My Urologist Refuses To Do Followup

I was diagnosed with prostate cancer in January 2017 by my urologist and scheduled da Vinci surgery to be done by the same urologist in mid March. I subsequently cancelled the surgery after doing my due diligence and realizing that surgery wasn't the best choice for me. My eventual treatment was SBRT with Dr. Debra Freeman at the Cyberknife Center of Tampa Bay in Florida. My SBRT treatment regimen was completed July 26 and I told Dr Freeman that I would schedule followup urology visits and PSA testing with my urologist.

Surprise to me! Upon trying to schedule an appt to be examined by my urologist and have my three month PSA test done, I was told that my urologist is too busy with surgery and their prostate cancer followup program is limited to only the patients who had surgery with his group so I'm not eligible to be seen.

Maybe I'm naive but I was flabbergasted. This urologist is the department chair for one of the most prestigious medical centers in America. I tried to make an appt to have a urological examination and a PSA done. I'm already a patient with this institution and my urologist's facility does not do SBRT so once I made the decision to do SBRT, I had to go elsewhere. From the collective experience here, is this normal procedure? I can get my PSA done at any number of places with no problem but it made sense to me, being 70 years old, to maintain a relationship with my urologist.

Suggestions? Should I just move on and find a new urologist? Should I call my urologist and ask them what the hell they are thinking? I never asked my urologist to provide feedback to me on the efficacy of my SBRT based upon my PSA tests that I will be doing over time. I simply said I wanted to be examined by my urologist and maintain a relationship with my urologist for any current or future issues.

Infuriating. But urologists are a dime a dozen, and any one who is halfway competent will be all you need. In fact, if you just need a beta blocker, Dr Freeman can phone it in. I have my PSAs done at my PCPs office. What do you really need a urologist for at this point?

19tarpon47 said...


Should I just move on and find a new urologist?

Your urologist sounds like a petulant little a**. Yeah, move on and find someone who cares.

Jim

Ask your RO for a local referral. Or ask your PCP for a referral...or if you even need one. Your PCP can arrange your blood work and your meds.

Yeah, he is being a jerk, especially since you have a prior relationship and they don't offer SBRT. Having said that, no physician is legally obligated to continue to see a patient as long as they give you reasonable notice and time to find a replacement provider. Did they send you a letter to that effect? They should have. As there are certainly other reasons to see a urologist besides PC, I would find another to work with you.

I had surgery and elected to follow-up with my internist as I no longer have a urology problem. After my yearly visit I do email my surgeon the PSA result and he always responds.

The urologist probably has enough business that he doesn't need yours. In my opinion, he is short sighted. There is always the chance that you will develop another urinary issue, which could lead to more work for the surgeon/urologist.

However, it is his business decision not to see you now. You should certainly look for a doctor willing to treat you. There's always someone else, and you may be happier in the long run.

Good luck.

Best to move on. If you're just monitoring with PSA tests, your primary care doc can order those and watch the numbers.

Any doctor with that attitude deserves to be avoided.

Andrew

Thanks for all the helpful replies. I guess I'm just old fashioned in that I expect more from the medical community in the way of putting the patient's well-being first. However, I get the message and will definitely move on. As many have said, I can easily get my PSA done in many locations. I simply thought it would be a good idea, given my age, to be followed by a urologist. That said, I am quite healthy, have no urological issues a the present time, and will get along just fine without him. And in the future, if I need a urologist, I'll find a different one. Thanks again for all the thoughtful comments. As always, I appreciate it.

Skip

As Allen said, why do you need a urologist? I'm 8 years out and have never seen a urologist since treatment. your PCP can take psa and monitor you as well as a urologist. You can always see one if you develop any problems, but I would first go to the RO that did your SBRT.

I'd move on, if just for principle. Your PCP can order the tests, as mine does at every 6 month visit. This may be fun since the lab has changed from Solstas to Quest (which acquired them).

After my initial consultations with my rather large local urology group and not being impressed about the direction I was heading, I went to Hopkins. Nearly 2 years later, I took my father in law to the same group for an incontinence issue, and, when I was making small talk with his urologist there and I mentioned what my situation was and my going to Hopkins, he said "Good choice. I would, too."

Ya gotta be your own advocate, sometimes!