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Firing doctors--details?

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Posted 6/13/2013 7:18 PM (GMT 0)
Doctors should read this thread!!!

It is interesting how inattention to detail -- from the doctor and/or his office staff -- causes so much grief!!! If doctors and staff would only TAKE CARE OF BUSINESS IN A TIMELY MANNER, there would be very few complaints.

This reminds me of a very funny thing that happened to us  recently. Not a medical incident. We were at Lowes searching for new carpeting. I had done my homework, but when we went there I was reading the label and did not understand something. The salesman indicated that their carpet EXPERT will be back soon. Okay, the expert arrives. I told him I didn't understand what the label was saying. What does it mean? He looked at it, scratched his head, and then proclaimed he knew exactly what it meant. He then proceeded to read that label to us, word for word. We still chuckle over that.  We went elsewhere!

Somehow, that reminds me of some of the non-communication stories in this thread, except there is a LOT MORE at stake!

Mel

Posted 6/13/2013 8:41 PM (GMT 0)
The first doctor I fired was a urologist that I had been seeing for 6 or 7 years. He was a nice guy, but after 7 negative biopsies he didn't have any answers and I knew he was at the limit of his knowledge base. The first time I asked for a referral for a 2nd opinion he said I should see his plumber. I told him I wanted the name of the best prostate Dr he knew of and he finally referred me to a urological professor at UCI that seemed to know what he was doing. When I showed up for my 3rd scheduled biopsy with him they said he left UCI and another doctor would be doing the biopsy. The other surgeon was trained by Scardino and seemed quite knowledgable. He found 1 core G6>5% after taking 26 cores. He had only done 8 robotic surgeries so I said I would not be using him for surgery, but would like to keep him on for 2nd opinions and to run thing by him. After I saw Scholz who told me that I had a much more serious cancer that was found on my biopsy and needed further testing and a CDU targeted biopsy the surgeon disagreed. When I told him Scholz's reasoning about my PSA patterns and a suspicious spot that showed on the CDU that also showed the needle tracks of his biopsy missing that spot he still disagreed. When I sent him the biopsy results from Dr Bahn that showed a large TZ tumor G 4+3 and that both Bahn and Scholz agreed that the location of the tumor was not conducive to surgery and radiation was the best option he again disagreed. When I asked him how he could make that recommendation without looking at the images he didn't have a good answer. When I asked him why Scardino wrote that TZ tumors, especially involving the apex were surgically problematic and mostly not successful he again couldn't give me an answer. He also had never heard of Combidex, but knew of Dr Barantsz work with other urological cancers. At that point I knew he wasn't adding anything useful to what I had already learned.
I have fired a lot of people in my business career and it is never pleasant. In hindsight the only regret I have is that I wish I would have done it sooner in every case. It's the same with doctors and other professionals, you tend to keep them too long when you know in your gut that they are beyond helping you anymore.
Posted 6/13/2013 9:11 PM (GMT 0)
Mel,
I agree, the way a doctor's office is run is a reflection of that doctor. The lack of detail and follow up in the office is a direct reflection of how the doctor operates. If he does not demand high standards from his office staff he will also not demand that in the OR. If his office staff is poor at follow up, you can bet he is too. I've done enough consulting that I can tell the personality of the boss just by looking at his operation and vice versa.
Organizational behavior research done at Harvard in the 50s and confirmed by countless research studies proved conclusively that the organization takes on the manager's personality and knowing one you can accurately predict the other. The old WW 2 classic "12 O'clock High" shows how the performance of a bomber wing changes drastically when a new commander is appointed. The old movie is now used to teach organizational theory to managers. If you ever get a chance rent it on Netflix and view it looking at the personality of the different commanders and how the organization changes to reflect their personality traits and management style.
Posted 6/13/2013 10:12 PM (GMT 0)
I've told this before. My first urologist who did my first biopsy. I was referred to TUCC a large local urology group right on the Denver Broncos Stadium site. Not having a specific doctor the receptionist or who ever answered the phone just assigned me one. I saw him a few days later and had a biopsy scheduled. He didn't warn me much of what to expect except that it wouldn't be much and I wouldn't be sedated so I could drive myself to and back. It was true it was no big deal and a few days later he called and scheduled an appointment with me. Of course like most I was in shock about the dx for I felt fine had no symptoms and all of a sudden I have cancer. He never described my numbers as low risk, I heard all the partin tables etc somewhat but when I asked what happened if I did nothing I received two strange answers. The first one was that no patient had ever asked him that before which I found hard to believe. The second answer was I'd be dead in 7 years. Of course I was in shock and it was soon apparent to me that not only did I have low risk Pca the 7 year answer was either he's that incompetent or he mistook me for one who panics and is on an OR table 5 weeks later. Needless to say I never went back to him and when his office called a year later I just had to laugh. This is a very popular urology center here. I'm not sure how their other doctors are but I warned two friends who were referred there to make sure that they don't see the same doctor or better yet go out to the CU medical center where I was treated.
Posted 6/14/2013 12:04 AM (GMT 0)
I dismissed my surgeon and his urology practice.  PSA emerged again about 18 months after surgery.  In the summer of 2011, the thing more than doubled in three months.  My surgeon was certainly relaxed about it.  When PSA emerged again he thought doing another PSA in six months would be adequate.  I had to fight with him and his staff to get two more PSAs out of them during those three months, and as it happened I am glad I did.  I also started looking around.  By October I moved management of my case to Memorial Sloan-Kettering, as I figured this was shaping up as a big fight with PCa, and I thought it best to go with a comprehensive treatment center.  Still lost four months during this hassle. (Oh, and the final cake on the icing, my surgeon also left me with an umbilical hernia, which required hernia surgery (open) to repair.) 

Newspaper Lover

Age 69

DaVinci surgery 11/09 upstate NY; nerve bundle taken; clean margins, clean seminal vessels, no incontinence, no erections.

Rising PSA noted 06/11

Gleason 8

Time to recurrence 18 months

Three month doubling time (summer 2011).

PSA rose from .07 on 06/11 to .17 on 11/11.

09/11 hernia surgery to repair umbilical hernia left over from the DaVinci

10/11 Moved management of my case to Memorial Sloan-Kettering in New York City

MRIs and bone scans negative so far.

Started hormone therapy (Lupron/Casodex) 12/11

Began radiation (SRT) 02/20/12.

Finished SRT 04/16/12

Last Lupron shot 03/12

07/12 PSA and testosterone "undetectable" 

01/13 PSA “undetectable”; testosterone (T) level at 452 ng/dl

Next set of tests July 2013.  Currently receiving no treatment

 

Posted 6/14/2013 1:24 AM (GMT 0)
I liked the Dr. who diagnosed me. but when I asked him about DaVinci, he said he was too old to learn it and to get enough surgeries under his belt to feel comfortable about doing them. He only did open surgeries.
Liked the second doc who did do robotic, as he had over 1000 and had his fellow doc in the room, who has done way more than that to oversee and advise. When I had a 3 month doubling time in my Psa, he called me out of the blue and had an appointment scheduled for me to come see him. He told me that with my pathology he didn't expect to see the rise. Walked me through radiation at a shared clinic site, and would call occasionally to see how I felt. He's shown nothing but concern since then. I've had no qualms about recommending him to anyone else.
Did fire an eye doctor who said he saw a tumor behind my eye and ordered an MRI. But this same doc asked my sister-in-law if she suffered from vaginal dryness, and then wanted to pray with her at the end of the visit. Went to another eye doc who saw a spot but said it had probably been there since birth. Had lasik surgery, and all is well.
Bob
Posted 6/14/2013 2:35 AM (GMT 0)
I fired my urologist for not giving me unbiased information. His take, surgery would cure me and radiation will fail me within 10 years. He was not trying to take my money.....he honestly believed what he was saying. His knowledge of radiation treatment was 15 years dated.
The second urologist I spoke to is nationally known. He was completely unbiased and gave me numbers of brachytherapists I should see. He told me that in his opinion....the treatment outcomes were similar between radiation and surgery and the decision should be made based on the side effects the patient can live with.
Paul
Posted 6/14/2013 3:00 AM (GMT 0)
JohnT, that is a great movie you cite, assuming the one with Gregory Peck, one of my fave's from that time period.

david
Posted 6/14/2013 4:24 AM (GMT 0)
Oh goody goody this feels like HW ... thanks so much Mel.

1. my loving PCP. Small town, everybody is friends, she's been giving me Testosterone and Thyroid Rx for 8 years and making me come in for tests every year and DRE every other year. Go in for my 50 yo physical, she calls to tell me that my PSA is high and i should retest (not so easy since i live 500 miles away). After finding HW and YaYa and a couple of other sites, i call back and ask how high? I figured i was getting tested every year, she knows my family history, we caught it early, how bad could this be -- 36 FML! She hadn't checked PSA in 6 years! My lawyer fired her for me ...

2. PCP refers me to a uro who can't see me for 3 weeks (small town insurance plan too) ... finally i get in there. He's late, clearly not prepared -- sees the PSA number and gets serious as h***, "that's an interesting number." Does a DRE, finds the problem, says i need to come back for a biopsy. Thanks to HW, I explain that i have a flight out the next day (500 miles remember) but that i'd called the day before and asked them to prepare to do a biopsy and that I'd gotten the prep sheet and prescription for antibiotics signed by him and was ready since that's what his staff said the day before! After a bunch of surprise and upset technicians they do the biopsy. After three days the result, G9; he says they'll call back to make followup for scans. TWO weeks later they call to schedule CT scan -- i point out that i've switched my care, had the scans already, and won't be needing them any longer ...

3. Doesn't know it yet, but the pendulum is swinging and i can see the writing on the wall ... i call her Dr No -- no imagination and no aggressiveness.

Mel, this is fun ... but please don't get zufus going, he fires doctors for sport. i think he has the record

Blessings,

Ray
Posted 6/14/2013 4:47 AM (GMT 0)
Gosh, I've fired a number of physicians over the years, too many. Having been in and out of specialists with my kids for 34 years, I've had the opportunity to meet some amazing medical professionals as well as some I just shook my head at in amazement.

My favorite had to be a peds orthopedic surgeon who flipped my child like a rack of ribs when he didn't realize anyone was looking. This man is known for his less than sweet disposition yet residents and fellows line up to work with him because he is one of the very best in the business.

Now to get a picture, Jil was multiply impaired and blind. When he flipped her, he scared her and upset her terribly so what followed was not out of line at all. I very calmly walked up to him and asked him to please step away. He looked at me like I was a rookie tech or something and asked, "and just who are you?" My response was not what one would expect to hear; "the one who will break both your **** arms if you don't step away from my daughter now...please." At least I said please :) In his notes he called me a hostile mother. In mine, I referred to him as something much less complimentary.

Fast forward 8-10 years. Our son needed a very specialized orthopedic surgeon when tumors were discovered in his femur/hip. I knew who I wanted and of course, it was none other than the same surgeon. He is considered one of the best limb preservation surgeons anywhere in the country. Prior experience or not, we needed to pull together a team of specialists and he topped my list. We were quickly set up to meet with him which kinda surprised me after our last meeting. He walked into the room, looked at me and asked, " are you still mad at me? He then followed with a deep apology for not realizing just how insensitive he had been years before and thanked me for teaching him one of the greatest lessons of his medical career. I'm not sure how true that is but, he and our son continue to have a positive working relationship still today. Maybe he learned a lesson. Maybe he's just afraid nono

Swim

 

Posted 6/14/2013 5:18 PM (GMT 0)
I've fired/released too many people in my professional environment in the last ten years to take any pleasure in firing anyone. The only situation I can relate to in this thread is Todd's.

I didn't fire my hometown urologists when I decided to to go with Samadi's extensive experience instead, but he basically fired me telling me that if I went with Samadi they wouldn't follow up with me should anything go wrong and I'd be stuck driving to NYC for anything and that Samadi would ignore me once th eoperation was over. That statement only reinforced my decision to go with Samadi and I walked out with even less doubts than I had going in. I didn't need to fire him.

I think the flip side of the question asked here is what medical professionals including doctors and analysts think of people like us who posts on boards like this and/or take pleasure in talking of our exploits in firing "Godlike" Doctors. It would indeed be an interesting conversation if all involved lowered their guards.

I've actually had this conversation with a few medical professionals and their response was rather predictable.

Posted 6/14/2013 5:53 PM (GMT 0)

My Doctor fired me! Had been going to same urologist for years, as he was the only game in town. Did at least three biopsies and never found a thing. Finally had acute urine retention and he leaves me with a cath from the emergency room for two weeks till he can “fit me in.” Finally decided he was going to do an open Prostatectomy (for enlarged prostate?). Sent me home with cath and set up surgery date. I decided on a 2nd opinion in Cleveland. I called and asked to cancel surgery for now (still had cath). The receptionist/scheduler asked if I was getting a 2nd opinion? I told her I was and she said that if I do don’t bother coming back to them. I was fired! All for the better, the 2nd opinion Dr. did a vaporization and saved a great deal of recovery time (about six weeks). Then about 2 years later found the Pca. Something the first Dr. should have found years before.
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