Do I still need a uro?

I suppose the title of this thread isn't correct since I actually haven't seen a uro since 2012 when I was diagnosed. Shortly after I began a relationship with Prostate Oncology Specialists, who coordinated my HDR brachytherapy and IMRT with the docs at UCLA. I've continued to see my oncologist at POS...first he was overseeing the completion of my ADT and since then for PSA checks. I've been more than pleased with his care and acumen and he was so very helpful when I was diagnosed. But now my needs have changed and faced with POS's annual "membership fee" of $250, I feel it's likely time to move on.

Which leads to whether or not I need a uro or not at this point. Since finishing my ADT in 2014 ago my PSA has been low and steady. While I don't urinate quite as well as I did, I pop a Rapaflo every 4-5 days and I'm fine. After initial three-month PSA checks, we've been increasing the time between blood draws and at this point POS has only been checking my PSA every 9 months. So I'm wondering if I just have my GP test my PSA at my annual physical and I'm sure she can also prescribe the Rapaflo. Or should I strike up a new relationship with a Uro instead? I didn't mind the uro that diagnosed me with the exception that immediately afterward he had me in the scheduling department to pick a surgery date.

PS I have thought about one last appointment with my doc at POS, which is currently scheduled for May. Just to get this take on this issue as well. But that dang membership fee...

$250 a year is worth it to stay with a doctor/treatment center you're happy with. You're buying peace of mind. It's wonderful that you've had such immense success with treatment. But Gleason 9 requires continued vigilance. If g-d forbid your PSA starts rising again or some weird symptom raises an alarm, you'll be glad you stayed with the oncologist who has been with you through thick and thin.

If you choose to leave POS, it's probably sufficient to have your GP monitor PSA. I don't see why you'd need a urologist.

Thanks gentlemen for the feedback. I think that what I'll do is pay the membership fee for this year and discuss with my POS doc when I see him in May. I can get his feedback on the best path going forward.

I agree that 250 bucks is not a big deal in long run. (Or the short run for that matter.) But as someone who simply comes in for a PSA draw every nine months, it leaves a bad taste in my mouth, despite my respect for my doctor. And the fee is being instituted due to the lower reimbursements on tele-medicine visits, but it's not like *I'm* doing tele-medicine for my PSA draws. I feel like I don't have a dog in that race.

Michael_T said...
I feel it's likely time to move .

....That’s what jumps out at me Michael.


Frankly, after the first swing of the bat with PCa, I don’t understand why anyone really needs a uro again, barring other urological problems.

POS isn’t going anywhere.

mattam said...
Michael,
They get you one way or another. My dental office recently charged me $25 for Covid-19 disinfection, which I interpret as "we aren't doing as much business as we used to," so you gotta pay more.

My dentist explained to me that his office has to buy extra gowns and other protective equipment on a daily basis to fight covid. Because of shortages, the cost of these items went up quite a bit (several fold).

Cyclone-ISU said...
It was my decision to promote my oncologist as the "quarterback" of my medical team.

Cyclone...that's exactly the way I thought of my oncologist at Prostate Oncology Specialists after I was diagnosed. He was my quarterback (sometimes I thought of him as a point guard) for my medical team. But seven years later, there's no medical team to quarterback anymore.

I very much appreciate everyone's thoughts on this thread!

Membership fee is ridiculous. Given your history I would move on.