HealingWell
Search Close Search
☰

Example of typical attitudes from some uro-docs (one of our members recently seeing another doc)

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 8/17/2011 11:18 AM (GMT 0)
One of our members whom I have written about before (with his permission, too) as he cannot post here anymore, so I will mention his visit to a new and another doc he visited that is near to his location.  Now this patient has a very serious case of PCa, so serious that surgery would likely be done for nothing, so he avoided that treatment and avoided radiations and went  eventually to HT therapy.

Anyway none of his prior docs put him on any HT therapy, while his psa rose to over 130 level and he had a few different opinions on his case. They wanted to take out his bladder and prostate because of PCa. He had no insurance so originally could not afford the high priced Lupron (et al). Later they got approval for Zoladex from the State or such...well he didn't want LHRH drugs. So, he later got onto casodex or generic casodex(from a doc whom could not believe the others did not do so prior) and did excellent on it and quit about alittle over a year ago...because his psa was that stable and good.

He has been monitoring his psa closely now, since being off drugs for a year+.

So, in seeking a local doc for getting additional blood work and scripts for psa testings, he sees a new uro-doc. Well the uro-doc asked about his background and what was going on, the uro was not impressed with the results on casodex and could careless. Uro-doc says you need to be on Lupron  (like it is the only choice-LOL?), our friend refused and said I would go back on casodex or look at my choices 'if and when' it seems needed. The doc was miffed that a freakin layperson would challenge his arrogance of expertise  (LOL- uro wanted the cash flow and long term billings/profits from LHRH drugs). So, the doc called the patient 'a piece of work' and said we shall see at a later date about another psa test, perhaps Oct. and they parted in this fun manner.

So, the wonderful doc calls the patient to his face:  'a piece of work' (equal to saying you are a donkey)  for having his own decisions on his PCa and choices. This is typical of arrogance and self righteous attitudes I see, I hope you see how 'sales' influences what choices you might get offered or told. You are a possession in PCa, not to think or look at your choices and what you might want to do, this happens more often than you might believe. This is why I have such a high regard for uro-docs in general, plus mine was a jerk too and got fired.  devil   

Post Edited (zufus) : 8/17/2011 5:23:53 AM (GMT-6)

Posted 8/17/2011 12:29 PM (GMT 0)
Unbelievable!!! And at the same time believable. I got rid of my uro doc when my surgery failed and haven't seen one since. Maybe it just me and the doctors that I have seen, but I find medical oncologists more reasonable and willing to follow an approach that you are comfotable with. At this point in your friends journey, I not sure way he is still seeing a uro.
Posted 8/17/2011 12:34 PM (GMT 0)
Ditto.............Question Everything !!!!!! Do your own research.... do not go with the status quo....  Cooper wink
Posted 8/17/2011 12:45 PM (GMT 0)
I agree that we should learn and question everything, but what kind of doctor would this guy be if he let the patients' wants over-ride his professional opinion? He wouldn't even need to go medical school to do that. People could just call in and say, "Give me a script for Casodex."

We all need to find a doctor whose judgment we respect. We can make our case for a particular course of treatment, but ultimately the doctor is responsible for treating us in the manner that he deems best, using his professional expertise. If we disagree, and of course we sometimes do, that doesn't make him a "jerk" in my opinion, anymore than it makes us a piece of work. We're paying for professional medical treatment. If we don't trust Doctor "X" to give it to us, then it's time to move on to Doctor "Y."

I hope your friend finds the doctor that's right for him.
Posted 8/17/2011 12:46 PM (GMT 0)
I fired my first one. He belonged to a huge Uro group. While looking for my 2nd opinion, one dr.s name kept coming up. But there was a 6 week backlog to see him. I get a call and the nurse says he had a cancellation, would I like to slip in? Heck yeah, but it was 2 days prior to the 1st docs appt. for the biospy results. I call the 1st doc to release my info to the 2nd doc, and he gets all huffy and puffy about how I would dare see the 2nd doc prior to him and at first refused to send anything. I had to threatened him with legal action to get it done.

Sure enough, at the original docs appt., he was a rude jerk. His friendly demeaner was history. He lied to me by telling me the 2nd doc was no longer doing surgery himself, but was only teaching students. Then he tried to refer me to a doc in his group for RALP. He also refused to allow me to record our appt. since I was alone. The final straw was when he was looking at a drawing of my prostate biopsy and I stood up to see it better, and he littlerly yelled at me to sit down. I wanted to yank him across his desk, but calmly remained standing and said. You are fired MF. and calmly walked out.

I usually dont call people names, so I am gonna blame it on the PCa.

Post Edited (Startech) : 8/17/2011 6:49:32 AM (GMT-6)

Posted 8/17/2011 1:02 PM (GMT 0)
I too have enjoyed a few arrogant doctors. But one of Zufus' points was that we have to be aware that financial concerns, whether conscious or not, cloud the doctor's judgment. They do care about making money off Lupron shots.

We are judged from the moment we begin the process, particularly when we provide our insurance information. Doctors know which insurance companies are "easy," and are very happy to have a patients with the right insurance walk through the door. Some are more than happy to prescribe multiple, potentially unneeded tests, determined not by what is required for diagnosis, per se, but what insurance will pay. Patients with less desirable insurance, or even Medicare, may have trouble going to the doctor of choice, who may not like the payment structure or other limitations.

My mother, who was recently treated for gall bladder cancer, chanced to hear doctors in the oncology practice discussing the financial desirability of numerous patients, and was shocked to hear the cupidity as they classified some as not remunerative and others (including my mother) as gold mines.

Medicine is a business, and we as consumers have to be wary of being manipulated for financial gain.

Nellie
Posted 8/17/2011 2:42 PM (GMT 0)
zufus,

If your "friend" is who I think he is, is there any doctor on the earth that he would ever be happy with? It was always constant doctor bashing, all the time. I sincerely hope that he doesnt' burn all his bridges with the doctors in his area. It works both ways, nothing wrong with being an informed patient, my doctors even like and encourage that. But if you end up with patients that think they know more than the doctor, act rude toward them, and then turn around an be non-compliant, then what is the point of going to a doctor?

I've been fighting serious medical matters since I was 28, so that's for over 30 years now, and in all that time, only "dismissed" a total of 2 doctors during that time, and both were neurologists.

I agree with something Clock said above, a good doctor is not going to risk sound medical opinion simply over the wishes of the patient, he would be doing the patient a great disservice. Many doctors will compromise with a patient, if the other option(s) are medically sound. I would expect nothing less than that with a good doctor.

Wish your friend well, but he has been fighting stuff like this from day one. Do you think perhaps it could be for reasons other than bad doctors and their alledged never ending love for money?

David in SC
Posted 8/17/2011 3:25 PM (GMT 0)
Stepping outside the box for a second.... I can relate to the doctors side of things.

I do technical support for a high dollar accounting software. I deal with “patients” that range from-> they have no business sitting behind a computer to hard core CPA kind of people.

Technically, not counting the programmer, I am the Worlds Leading Authority of this software. On a rare occasion I’ve had client’s doubt/challenge/question an answer I’ve given them. I had one client question everything I said. I all but told him to quit calling if he knew all the answers...

Posted 8/17/2011 4:01 PM (GMT 0)
I'm not surprised as the average Uro is out of his skill level when it comes to HT, and when it comes to PC his knowledge is usually only superficial if he has a general practice not specializing in PC. The same can be said for ROs and GPs.
We expect too much of our doctors, and today's medicine is so complex and advancing so fast that unless a doctor is a specialist in one narrow field his knowledge of any one specific cancer is probably out of date or superficial at best.
I spent 7 years with my 2nd Uro, who was a good guy, before I finally realized that he didn't know that you could MRI a prostate or knew what PCA3 was. When I asked for a 2nd opinion he said he could set me up with his plumber. My next two uros at UCI had better knowledge, but once I had read Dr Strum's book and had a consult with Dr Scholz the knowledge gap was immediately evident.
This is not Doctor bashing, but a realization that a doctor who has a general practice cannot keep up with the knowledge of every major disease.
JT
Posted 8/17/2011 4:59 PM (GMT 0)
Wow, as I read these postings I am more convinced that my current reservations about continuing with my urologist may be justified. I asked about using alternative HT drugs, specifically DES, and was turned down flat. Politely done but it was evident the subject was closed with him. His practice has treated me well and has given me substantial cost discounts due to being uninsured. Not that I think they are losing money on me though.

Don

 

Posted 8/17/2011 5:12 PM (GMT 0)
I believe you have a better chance by going to a cancer clinic instead of just a Uro. My first 2 Uros (who were both local) recommended surjury...although none of them did it or were qualified to do it so I was finally referred to a Uro in syracuse who looked at me and said I'm one of the best at surjury and have done about 1200 of them but I dont think that would serve you best.....I will do it if you like but I can take a walk over to our radiation docs and lets see what they have to say. If not for the yano website, i may have opted for surjury. several members here also said that radiation may be better because of my gleason 9 and PSA of 94.

My last doc...who is a URO, took me through the partin tables and really explained to me why radiation would be best. He told me I had a 92% chance of it already being outside the gland so I am now doing 45 days of radiation and I got a clinical study for Lupron which makes it free. In just 30 days of Lupron...my PSA went from 94 to 17.

The thing is I cant really see a Med. Onc. unless I am referred so I have a urologist and radiation Onc as my 2 doctors right now. Since they are one of the better clinics in Upstate NY...I decided to stay with them. I was very impressed that the guy referred me to radiation instead of trying to make a buck by doing the operation.....thats when I trusted this place and decided to saty with them....Its about a hour and a half drive but worth it.

before this cancer I assumed that doctors had our best interest at heart...now I see I was wrong....its all about the almighty dollar. which is really sad for a country of our stature in my opinion.
Posted 8/17/2011 9:20 PM (GMT 0)
Casper319- Sure is fun being somebodies cash cow in PCa. You will enjoy my journey as it overlaps what you have experienced, only I did it on my own via 8 opinions and back in 2002 April using limited internet and book information.  Glad I got all my opinions that showed me the 'real world' that the books don't....bias, agenda, and even had a liar or two in the bunch....great hypocratic oath.  I was refused surgery by DR. Mani Menon our first LRRP doc in the USA (not Spamadi-lol), and he was totally correct and righteous. (salute righteous doctors= so I am fair and  balanced= LOL) .However another local surgeon guaranteed me a cure and 1% chance of incontinence  (today I call him a liar and deceitful type).  None of the other 6 opinions I got ever included any chance for cure (LOL).  Here is why:  2002 Mar. total urinary blockage and in emergency room, no bph and gland size normal, it was because of huge amount of PCa:  bPsa 46.6  12/12 biopsies  all 80-95% PCa in each, Gleason scores found 7,8,9's (2-sets like that), pni found, ct and bone scan appearing clear.  Surgery was rejected by Dr. Menon and he knew I would fail immediately...glad he is trustworthy enough to tell the patient, the other doc should be horse whipped. I got specialize radiations and I myself had to beg to get ADT3 for HT prior (Bolla abstract studies were my clue for possibly living longer).

I got a rarer radiation protocol of two machines, neutron rays via Cyclotron (only one in the USA currently in use, 3 exist) and photon rays via IMRT thereafter. The most potent 1-2 protocol of exterior radiation I could get and signed off on getting the most exposure possible.

My uro doc never gave me casodex prior (mistake made by an 'expert'), never told me how many biopsies I would get, never told me how long or if intermittent Lupron was even an option, never mentioned other drug choices, never offered anethestic before doing the biopsies. Did refer me to his franchised pal the liar surgeon guy whom I scratched off my list quickly, did switch me from Zoladex in the beginning to Lupron and the only reason I could find, was his billing increased $700 more per shot. Anyway I fired him finally in 2004 and dropped the ADT3 drugs and went to DES 1-mg. (you know the drug that is junk and will kill you yada-yada). Well it is still working 7+ years later and I use it intermittently and costs about nothing (no patents), like no side effects (but uro-doc wouldn't know???). So, yeah question your experts is maybe worthwhile (lol). I was failing on ADT3 back in 2004-5 (uro could care less), I charted psa's monthly and got them at a walkin testing facility and his palace too...proactive on my disease (probably illegal according to my soup n_zi uro-doc). I have a great open minded oncologist type doc, whom has no problem discussing how we PCa patients do get cashed in on and telling me the truth on alot of things. (very refreshing to see the differences) been with him 7+ years and he has made no profits off me (no drug profits or protocols), just office visits and blood work analysis and plenty of office time discussions. Even has handed me a few journal articles to read via copies.

Anyway it is your battle friends, maybe you should decide how you wish to fight it, there are many choices, some you will never be told exist...once you are a failed to be cured patient you are out of the expertise of the uro-doc (fire him) and find an oncologist type and if you can a specialist in PCa might be worthy.  John T is totally correct about the expertise on PCa that is lacking in many doctors of whom patients are placing the lives into their hands.

Posted 8/17/2011 11:59 PM (GMT 0)
I hear you zufus. I was a little more informed by this site and yano and just plain researching on the internet. I guess I should have researched a little earlier though. In the end I believe I got the best treatment but I prohbably wasted 45 days messing with insurance and 2 local Uros who didnt really have a clue.

My first DR... a chinese dude....told me I had cancer over the phone....then went on to say my aggressive gleason of 9 and that I had 40% chance to live anohter 5 years.

I thought I was being punked or something.....then he asked me over the phone how I felt!

the thing that pissed me off is that his office is 2 blocks from my house...a 3 minute drive. He could have at least called me and had me and wife come in. Thats when I did some research on him and sure enough he sent me a letter 2 days later saying he was leaving the state and he sent my insurance another referal...only to be another local guy who was another total clown.

I dont post much here but read alot and it has helped me immensely. I now at least understand the system and do extensive research on every Dr. I get assigned. I finally got it right with my 3rd Uro but I wasted 40 plus days and with a gleason of 9 and PSA of 94...every day counts.
✚ New Topic ✚ Reply