HealingWell
Search Close Search
☰

Getting doctors to work collaboratively on your case

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/17/2017 7:38 PM (GMT 0)
I've read in the forum many times about people having doctors working together. Just for example, some guys seem to have Dr. Kwon or Dr. Myers as a consultant who works together with their local medical team. I'm finding it quite difficult to find doctors willing to work/collaborate with other doctors outside of their own hospital system, let alone ones that will would agree to work on the advice of the remote expert.

For those that have had luck, how did you do it? How did you approach it? Did you just have to keep meeting with doctor after doctor until you found one that would work with an outside doctor?

Thank you for your ideas.
Posted 1/17/2017 8:01 PM (GMT 0)
My experience is limited, but I'll summarize it anyway. In my case, my ongoing care is managed by a team from the same hospital system. My RO is the quarterback (at least for PCa), assisted by my urologist, cardiologist and my internist. They have consulted my electrophysiologist at another hospital system for approvals prior to starting radiation treatment (to ensure that my pacemaker would be OK) and after finishing treatment. They also accepted input I sought from Dr. Morgentaler (PMH Boston) regarding TRT management. He is only used on an as-needed consulting basis.

My case was not the simple, straightforward case presented by many favorable intermediate risk patients. I pretty much brought the team with me, as most are from my hospital group. I personally manage the interface with the electrophysiologist. My RO sought the referral to Morgentaler and reached out to him for me. I then made the appointment and carried on from there.
Posted 1/17/2017 8:31 PM (GMT 0)
schoolpsych-

Will your ART be done at Cleveland Clinic as well?

In my experience, similar to yours, a "team" approach is more wishful thinking than an actual dynamic. There is really only one doctor who is really in charge, and that is the doctor who is actually doing your latest treatment. So for you, the torch will soon be passed from your urologist to your radiation oncologist. It can get a little complicated if, for example, you wanted to have adjuvant chemo with your ART - in that case, your RO would probably work with an MO in arranging that, but your RO is still in charge. If you had incurable prostate cancer, an MO would be a preferable choice as "quarterback." Now that my RT is long done, my case, such as it is, is back to my urologist.

What this brings up is the importance of keeping your own copies of all your health records, preferably electronic. It is a lot easier to email a new doctor working on your case a copy of your electronic health records than to depend on another doctor to do it.

So, yes, it would be nice to have your doctors collaborate without your egging them on. But in the real world, I think the patient is better off if he accepts responsibility for it. You are the team manager.
Posted 1/18/2017 2:49 AM (GMT 0)

Hello SCHOOLPSYCH,

I feel fortunate, to be honest ... I feel that my doctors are working together as a team ...

I have friends who have the same diagnosis ... they have different doctors than I do, and they do NOT have the "team" experience ... sigh ... in fact, I have one friend who feels that his doctors are being "territorial" in his case ... my friends is somehow "caught in the middle" ... again, sigh ...

Having the TEAM EXPERIENCE makes quite a difference, I must say ... I feel blessed in that regard, I feel fortunate ...

Looking back, I WILL say that some things went into creating the "team experience" in my particular case ...

I started out with my original urologist at a nearby local hospital ... in due time, I found out about the "early chemo plan" and added an oncologist to my "team" ... fortunately, my urologist and oncologist knew each other ... had a positive working rapport ... and they began to consult TOGETHER on my case ...

This included team consultations and the sharing of my lab results and PSA scores, as my chemotherapy treatments began ... all the while, my ADT hormone shots continued ... and they both watched over my case.

Many members on this website know that my father is also a prostate cancer patient, right alongside me. My father and I both consult with the same urologist and oncologist --- so, my dad and I have an incredible bond with our local doctors, who are both watching over "father and son" ... in a manner of speaking. You can see the sense of "teamwork" in action here ... involving both my father and me.

At the suggestion of a friend who shares in my diagnosis, I became very interested in visiting Mayo Clinic. I had heard tremendous things about Dr. Kwon, and decided that I wanted to seek out his knowledge and expertise in my case.

However ... and this is important ... I talked to my local doctors here FIRST ... I included them in my decision-making ... they respected and appreciated that ... and whole-heartedly endorsed my decision to visit Mayo Clinic. Because of the trust and rapport my father and I both have with my local doctors, it seemed very fitting to include them in my decision-making process to visit Mayo Clinic and to seek out the expertise of Dr. Kwon.

Yes, I am the "manager" of my medical team ... but I feel that including my local doctors in my decision-making process ultimately led to the TRUE and TRUSTED team concept that is now in place for me, going forward. It was an integral step in forming the TEAM.

My local doctors were there, right beside me, every step of the way in all of this ... a testament to their dedication to my case.

From there, I decided to add that additional level of expertise ... with the blessing of my local doctors.

I now travel up to Mayo Clinic in Rochester, Minnesota, every few months for additional scans and to consult with Dr. Eugene KWON. Dr. Kwon is a urology oncologist, with expertise in advanced cases. Several other members here on this website also consult with Dr. Kwon.

When I first met with Dr. Kwon, we went over the results of my tests and scans while sitting in his consultation office at Mayo Clinic.

Dr. Kwon immediately "reached out" and telephoned my local doctors and expressed a sincere desire to form a team ... to share test results ... to share scans ... and to consult TOGETHER, in regard to my case. There was an immediate sense of TEAMWORK in place. I knew in that moment that I had a medical TEAM that was dedicated to my case.

This teamwork has continued ever since. In all of that, I feel very fortunate, and hope that my other brothers here will have the same experience in their lives.

Hope that my first-hand experience shines a light on what is possible, in terms of forming a TEAM CONCEPT ...

With all my best,
Iowa State University ~ "Cyclone Team Fan"
Posted 1/18/2017 12:31 PM (GMT 0)
I am in a similar situation to TA. When I started my uro and rad onc came to me as a team, though they were in different practice organizations. I have always seen my uro every quarter. He monitors the PSA and T levels and he administered the ADT. Of course I initially saw the rad onc weekly during radiation. Then quarterly then yearly and now not at all. The two have collaborated on nearly two thousand cases in this manner. They report to each other on everything. When I get my PSA it is sent to the rad onc and my PCP.
Posted 1/18/2017 5:00 PM (GMT 0)
Thank you Paxton, Tall Allen, ISU-CycloneFan, and JNF. Your responses are quite helpful.

ISU-CycloneFan, your approach of talking to the local doctor about consulting with an outside expert is a great idea that I hadn't thought of. Involving the local guy in the decision seems like it might be a good way to lessen the defensiveness.

Tall Allen, I'm open on where to get the ART. My surgeon will certainly be referring me to a Cleveland Clinic RO. However, as a part of my earlier work interviewing doctors for an initial treatment plan, I met an RO from the other local hospital system (University Hospitals/Seidman Cancer Center) that I really felt comfortable with. I imagine I will need to meet a few ROs and make a decision.
Posted 1/19/2017 2:31 PM (GMT 0)
I'm in a situation where there's probably the most favorable environment for physician collaboration - it's all under one roof so to speak. MD Anderson. My records are easily accessible by my urologist or RO, when we set up appointments for follow up it's easy to schedule both for the same day. They have access to all of my labs, scans, etc so I don't have to manage record keeping.

Do they chat with one another about my case? I doubt it - my urologist referred me to the MDA RO essentially handing me off to that department. The urologist is still following me for any post-surgical problems. The RO is following me for any RO related problems. I do suspect they read each others physician notes though.
Posted 1/20/2017 1:33 AM (GMT 0)
I found out today when I met with my RO that she and my uro actually DO talk about shared cases. They apparently have quite a few, and although their offices are a mile or so apart, they do work together quite well.

Also, when I was looking for a specialist in a facet that neither my uro nor my RO felt comfortable with, it was actually my RO who reached out to a colleague and got the recommendation that I hop out to Boston to meet with Dr. Morgentaler to get his input. The RO and uro are now using that input to manage my care. Whether it is formal or informal, if you can get the team to communicate, the result is bound to be better.
✚ New Topic ✚ Reply

HealingWell

Connect With Us
© 1997-2024 HealingWell.com LLC All Rights Reserved. Our website is for informational purposes only. HealingWell.com LLC does not provide medical advice, diagnosis, or treatment.