Sunday, March 10, 2013

Third Time’s the Charm?

I am now in the process of finding a new doctor to treat my carcinoid cancer.  This new doctor will be my third since my initial diagnosis in August 2010.  I started with Dr. Jekyll at Memorial Sloan Kettering Cancer Center. That lasted about 15 months.  Then I went to Dr. Ratner at Mount Sinai who works with Dr. Warner – I’ve been with him just over a year.

I have never had any trouble with doctors before I had cancer.  However, I have not had a really serious medical issue like cancer before either.  

A few months ago in the magazine “Consumer Reports on Health”, the editor wrote a note called “Why I like my doctors”.  In it she says, “I like my doctors because they are smart, compassionate and punctual.  They take time to answer my questions and address my many concerns”.  Research has shown that a doctor who connects with a patient is often successful in encouraging them to comply with medical advice and regimens that can lead to a healthier life.  She says she likes her doctors because “I believe they have my best health in mind.  It’s easy for me to listen to them because I know they listen to me.”

When one has cancer, I believe it is important to go to a multidisciplinary center where they have oncology, radiology and surgery departments and everyone works together.  My first doctor was at Memorial Sloan Kettering Cancer Center (MSKCC) which is a very strong multidisciplinary center.  My doctor, however, was neither smart,  compassionate nor punctual.  After he told me I could not make a doctor change, I fired him and moved on to Mount Sinai.  Currently, I go to Dr. Ratner who is not a carcinoid specialist but who works with Dr. Warner who is.  I am comfortable with Dr. Ratner, but not as comfortable with Dr. Warner.  Dr. Ratner is smart, compassionate and punctual but defers to Dr. Warner when I need to think about a different treatment plan or make an important decision.  Dr. Warner is recommending exploratory surgery to perhaps find my primary tumor and to reduce the tumor burden.  That’s all the information I can get on this potential procedure. He says I should go talk to a surgeon at Mt. Sinai if I want more detail on what the procedure will entail.  My opinion is that the doctor who is treating me should be able to at least outline what will occur during the surgery, explain why it needs to be done and when, as well as offer an explanation of other treatment alternatives and their pros/cons.  After 3 appointments with Dr. Warner, I do not feel comfortable with the proposed treatment plan because I can’t get enough clarity on what will happen to feel like an informed patient.  I have not found a good doctor-patient connection with Dr. Warner and have decided that I need to make a change for the following reasons:

1)   I believe it is important to have one doctor who I feel comfortable with managing my care.
2)   I really need my doctor to talk clearly about the options, how we would define success and what the risks are for each suggested treatment.
3)   After 2.5 years with diagnosed cancer, I am getting much more competent at understanding what my needs are.  I have developed biases in favor of doctors who are on their way to success and against those that have achieved success but forgotten how to be smart, articulate, compassionate and punctual.

Over the past several weeks, I have visited with two new carcinoid cancer doctors as part of my search for a more effective doctor-patient relationship.  Even though I have become pretty jaded on oncologists and cancer, I was pleasantly surprised with both doctors.  Both were smart, compassionate and articulate.  They explained all the issues with my case and spent time answering questions. 

After this 2.5 year struggle, I am glad to finally find some hope of achieving a good doctor-patient relationship.  I’m taking a well needed vacation and will report back on my medical situation after I return.