When you fire your AN doctor . . . .

[Nancy Drew]

I recently switched AN doctors, and my new AN doc will be performing my GK in Oct.  I had been in W&W mode since 12/05, and I was content enough with the AN doc I had been referred to by my ENT.  My AN was found by accident, I had no symptoms to speak of, and I was content to W&W with annual MRIs.  The MRI I had in May showed slight growth, and the AN is starting to act up.  My AN doc suggested I have GK right away.  Told him I wasn't ready to make a decision yet, and he gave me the name of another doc for a second opinion.  That doc was wacky.  He gave me his opinion from reading the written MRI report only.  He didn't have a disk player on his computer so he said he couldn't look at my MRIs.  He finally found a computer as my insistence . . . . long story, but he did change his opinion after looking at my MRIs.

So, I decided to get another opinion from a doctor who was recommended by someone I met on this board (this doc treated his AN with GK, and he liked him).  Long story short, I liked this new doctor so much I decided to switch over to him.  His personality is a better fit for me, and I also learned he has the most experience with GK in this part of the country.  My new AN doc did not try to "steal" me from my original AN doc so this was not an issue.  I told him I was there only for a second opinion.  BTW, both doctors use the same GK machine.

I wrote my original AN doc a letter stating I was transferring my care to the new doc.  I thanked him for his excellent medical care, and I said I would not hesitate in recommending him to another patient.  I ended by saying it was just a personal decision to change doctors.  I thought it was a nice letter--not berating at all.  I also have only high regards for the doc, and he has an excellent reputation.  Just not a good fit for me personality wise now that I am seeking treatment.

A few days ago I received a letter from my original AN doc stating he would appreciate the courtesy of a more detailed explanation of how he could improve the quality of his care.  He also said he was sorry he did not meet my expectations.  He wrote some other stuff in the letter that seemed like he wanted me to feel guilty for changing docs.

I haven't written a reply.  In fact, I have considered not replying at all.  I have never received a letter from a doctor asking for this kind of info, and I have changed doctors a few times in the past.  Have any of you ever "fired" your doc, so to speak?  Did your doc ask for an explaination as to why you transferred your care to another doctor?  If so, did you reply?  CONFUSED!!!

Nancy

[lori67]

Nancy,

While I've never had to fire one of my own doctors, my sisters and I recently had to fire my Mom's heart surgeon.  We sent him a letter documenting all the reasons we felt it was necessary to find another surgeon (it was a lengthy letter - and 3 of the 4 of us are nurses!).  I was actually shocked to get a response from him!  I fully expected him to glance at it and then toss it in the trash, but he actually took the time to respond.  Which is probably part of the reason he didn't have time to take care of his patients in the first place!  Anyway, he was very apologetic about the poor quality of care my mother received from him and didn't even try to defend himself.  I have a feeling this was not the first complaint he's gotten.  The funny part was that he offered to continue being her doctor and promised to do a better job next time.  Yeah, right.

If you have any contructive criticism to give him, then I'd write back to him and let him know what you think.  You may not be the only patient feeling the way you do.  But if you feel it's more of a personal connection thing that was missing, I probably wouldn't bother.  There's not much he can do to fix that.  I certainly wouldn't feel guilty about it though.  I don't think he'll lose any sleep over it, so you shouldn't either.

Lori

[wendysig]

Nancy,
You obviously found a doctor you ocnnected with and this part of the "gut feeling" everyone talks about.  If you didn't have it with your first doc and you do now that is great.  I think the fact that you wrote a letter of explanation to the first doc is great and really doesn't require a followup.

Wendy

[Dan]

Nancy,
I didn't really fire my Dr. but I did stop going to see them.  The ENTs (wife and husband) that found my AN I think are very good but as far as ANs go they have only one opinion GK, GK, or GK and from what I have read hear I don't think the GK is as up to date as in the USA, most insurance companies in Germany still won't pay for it because they feel it is still in the reseach and testing phase.  They didn't even want to give me a referal to a nerosurgeon.  They even told me that nobody comes out of brain surgery the same as before.  If I ever have other ENT problems I may go back to them but for AN, no way.  I found that I felt alot better after I had talked to all the specialist before making my decission.  You have to make the choice and feel comfortable with it and with your Drs.

Dan in Germany

[DebraInTexas]

I didn't fire an AN doctor, but I did fire my oncologist three years ago.  I was diagnosed with breast cancer and went through many many surgeries, including a mastectomy and reconstruction.  After all of that, I met the oncologist.  I did not feel comfortable with him at all.  Basically, he told me I was on my death bed and that I needed to sign up for this trial right away, among many other disheartening things, including "no, you can't record our sessions, you may take me to court someday".  He was totally different from the surgical ongologist I just spent two and a half months with and used a small tape recorder everytime I went into his office.  Needless to say, I was devastated after I left his office and a friend that was with me felt the same way.

I called a friend of mine who was a physician's assistant just to go over the appt. and she said, "Debra, you know you can fire that doctor, right?"  Until she said that, it never crossed my mind.  I don't have to have him as my doctor.  So...I asked for a different oncologist from my surgeon and he recommeded me to my current oncologist (In the same hospital and same department), which I love.  The hospital itself did send me a survey to fill out as to why I was changing providers, but I don't think I ever even filled it out....I had way to many other important things I needed to take care of including chemotherapy.The doctor himself, never contacted me again.

Bottom line is, it is your body, your life, your decision.  If you want to change doctors for any reason, then you should and you should not have to explain yourself to anybody.  You are making the decision for you and noone else!  I say, you made the best decision for you at this time.  No need to explain anything else.  Pat yourself on the back for making a choice that was in your best interest and never look back.

[Tamara]

It is certainly true that you do not need to give the doctor you fire any explanation.  I work for a close friend who is a doctor, however, and know that he tries very hard to provide superior service to all his patients.  Whenever someone leaves our practice for any reason, he wants to be informed and truly wants to know if there was anything our office could have done differently.  So, my suggestion is that if you think the first doctor genuinely wants feedback in order to improve (not just to make you feel guilty), send him a short note.  My guess is that he wants to know if there is something that drove you away (say, a rude receptionist) that he can fix.  If you think he just wants to give you a guilt trip, then don't bother responding;  otherwise, maybe consider it.

Tammy

[leapyrtwins]

Nancy -

the way I see it you have two choices.  One - respond to his letter or two - don't.

While you certainly have every right to change doctors and don't have to "answer" to anyone, IMO this could be a great opportunity to really make a difference in how this doctor interacts with other patients.  If he's objective enough to consider your feelings and how they relate to the way he does things, he might be willing to make positive changes in his practice.

I think the fact that he asked is a good sign.  Doctors are busy people - and this being America, we all have choices - although some of us are limited by our insurance networks  - so I don't think he's asking you because he has nothing better to do.  I also don't think he's concerned about losing one patient - namely you - since there are many others out there.  If he truly didn't care, I doubt he would take the time to write you a letter - okay, realistically, dictate one to a member of his staff 

I say it's worth your time to respond to him.  At least that's what I would do.  IMO it's just one more way you may be able to help another AN patient - which is one of the reasons lots of us hang out on this forum.

Jan

[MAlegant]

Hi Nancy,
I have to agree with Jan and others: almost without exception doctors just want to do the best job possible for obvious reasons.  If you are so inclined, write back and let him know what led to your decision in as much detail as you think will best inform the doctor as well as his future patients.  Doctors are only human and are just as insecure as the rest of us.

Glad you found a doc you like and trust.
Best,
Marci

[Jim Scott]

Nancy:

No need to be confused.  No physician, who, in effect, is really running a business, likes losing business i.e. patients.  However, a patient changing doctors is not all that unusual.  The doctor sending you a letter shows some concern on his part.  For all you know, he may lose patients on a regular basis.  Whether this attempt to find out why you left is sincere or simply a pro forma situation is unknown.  Assume the good-but-wacky doctor is sincere. 

I would respond with a concise letter explaining that, as you've indicated here, you feel your 'new' doctor is a better 'fit' for you.  Freely admit this is a subjective conclusion.  Emphasize, again, that it isn't his care or expertise that is in question.  Of course you wouldn't mention his 'wacky' personality which he would naturally see as an insult, even if it may be the real reason for your leaving his care.  If doing this is too stressful or awkward to get into, simply ignore his letter.  Assuming your bill is paid, you owe him nothing. 

My wife 'fired' a doctor by simply calling the office and requesting her files be transfered to her 'new' doctor.  The reception from the doctor's secretary was cool but no questions were asked and the file transfer was completed smoothly.  As I stated, it happens.  Doctor and patient are not always a good fit.  I wouldn't allow this to preoccupy you because you don't need any stress at this point, so just do what feels right for you. 

Jim

[robynabc]

Hi Nancy,

Was that Dr. Cass?

No need to feel guilty.  About 3 years ago I had very bad Pnuemonia.  I went to my doctor 4 times in 10 days.  I begged him to give me anti biotics.  I had a sinus infection before that. This is a long story but I ended up yelleing at him and asking him how he could send me home like that.  He ignored me and treated me like he was my superior.  Well,  I went back on a Friday and ended up in the hospital on Monday. with a really bad case of pnuemonia.  It was obvious I had it for many days.  Later,  he sort of apologized and I told him exactly what I thought of him.  And I never felt guilty once.  He also lied to my doctors at the hospital and said he checked me and he didn't. 

I wouldn't feel guilty at all. And if you have the time to tell him why that would be great but if not no worries there either.   I think it is good that he wants to know. 

Hi from Colorado.

Robyn

[Nancy Drew]

Yes, Robyn . . . Dr. Cass for the 2nd.  He might be OK, but he didn't impress me much.

It is interesting to read all of the replies here.  I have also had mixed replies from my friends also.  I think I already wrote the guy a nice letter to begin with.  In fact, I thought it was rather nice of me to tell him I was changing docs in the first place.  A part of me tends to think that my old AN doc is a cry baby . . .SORRY . . . maybe not a nice thing to say, but it seems that doctors should be used to losing patients for whatever reason.  I sort of think he might just want to put another knotch in his GK belt so he can become the "expert" in the area.  I'm still turning this one over in my head.  I've made one decision to have GK so why worry with making another decision just to appease a doctor.

BTW, I emailed the letter I mentioned above only to receive it back because I had not signed an email release.  Why in the heck do they even put an email address on their card in the first place!!!  Oh bother!!!

Nancy 

 

[robynabc]

You know what i would not worry about it.  You have enough to think about.  You don't have to hold his hand.  If you have better things to do than move on.  There is no reason to worry about it. In my very humble opinion,  You did a nice thing by writing a letter.   

[DebraInTexas]

Don't make a decision to appease a doctor.  Make a decision that appeases you.  After all, you are the one that has to live with it.  I can say this, because in the past and sometimes I still tend to be, the person that wants to make everyone else happy.  Well, guess what this is about you, no one else!

[MAlegant]

Yes, well, he could just be a cry-baby. Good point. 

[goinbatty]

Over the years, I've basically fired 3 docs by just not returning to them and transfering care to another physician.  Being a nurse, I'm a bit on the selective side. 
Just wanted to add that unlike years ago, physicians offices are run like businesses.  Depending on what you are being seen for, a certain amount of time is allotted on the schedule.  For example, a complete physical would require more time than a follow-up office visit.  Also, the visits can be coded differently for billing purposes depending on time.  I added this info to show the pressure physicians can be under which can result in hurried visits leaving one feeling that they were cut short.  This is of course no excuse in my book for a physician not taking the time necessary to address a patient's concerns.