicidal thoughts. Now he insist I pay in advance for my next visit.

[j-o-h-n in reply to Hidden]

I went to my psychiatrist and he told me to "lay down on the couch". He then asked me "what I do for a living?". I told him "I'm auto mechanic" He said "Ok, then get under the couch".

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 12/11/2018 6:03 PM EST

[Hidden in reply to j-o-h-n]

Either distain for Mcwrench or just making a paying customer feel at home... funny on many levels .. Thanks j-o-h-n-

[Hidden]

I’m afraid so.

[whatsinaname]

Yep, this phrase "standard of care" gets bandied around quite a bit, isn't it ?? I get it a lot here in Bombay as well.