contract with dr to not rate them on line

[leapyrtwins]

Jim -

thanks for your last post.  Very well said and I totally agree with all your points.  You have a way with words that I'll never get the hang of.

Carter -

if I'm the one who ticked you off - or came across as less than supportive - I sincerely apologize.  That was not my intention at all.  I've always found one of the great things about this forum is that we can respectfully disagree with each other when expressing our opinions. 

I was lucky enough to have a doctor who believed in telling me every possible side-effect of both radiation and surgery, even if the chances of me getting it were very, very small.  That's just his style; he believes that patients should be fully informed.  And while initially this approached scared the sh*t out of me, I swiftly came to appreciate his honesty.  I am truly sorry that you had a doctor who didn't communicate such important issues to you - he was definitely remiss in not doing so.

DHM -

Dr. B is not a real doctor.  He just uses this name on the forum.

Jan 

[no2hopkins]

This is obviously an important topic and has provoked a lot of great discussion.  I have even received e-mails from folks unhappy with their docs, but not interested in posting.  I think several good points have been made. In no particular order:  A patient bears some responsibility for finding a doc he/she feels comfortable with and who appears to be competent.  Magazines touting Top Docs are actually reporting docs nominated by their peers and not some independent review.  Docs make mistakes and some are just not good at what they do. Those docs should be held responsible for their poor performance in whatever way the patient feels appropriate (I don't think this has anything to do with sour grapes). And lastly, stuff does happen.
My advice would be to confront your doc if you are unhappy or change docs as I did.  My neuro suggested stiching my eye shut when it became apparent I had lost the ability to close it.  He was unfamiliar with inserting a gold weight in the lid when I told him I was considering that and he laughed when I said I had taken to wearing swimming goggles in the shower.  While not his specialty area, I would expect him to have some exposure to eye issues after surgery and some practical advice.  I won't bore you with more of my particular dissatisfaction with my doc, suffice to say I left Hopkins neurosurgery after that.  I sincerely hope anyone begining treatment has great results. Remember docs are just people who hae gone to school to learn a particular skill.  Some are good others aren't. Don't be afraid to tell a doc you don't think he's good enough for you.

[Doc]

DHM - Like I've already said elsewhere in this forum, I'm not a Doctor, just like Jan has already happily pronounced.  However, Doc has been my nickname most of my 52 years and was given to me by my father, who as it turns out, was a very big bugs bunny fan. He wasn't a Doctor either, he made his money in the carpet industry...probably had a few Doc's as customers. I use "Doc" everywhere, including on my business cards and it was also on my Battle Dress Uniform name tags for the twenty years I was in the military.  When anybody asks me "whats up Doc?" I have an answer for that too, not appropriate for these pages.

Have a Fun Day!

Doc

[leapyrtwins]

Remember docs are just people who have gone to school to learn a particular skill.  Some are good others aren't. Don't be afraid to tell a doc you don't think he's good enough for you.

Absolutely. 

While your post is full of many excellent points, this quote especially resonates with me.

I have consistently been thrilled with my doctors, but like you I have had many complain to me about their doc via email.  Interestingly enough, these complaints include doctors from some very well known facilities - which only proves to me that you need to look at doctors as individuals, not as a group.  I have met many doctors with partners I would never see - even in an emergency.

Not every doctor is for every patient, but moving along is an option that patients should exercise when they feel it is necessary.

Jan

[lori67]

Just throwing in my 2 cents here - I think a patient bears more than some of the responsibility for finding a doctor he or she is comfortable with and who appears competent.  I think the patient bears all of that responsibility.  Getting back to the auto mechanic analogy, I don't think I'd take my car in to be fixed if I wasn't comfortable with the mechanic or if he didn't at least appear to be competent.   I would keep shopping until I found one that I was comfortable with.  I would certainly do the same when it comes to my own body.

The doctors responsibility is to be schooled and qualified to do the procedure you hire him to do and to disclose all the risks and benefits associated with that procedure.  If I'm not comfortable with the amount of information being provided, it's my responsibility to ask more questions until I am comfortable.

I'm saying this as a person who came out of surgery 2 1/2 years ago with SSD and facial paralysis, so I fully understand what it's like to live with the things that can go wrong.  I do not view my doctor as incompetent because these things happened.  Unwanted results can and do happen to all surgeons - that's life and that's a part of being human.  Considering what would have happened if I hadn't had the surgery or what could have gone wrong during brain surgery - I consider myself pretty lucky.

There's my 2 cents for the day.   Keep the change.
Lori

[Jim Scott]

As my final comment on this thread (I promise!) I'll add that Carter is right about confronting a doctor who seems incompetent in some area he (or she) should be knowledgeable about and that we should follow his example of leaving any physician's practice if and when he (or she) doesn't respond to our needs.

Lori's observation about doctor's peers 'rating' them as mere cronyism in action is well taken.  I look at a doctor's record and whatever information I can gather from former or current patients, not magazine articles or websites.  When possible, I consult with a nurse, an old friend of my wife's.  She has some knowledge about most doctors within our geographic area and will give us her unbiased opinion, based on what she knows.  She has never steered us wrong.  

Beyond that, we are somewhat at the mercy of fate.  Even a good, skilled doctor can have a poor surgical outcome without doing anything wrong.  I don't waste a lot of time complaining about a doctor I'm not happy with, I simply leave his (or her) practice.  If I'm especially upset, I may write the doctor a 'more in sorrow than anger' letter expressing my disappointment - but that's about as far as I'll go.  Life is too short to harbor a lot of anger that achieves nothing but generating angst on my part. I recommend others consider 'moving on' when confronted by a doctor that fails to meet their (realistic) expectations.  Well, it works for me.

Jim  

[carter]

ok - when i wrote yesterday, i was not mad about references to me - i was upset about references made after other good people expressed their issues.

Dr's may well talk a good game during consultation ...  but act another way completely as time goes on. 

as a patient, i asked questions, but i was not educated enough to ask the right questions!  ie - success rate?   the profess it and my CK to be "GREAT" as the tumor is shrinking.  so what if i lost my hearing and my lower face is numb.  that does not count.

but more than anything i have found that you can not fire a CK dr.  many of the good surgeons in a town will not see you after CK.  yes i have been turned away. 

then when i expressed my displeasure with the neurosurgeon that ran the, he offered to refer me to House.  this is i wanted to add surgery to the list now ...

i had to slow down on my words as i realized that if i fire him - who do i go to?  there are 0 more CK neurosurgeons in town.  so i can travel to get my follow ups for the next 4 to 5 years?  my insurance may stop out of network coverage?   then i am forced back to town.   is he going to then take me back?  not after what i have already said to this person!

so if you have had surgery, you may have other local drs.   if you have had CK - you are to stay with this small group that is associated with the CK machine or go out of town?
this is nothing that i considered in the decision process.

life is still pretty good .... i have not had a bad headache in several weeks.

i am just nervous as heck ---- hearing gone- then facial numbness ---- will there be a next thing?  the dr said to just trust him ... he has no conception of the concept that trust is earned.  not given to any with a MD.  at least not in my world.

[leapyrtwins]

Carter -

you mention that your hearing is gone.  I know this is off topic, but have you looked into anything to help with that - like a BAHA or a TransEar?

I found post op that being SSD was incredibly frustrating and annoying to me - and ultimately I realized it was depressing me also.  The BAHA involves surgery, so you might be hesitant to do that, but the TransEar doesn't require a surgical procedure and those who wear one seem to really like them.

Just a thought,

Jan

[no2hopkins]

This has turned into a great discussion.  I mentioned that IMO a patient bears some of the responsibility of choosing a doc that meets his or her needs in an earlier post. The reason I stated some and not all of the responsibility is that many people have no choice.  They are restricted by their insurance or geographical location or other reasons. Unfortunately some folks can't shop around or leave if they are not satisfied.  In those cases, I don't hold the patient responsible.

[ppearl214]

As many of you have learned about me over the years... and for meeting me in person to witness the ails in life that plague me.... one thing I have learned over this time... doctors are not gawds. 

I've challenged them, debated them, quizzed them (many of you witnessed this during meetings at the ANA Symposium, esp over "Pirate lunch" at our table), became far too educated for them, dumped them like hot potatoes yet, worship 1 or 2 that have profoundly helped me over the years..... all the while remembering one thing... they are human too ... and to err is human....

Thus, I continue to stress to all those that speak with me...become the best, well-informed patient you can be. As patients, it is also up to us to stay on top of the situation and challenge as needed.  Seek out multiple opinions in situations that require it... and once you are fully armed with info, make the best, well-informed decision you can (for any ailments, not just AN's) for you and your own, personal/individual situation.

My 2 cents.
Phyl

[Pooter]

This has turned into a great discussion.  I mentioned that IMO a patient bears some of the responsibility of choosing a doc that meets his or her needs in an earlier post. The reason I stated some and not all of the responsibility is that many people have no choice.  They are restricted by their insurance or geographical location or other reasons. Unfortunately some folks can't shop around or leave if they are not satisfied.  In those cases, I don't hold the patient responsible.

I think you should consider changing this to "the patient bears most of the responsibility of choosing a doc that meets his or her needs".  While there may be some cases where the patient has limited options, by and large those limitations are put on themselves.  The convenience of going out of town, or expense of going out of town, etc.. is largely more powerful than their desire to get better care.  They tell themslves, "I MUST see this local doctor because he's the only one who treats this condition" whereas they DO have the choice of inconveniencing themselves (time, money, etc..) to go out of town.  It's not that they do not have a choice, but they're choosing to stay local for the convience.

I don't have a problem with them making that choice, but nobody should say that they do not have a choice.  They do, they just don't like that choice so they say they have no choice.

I'm in no way diminishing your outcome or that of anyone else.  Post-surgery outcomes cannot be guaranteed by ANY doctor.  Any doctor who guarantees a particular outcome is blinded by their own gawdliness and you should run for the hills if ever given that kind of guarantee.

For example, there are many Canadians that have been disatisfied with the speed of treatment in Canada, so they come to a doctor in the US.  Another example is that many people travel across the country to get treated at House and other institutions because they felt it was right for them.  Luckily, my doctors were local and were extremely good in my mind so I didn't have to travel.  If they weren't, you bet your patooty that I'd find someone in the country that I was comfortable with doing my surgery and I'd travel there to have it done.  Luckily, I wasn't faced with that choice.

I agree that this is a good discussion.  One that merits us having it.  I simply disagree that the patient has NO or SOME of the responsibility for their own choices.  Rather, I feel they bear MOST of the responsibility for choosing their doctor and location for treatment.  There are things that are out of their control (bad outcomes happen to patients of the best doctors for example) and they shouldn't be "blamed" for that, but neither should the doctor.

Regards,
Brian

[leapyrtwins]

Phyl -

I'm with you - from the not believing that doctors are "gawds" to the worshipping 1 or 2 myself.

Wish I would have sat at your Pirate table at lunch; that must have been a very interesting conversation.  Sorry I missed it!  (No offense to those at my table).

Jan

[CHD63]

Jan .....

That was one of the really neat things about the Symposium ..... all of the interaction with the medical professionals ..... personally talking with them as well as how they talked with each other.  We had an excellent large group of professionals there and they were top-notch.  Even though they disagreed with treatment protocol, they were very respectful of each other.

I have been reading this thread with interest.  Since I have never felt the need or desire to sue anyone for anything, I cannot identify with extreme dissatisfaction with any medical care I have received.  However, I have always done extensive research on whatever condition/symptoms I have had and consulted with many trusted medical friends before choosing a physician and perhaps that has resulted in my good care.  That being said, even my good results were not guaranteed with either of my brain surgeries (or several other surgeries, for that matter) because everyone's body is unique and no surgeon knows 100% what he/she will find before opening the patient.  MRIs give a "best guess" but inside the skull is a very complex area of many critical systems ..... all of which are slightly different in every person.

Clarice

[leapyrtwins]

That was one of the really neat things about the Symposium ..... all of the interaction with the medical professionals ..... personally talking with them as well as how they talked with each other.  We had an excellent large group of professionals there and they were top-notch.  Even though they disagreed with treatment protocol, they were very respectful of each other.

I agree.  This was one of the many incredible things about the symposium.  Meeting others - both on and off the forum - was another highlight.  And, in addition, the sessions were very informative and interesting.

I'm looking forward to Cincinnati in 2011.

Jan

[no2hopkins]

I don't have a problem with them making that choice, but nobody should say that they do not have a choice.  They do, they just don't like that choice so they say they have no choice.
Nobody?  Hmmm, I think this statement is a little presumptuous on your part.  There probably are people who act out of convenience, but I would say that's the exception. I am blessed with good insurance and it sounds like most of the folks on the discussion board are equally blessed, but I'm pretty sure ANs don't discriminate based on insurance options.