Are some docs like car mechanics or such a correlation exist? Dr. Strum's words

Hey this may be taken out of original complete context, but Dr. Strums message is resonant and clear. I regard him the most highly in the oncology world via his actions, deeds, knowledge, compassion, free advice on P2P for PCa patients and his books, conferences and sharing of real needed information to patients.  His words recently on a P2P for a patient with some health side effects going on:

(Dr. Strum)-

'Stephen Strum, MD>
The most ignored recommendation that I consistently make is for all
patients with any serious illness to realize how the varying levels of
competency amongst physicians impacts the DIAGNOSIS, EVALUATION &
TREATMENT.  Lay people assume that all physicians are alike or similar
in talent, passion, curiosity, competency, compassion and equally
conscientious.  This is a far cry from reality.  We docs are no
different than car mechanics: there are the few outstanding, the 5-8%
good, the 70% average, and the 20% dangerous.  The breakdown regarding
percentages may be different but this is my take of what I have seen
in 40 years of medicine. An expert pathology review of the diagnostic
biopsy or the RP specimen with utilization of biologic information
that can be obtained from IHC (Immunohistochemistry) testing is for me
a FOUNDATIONAL recommendation.'

---------------------------------------------------------------------------------------------------(my words=)

To bad we can't clone such a wise doc for our much needed help for mankind in general.
I am going to agree with his thoughts and what the heck the percentages given, seen a number of docs and other patient histories over  8+ yrs. in PCa forums.  I feel for the ones whom are mislead, over sold, under analyzed and over treated or under treated. These errors and less than great medical services should not happen and especially for the outrageous costs envolved and profits made off of patients in general.  Knowledge and even street smarts are your friend in medical issues and finding your best answers in your particular case.  Like he mentioned maybe 20% are just plain dangerous, hopefully you did not hire such in your treatments.

Peace to you  (to our corpus of brotherhood in the fight against PCa)

 I agree Dr. Strum really is a terrific guy.  Hugely knowledgeable, enormously dedicated, charitable, etc.  We need more like him.  Interestingly, I have not seen anyone on this board who has consulted with him (other than perhaps via p2p).  Is there anyone?

 

What is P2P?

Dan

Zen, I would rather err on the side of the truth, then to be deluded in half-truths or wrong data concerning my health. I believe it was Zufus's original call here, but its true: this is power in knowledge of what we all fight here, and this knowledge goes a lon.g way to abate fear

Newbies need to know the truth straight up it is a maze and jungle out there, no sugar coatings. Get scared to some degree and study up and know when you are being fed a line vs. frankness and real truths, only the patient lives with the side effects, results and after the deed(s) are done.

I have talked with Dr. Barken years ago and Dr. Strum just a little (via emails) and his co-author Donna Pogliano in various emails(she got me into his book on the inside cover 2nd edition). Andrew (Ohio State) got in touch with Dr. Strum and Leibowitz atleast to get an idea of what that is like. As for treatment, have one guy in our local prostate meeting group whom is under the care of Dr. Scholz and receiving Leukine treatments. He flies to California a couple times a year to see him.

We had one guy on this forum who got a DaVinci surgery apparently by a newbie trained doc, this doc did not even get all of his gland removed, it was botched, covered up by his doc and his doc referred him to friend radiologist for 'salvage' job on his rising psa levels. He found out about the whole scenario and was suing his surgery doc. Hopefully nobody gets that type of wonderful treatment and care. There are other examples and plenty of imperfect assessments on patients, and rushed into whatever treatment protocol. You may have to make a very tough decision in your choices, but get to know all your possible choices and what to expect...hopefully you were told the details.

Excellent posts, zufus.

If Dr. Strum is correct, then 10% or fewer of doctors are good to excellent.  Not that surprising when you think about it. 

So if you simply go to your local urologist/radiologist - the one with the good bedside manner - for treatment, understand that you are rolling the dice.  That doesn't mean you will necessarily lose, but the dice are stacked against you.  Not every local doctor is in the top 10%.  

I say again, I think there will soon come a time when many fewer men are actively treated for prostate cancer, most urologists will simply monitor men with PCa, but if and when treatment (surgery/radiation/seeds/etc.) does become necessary, it will be done by a relatively few specialists in major cancer centers who do nothing but these treatments.

Zen9 

Dr. Strum:
Unusual for one professional to suggest others in his / her line of work might be less then superstars BUT alas it's VERY true as "seemingly" evidenced by many of the posts in this forum! Using mechanics as examples was a great idea as when technology advances in vehicles so must the mechanics who have to repair them. With prostate cancer there are a number of treatment / non treatment options available. Take DiVinci for example, almost all major medical centers offer the procedure these days and those who happen to be doing the first few it would seem thoset few patients might not do as well as those who have had the procedure at a facility that has performed thousands. Same goes for radiation, seeds, freezing.

74 years old - third biopsy 12/23/09 found two of twelve cores @ 30% and 70% Gleason 3+4=7. Vatikutti DiVinci @ Henry Ford Detroit - Dr. Peabody 02/10/10. Prostate 106 grams - nerves spared - four hour procedure due to urethra / bladder connect (large prostate issue) - margins etc. clear. Zero pads now. Five week PSA undetectable next one due early July. Henry Ford offers a class for ED and methods for returning function to what's left of the family jewels.