Doctors and Trust

Do you trust doctors more, less, or the same since being diagnosed and treated for PCa?

Post Edited (Tim G) : 1/24/2017 8:46:31 PM (GMT-7)

My husbands original urologist entirely neglected to tell him he had prostate cancer after a second review of the biopsy. We found out because the pathologist sent us a report to us by mail. We never went back to him again and even now he is blissfully ignorant that my husband has prostate cancer.

There were a pile of errors that we picked up along the way and the morel of the story for me was that doctors are fallible and patients need to become as informed as they can be to make good decisions.

The way I see it, it's about the money for the majority!

I've never trusted doctors much. They're meat mechanics. They are presented with a malfunctioning system ("the patient"), and they use a flowchart to isolate the problem. They apply a fix. That's it.

People are more complex than cars, and the treatments are less predictably effective than car repairs. But otherwise, it's the same basic approach.

When my kids were little, whenever a doc prescribed some ointment or medication, I'd look it up in the PDR to verify dose/kg, indications, and contraindications. With a tiny bit of latin you can tell what these may be for just by the name. Once a pediatrician prescribed "Mycolog" cream for one of our kids. I said, "Oh, you think it might be fungal?". He looked at me rather surprised and said yes. The root word is a common term for fungi, so it seemed obvious.

In PCa, many guys here helped me out because it was such an unfamiliar landscape. Treatments I'd never heard of for a disease I only dimly understood. "Hormone therapy", for crying out loud. Really? So I'm going to get voluntarily chemically castrated? You have GOT to be KIDDING ME! That's actually a thing?

With so much on the line, you bet I research anything the docs say. They really throw me for a loop when they go a direction I'm not expecting. Just recently, I fired an oncologist because it was pretty clear he didn't understand my case. We have to be very involved in our treatment plans; for this disease they have life-changing side effects.

The design of this poll is, well, incomplete.

I certainly trust what's referred to as the "community doctors" less, so I voted "less." Not saying all are untrustworthy, but I understand their motivations better. But more importantly I've learned which doctors are the real thought-leaders in prostate cancer care, and I trust in their motivations. But they are not necessarily "my" PC specialist, so I couldn't pick that poll choice.


Here's a great example of that I'm talking about...

Dr. Charles "Snuffy" Myers is not "my" PC specialist, but I trust his world-renowned wisdom (many HW/PC members have seen him, too). He's created quite a substantial portfolio of video segments which can be very helpful to men who are interested in elevating their knowledge about prostate cancer. A year or so ago, he made this comment, related to this thread topic, in one of his videos:

"I think it's actually criminal, the extent to which radical prostatectomies are being done at the community level, and being driven by the financial "need" of the surgeon. Don't help them buy their next Mercedes."

www.prostatepedia.net/blogs/ask-dr-myers/61768067-gleason-6-active-surveillance-or-surgery

I chose other, as I trust doctors more who are in well known clinics.
The last couple years has reduced my trust in my hometown doctors significantly.

I guess it's a matter of you get what you pay for. Well that's not the case because insurance pays it. So it's geography, better doctors in large cities and clinics.

<sarc>Why did you choose to practice in Topeka? "Well, I was 9998th in my class and no one else would take me. But I've got a license." </sarc>

I trust specialists more about their own specialty, less about other specialties. In fact, sometimes the best answer a doctor can give me is "I don't know the answer."

I have said this before. I have worked with physicians for almost 40 years. I have found that 10% are mind-numbing brilliant, 10% are idiots, and 80% are average. For some things, annual check-ups, getting labs and prescriptions, average is good enough. For prostate cancer, or anything else that could threaten my life, average is unacceptable.

Sorry...to answer the question...same

Paul

JW3104 said...
I have worked in the health care field for 30 years (not as a doctor) and I do not trust any doctors. They are humans, they focus on what they want to focus on and process the information you give them according to their training. Understanding that is important so you can challenge them on their answers to treatment plans and options.

36 years in anesthesia here(CRNA), and years as an RN and lab tech and military medic before the anesthesia and I can relate at least somewhat to what you are saying. Human beings, with all of the normal human bias. I probably trust them about the same as before diagnosis, which is to say not completely.

Most here readily understand that we need to be as educated as possible in order to be our own best advocates. Which is no easy task as it is not easy becoming an amateur doc in multiple specialties. But most here know the answer to this: is the average urologist most likely to recommend RP for us, in almost all PC circumstances, or recommend we see some other specialists to see if there might be some better options? Well, a few will do the latter. And will they really spell out all if the more than possible SEs and chance of cure and likelihood of needing RT anyway, depending on our risk/Gleason? Again, some will, many will not.

Same can most likely be said for RT guys, and many other specialties. It really is simple human nature. You can not expect a guy who spent 11-12 years post HS to start his practice, and who pays 100K per year in Mal-practice insurance, to convince a significant % of guys who come into his office that they would be better off seeking the services of another specialist.