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When your doctor tells you that he is no longer your doctor: what next? (Article)

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Posted 7/8/2016 2:22 PM (GMT 0)
Purgatory has reported in a concurrent thread that the physician overseeing his treatment for the past five years has left, apparently under unclear circumstances as to why, leaving David having to scramble now to find a new doctor.

While perhaps most of us have never faced this unexpected and likely unpleasant situation, and hopefully never will (although there may have been occasions when it was we who left the physician), it's obviously going to be a troublesome matter. Especially if it happens out of the blue, as it apparently has for David.

The article below is by a physician on this subject.

At first the author laments that many of the circumstances of practicing modern medicine have made it so difficult for some physicians, that leaving medicine altogether has become an option for them. That leaves their patients to find new providers, usually rather quickly, and which, the author reports, is becoming more and more difficult to do in many areas. ("Areas" in both senses of the word, both geographical and clinical specialty).

He then mentions the emotional impact that this can have on some patients, especially if they have been with the physician for a long time and prefer that person, and the news that he or she is leaving has been abrupt and unexpected.

He then discusses how insurance issues can hamper the patient's search for a new provider, that it's not as simple a thing as finding a new doctor one likes, but that the patient's insurance has to go along with this choice, and not impose restrictions. (The author's advice: as soon as you learn that your physician is leaving, contact your insurance carrier immediately to begin the process of finding a new provider acceptable to your carrier).

Ideally, a physician will announce departure or termination of practice with enough lead time to allow patients to find other resources.

But not always, and having at least an idea of what to do next in such short-notice circumstances is clearly a good thing.

A good read:

www.kevinmd.com/blog/2010/07/doctor-quits-leaves-medicine.html
Posted 7/8/2016 6:08 PM (GMT 0)
Very interesting read.

Years ago I had a doctor I really liked. One day he introduced me to a young doctor who had just joined his practice. Six months later I went in for a follow up appointment and found the old doctor had a health problem and was suddenly forced to retire. The young guy was helping to close the practice as he couldn't afford to buy the existing one and had been offered a job at a local hospital who promised to pay his student loans if he stayed on staff for a few years.

Andrew
Posted 7/8/2016 8:16 PM (GMT 0)
This has happened to me now 3 times. My uro onc left Vanderbilt, my urologist at Univ of Michigan left, and now my U of M med onc is leaving. Disruptive, yes. However, in these settings, there were other doctors that picked up my case. They had similar perspectives since they were in the same hospital/clinic settings. In fact, my replacement MO actually trained under my current one, so I'm quite comfortable with the transition. No insurance issues at all, and keeping the same case file, pre-existing condition approvals, and so on.
Posted 7/8/2016 11:50 PM (GMT 0)
Hello 81GyGuy,

Your posts are always insightful and thought-provoking ... I owe you a debt of gratitude ...

My angle on your post is a little bit different ...

I "lose" my main oncologist, once every year --- he goes on a "summer sojourn" back to his home in Kenya every year ... so that his young children can spend time with their grandparents, back in Africa ...

I meet with my oncologist every four weeks, year 'round, like clockwork --- but, this is the time of year when he is gone --- I'm ALWAYS thankful for his return, and not seeing him in July makes me even MORE grateful for the tremendous doctor that he is ...

I have thought many times about my life as a Midwestern "town boy" growing up here --- while his boyhood was spent thousands of miles away, growing up in Kenya --- I never would have dreamed that my life's pathway would intersect in such a powerful way with someone who grew along the coast of the Indian Ocean in Kenya, half a world away --- he is the doctor who HAS worked small miracles in my case, time and time again --- tremendous compassion, humility, brilliance, and gentle ways ---

Ironically, my own father is ALSO a prostate cancer patient --- so Dad and I are BOTH treated by this tremendous doctor --- and dad and I have formed a tremendous bond with this doctor who has been a lifeline and savior for so many ... the emotional bond described in the linked article that you shared in your post above.

When Christmas came around, I stopped and delivered a gift to him in his office. I also bought a special card in his honor, that let him know that a tree was being planted in a national park, in gratitude for all that he has done for me over time. Perhaps most importantly of all ... I've also found the WORDS to express how thankful I am to him for all his care and dedication to my case. If you've got a dedicated doctor like I do, find the words one of these days to let them know how much they mean to you ... shake their hand, find the words, or send them a personal note.

So --- I'm always thankful to see my doctor, upon his return from Kenya each summer --- and it makes me even MORE grateful for his presence in my life.

I have lived to see the importance of a trusted and caring connection between a doctor and patient --- I give thanks for that every single day.

Thanks for always being a valued brother here on the board, 81GyGuy !

Sent with my best,
CYCLONE FAN --- Hailing From Iowa State University
Posted 7/9/2016 2:20 AM (GMT 0)
CycloneFan -

Thank you very much for the kind words, they are very much appreciated.

As for making useful threads and posts here on the forum, I can only hope that possibly my efforts at doing so have perhaps from time to time helped some who may have read them. As I have noted here in the past, I am retired, and spend at least a couple of nights per week, almost every week, websurfing into the wee hours of the night, very often coming across topics and websites that strike me as possibly worthy candidates for threads and posts here.

When I do find them, I save their web addresses to a folder, which I review once in a while. If I spot something especially interesting or relevant, I move it into Word, write up accompanying text, then copy and paste the result into a thread on the forum here.

Not only do I enjoy doing that, but, as noted, I like to think that sometimes the stuff I post maybe does help someone in some way. It's a nice feeling, thinking that maybe in some way or another I did help someone that day.

But we ALL make a contribution here, some of us in some ways, some in others. In your case, CycloneFan, for example, I can see in your posts a sincerity and compassion that hammer home that what you are saying is meaningful and important. You entirely succeed in doing that. I'm willing to bet that when you teach, you teach your classes in the same way, and that your students sense this sincerity and compassion in you, and learn from you all the more because of it.

I sometimes think of this forum as you may think of your classroom, that you and your students are all a sort of melting pot of minds together, everyone learning from everyone else, and all are profiting from that experience.

I think we also achieve that kind of experience here.
Posted 7/9/2016 3:15 AM (GMT 0)
Thanks, 81. A very informative article from our resident librarian. Medicine is changing very rapidly. Our daughter is a primary care doctor and works for a large medical group in our area.
Posted 7/9/2016 10:11 PM (GMT 0)
To make sense of my doctor leaving situation, when my oncologist was in his own practice - he was great, kind, caring, would spend endless time with me, I really believed and trusted in him. about 2 years ago, he sold out and become part of a big cancer center, which it was bought by an even bigger hospital group.

I noticed the change in him immediately. I think for starters, they overloaded him with patients. And controlled his every move.

In the past year, was lucky to get five minutes of time during a visit. Most of it was done with his NP, who is a very nice and caring woman. I could tell he seemed more and more distant, almost cold, when he would talk to me.

So on this last scheduled visit, he came in at the end and told me it would be my last, not just me - but for all his patients. He made no provision to transfer to me another doctor in that group or any other group. He has been my "pain manger" the entire time, and holds all my prescription drugs under his thumb. I was running out of one, and he acted like he didn't care, wasn't his problem any more. The NP insisted to him to write one more months worth to hold me over until something worked out. Not the kind of drugs you just go off cold turkey and hope for the best, plus the fact that I really need to be on them.

When I asked what he was going to do in the future, me thinking he was going to another area or to another group, he said that it was the time in life when he needed to sit back and decide what to do with the rest of his life. I say BS. What well trained and experienced oncologist would just drop out and do that?

My wife's opinion as a well experienced nurse, thinks he's either been nailed with a major malpractice suit, perhaps one he lost for the group, or drug issues. I have tried to find out without an answer. Meanwhile, without a doctor, with the means to get the pain meds, and down to about 3 weeks max. before I am out. My family doctor has agreed to write my lesser meds, as he had done for 8 years before my oncologist took them all over.

Not sure what's going to happen, but there's high anxiety in my mind, as the pain is bad enough on the meds, I can't comprehend not having any relief without any of the meds.

Time is running out. Plus he was the doctor that advised me not to pursue any advanced treatments after the SRT failed almost 6 years ago. Knowing my PSA has been steadily rising.

Not a good situation
Posted 7/12/2016 11:33 PM (GMT 0)

Purgatory said...

So on this last scheduled visit, he came in at the end and told me it would be my last, not just me - but for all his patients. He made no provision to transfer to me another doctor in that group or any other group. He has been my "pain manger" the entire time, and holds all my prescription drugs under his thumb. I was running out of one, and he acted like he didn't care, wasn't his problem any more. The NP insisted to him to write one more months worth to hold me over until something worked out. Not the kind of drugs you just go off cold turkey and hope for the best, plus the fact that I really need to be on them.......

Meanwhile, without a doctor, with the means to get the pain meds, and down to about 3 weeks max. before I am out. My family doctor has agreed to write my lesser meds, as he had done for 8 years before my oncologist took them all over.

Not sure what's going to happen, but there's high anxiety in my mind, as the pain is bad enough on the meds, I can't comprehend not having any relief without any of the meds.

Time is running out. Plus he was the doctor that advised me not to pursue any advanced treatments after the SRT failed almost 6 years ago. Knowing my PSA has been steadily rising.

Not a good situation

You're going to have a difficult time getting a doctor to prescribe long-term opiate pain meds because of the renewed warnings and precautions regarding opiate use. Some doctors refuse to prescribe them except short-term in special circumstances. Many others are referring patients to pain clinics for management of chronic pain. These often include pain-med contracts patients must sign in order to receive prescription pain medications. The landscape has changed dramatically for pain management.
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