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Surgery Patients: Were you able to Communicate with your Dr in weeks afterward?

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Posted 8/23/2017 6:34 AM (GMT 0)
Just curious. When I need to communicate at my regular hospital via its patient portal, my doctors get back to me sooner or later.

However, having PC surgery at a major teaching hospital downtown, by a highly regarded PC surgeon, all patient portal communications to him have been filtered and answered by his staff of two: a nurse and a physician assistant.

I am wondering, is this normal? Do they achieve a rock star status and make so much revenue for the hospital they now longer have the time, or inclination, to respond? He did set up an appointment for three months after the surgery to meet with me but I don't think he realizes my problems with the side effects of incontinence. I just get the response, "What you're going through is normal" from his two person team.

So, assuming you went to a large, urban, teaching, university affiliated hospital, did you experience the same? Or is this just the New Normal of healthcare in 2017 America? Otherwise, I have had a very satisfactory patient experience and gave them top ratings on their follow up survey. But now I am getting depressed, and pissed (no pun intended).

Nick
Posted 8/23/2017 12:47 PM (GMT 0)
Nick, I had surgery at Mount Sinai in NY, a large teaching hospital, and my surgeon was Ash Tewari, one of the "rock stars".

He checked in on me, at the hospital in the evening after my surgery, and one of his "assisting Drs" checked in on me the next morning. After that, I never saw or spoke to a Dr until my 3 month follow up. Day of cath removal was handled by his nurse, and his PA gave me the path report. At the six week follow up, I saw his NP.

Even in the weeks after surgery, stuff came up that concerned me, I had many questions, I always emailed his NP, and she got back to me right away. But he was never available.

He does 3 surgeries a day 4 days a week, and only has hours on Fridays. I guess that's just the way it is. It's even hard for me to get my PCP on the phone these days, although he did give me his cell number .
Posted 8/23/2017 12:49 PM (GMT 0)
What you are experiencing is not "The New Normal" ..It's been normal procedure for quite some time....
Posted 8/23/2017 1:01 PM (GMT 0)
Sorry about your incontinence problems, Nick. Some on the forum have had those issues - even to the degree of going to a sling. You might ask your questions here if they're one's the voices of experience might help you with.

I think communication with urologist post-surgery varies. Some readily available, some relying on PAs. Sounds like you're getting stonewalled though. That's not good.

Wilderness
Posted 8/23/2017 1:24 PM (GMT 0)
Unfortunately Nick it seems to be the way it is! I made an inperson apt to discuss my hubbys pathology in person and to get a copy of the report, when he entered the office he asked why are you here! This surgeon is not a rock star but we have the exact same communication issues, a wall of people to go through in the hopes that he will return a call/email. Its very frustrating for sure, esp when you want expert medical advice from the professionals. I suggest making an apt with him prior to your 3 months, he cannot refuse and you will at least get face to face time.
Posted 8/23/2017 1:41 PM (GMT 0)
Not my experience at. My surgery was done by James Eastham at MSK. I have his email and both before and after surgery , he encouraged me to contact him and he always responded personally to my emails ( typically within the hour ). I also had numerous post surgery phone conversations with his nurse. Some initiative by me, some by her.
Posted 8/23/2017 1:49 PM (GMT 0)
An expert prostate surgeon has mad skills at teasing loose neurovascular tissues from the prostate without damaging them. That's what (s)he does. (S)he's good at it.

There are other people on the staff who are really, really good at answering patient's questions after surgery. That's what they do. They're good at it.

After my surgery I gradually realized that it was his nurse I wanted to talk to most of the time. Usually she could answer my questions better than he could and, if it was a question that did need him to answer it she was my ally in tracking him down.
Posted 8/23/2017 2:41 PM (GMT 0)
Nick,
I had surgery where you did and had a similar experience. My surgeon uses the same support team as yours does. Like you say, all emails using the patient portal are reviewed by the support people. They say that any question beyond their scope is referred to the surgeon for a response, but who knows? I certainly felt their method was a bit impersonal.

During my time at U of C after surgery, I did get a call from my surgeon, so I ended up with his cell phone number. I imagine if I called him with a question, he would call me back. I didn't try though.

My opinion is that U of C, a good hospital, concentrates on doing RALP but follow up care is formulaic and perfunctory at best. They did a wonderful job surgically, all things considered. However, when I've had questions and concerns about ED and rehab, the answers were pretty stock. I'm not sure the NP was really "listening".

Regarding the ED issue, I finally found a practitioner specializing is penile rehab for prostate surgery patients and began seeing him. I couldn't find anyone at U of C doing that.

After my surgery I developed blood clots and ended up in my local hospital. While there I was seen by my diagnosing urologist, who was on staff. At that time, and for a while later, I found him much more interested in my recovery. He even called me at home to check on me.
Posted 8/23/2017 2:56 PM (GMT 0)
Thanks everyone for that. I do have his business email from his business card, if I don't get satisfaction from the staff I will send one directly to him.

I do agree that a surgeon is a surgeon and not best at interfacing with his public.

Basic Question: Is a surgeon who does PC originally a urologist who became a surgeon? Or vice versa?

Thanks,

Nick

Post Edited (Nick2017) : 8/23/2017 9:26:40 AM (GMT-6)

Posted 8/23/2017 3:29 PM (GMT 0)
I met my Uro six times. Initial appointment, about 7 min., including DRE. Biopsy, which fortunately was fast. Discussion of biopsy results and surgery proposal, about 10 min. (He said he would call me with biopsy results but didn't. I waited, and wondered, for five weeks). Pre-surgery, met for 30 seconds. Post surgery, met for 30 seconds. Post surgery follow up and cath removal, met for 2 minutes. Never saw him again, thankfully. He was hyperactive and all over the place. He put me on edge. By his own admission, the office staff and portal of the major Urology group he belonged to was horrible.

By contrast, my MO spends time explaining things and he patiently and thoughtfully answers all my questions. The patient portal is outstanding and promptly posts all test results, and I have fast access to speak with real people if the need arises.
Posted 8/23/2017 3:32 PM (GMT 0)
I had my cath in for five weeks... The day it came out my URO gave me his cell number and we made plans on how to proceed if I needed the cath back in.

Other than that, I talk to his nurse/assistant. All has been well.

The only time I've experienced a lack of communication is when I get to his office to find out he's still across town doing surgery.
Posted 8/23/2017 4:23 PM (GMT 0)
I had a bit of this with my PCP. A couple of times I've emailed through the portal and received answers from her staff. I ask her about this during appointment and her reply was that the hospital had a rule that all patient emails should be answered within 24 hours. If she didn't reply, my email was forwarded to her staff and/or another doctor for reply.

The hospital's theory is that any answer is better than no answer. It also is helpful when the doctor is out of the office or too busy to be checking email. And, honestly, most of my questions are routine that most staff can answer.

Andrew
Posted 8/23/2017 4:23 PM (GMT 0)
Yeah, my surgeon has been great, I got the whole package. I was in the hospital 6 nights due to slow recovery, distended belly. She visited each day except Sat/Sun when duty Uro filled in. She called personally to give me the 2nd path report. In person consult to discuss further Tx. For the first few weeks I emailed her through the portal several times a week, and received a personal reply with in 24 hours, sometimes even less,
She seemed to go through her in box in around 8 am, unless it was surgery days, I tried to get my questions to her the night before for rapid responded. For a couple of items, like scripts, follow up appt, etc, her NP responded, and always within a day. They were on it.

The day I was released from hospital, I had some problematic swelling down there (1st day off JP drain), and went to Urgent care. Next day, NP called and asked me to send pix of the affected area to private records email. So, basically, told me to send her a dick-pic! turn

Follow up care had the same level of high quality communication, empathy and action.

Alas, I have changed jobs, and thus insurances and am now on a 'premium' HMO. I wanted a different provider for my RT, and can't see her any more (jsut passed 6-month mark of surgery), but I still keep her abreast of my progress though the in-mail portal and she always responds within a day. In fact its been a few weeks since I've emailed her, so I'm gonna do that now.
Posted 8/23/2017 4:30 PM (GMT 0)
I think it is pretty much par for the course. My guy is also the head of the whole urology department so I figure he is pretty busy. My MyChart messages to my surgeon get filtered though/answered by his PA and nurses but I know that he at least sees them because sometimes he will answer as well though his answers are typically one word - "yes" or "no".

Still, three-months since surgery seems like a long time to not be able to find time to meet with you. In my case, my surgeon came to my hospital room the morning after surgery to talk with me about the surgery, check on how I was doing, and to release me from the hospital. I'm not sure if this is his typical method or not. I learned from a nurse that I lost allot of blood during the surgery and that team was anxious about it so maybe I got a bit more attention. I saw his PA for removal of cath a week later but met with the surgeon personally for a three-week post surgery, scheduled follow-up.
Posted 8/23/2017 5:50 PM (GMT 0)
I met with Dr Ahlering right after surgery to go over my husband's surgery. DH was still out of it. The dr told me he was leaving for a conference the next day so wouldn't be there for discharge. However, he did show up again that night to check in which was nice. Next day we were checked out by another dr. We got the path report mailed to us and kind of struggled through it. The dr. did call on a Sat afternoon to explain the addendum and the weird tissue that ended up being G8 cancer at the apex. We had an extensive conversation. My husband was out of cell service that day and the dr. left his cell number for my husband to call if he needed more clarification. My husband did call once and the dr. called back and gave him all the time he needed to get his questions answered.
We have our 3 month tomorrow with him tomorrow. My DH's subsequent PSA results have been less than satisfactory at .2-.17 which some would say is the point for BCR and some not so much. We have not heard from him. His assistant has however sounded positive and said the results were "dropping" My husband asked if he should consult a RO and she said wait to speak to the dr.
I will say Dr. Ahlering's assistants are great and you have a direct line to them and they will even return calls after hours and on the weekend. Most of the time they answer the phone right away.
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