Read Peter Kafka’s recent thoughts on getting your medical team to work in unison. This is not a hypothetical either – Peter has a quarterback doc in S. California, lives on Maui, and wants to do chemo locally. (rd)

A Tale of Two Doctors

I know that some of you, like myself, rely on the expertise of a doctor at a Center of Excellence or a larger medical facility that might be a good distance away from home and then choose to get treatment for your disease locally.  This brings up the situation of two doctors communicating and working together on your treatment plan.  This is the circumstance I find myself facing at the moment.

For the past six years I have relied upon a trusted genitourinary medical oncologist, Dr. Jeffrey Turner at Prostate Oncology Specialists, to guide and manage my treatment course on this aggressive prostate cancer journey I am on.  Now that I have progressed to the point that a regimen of chemotherapy is called for, I have chosen to carry out this treatment at my local cancer center here on Maui.  So, I have been interviewing the few Maui-based medical oncologists to determine who could work under the direction of Dr. Turner.

One of the doctors I met with the other day was a young man who appeared to be quite knowledgeable, not long out of medical school and therefore perhaps lacking in practical experience.  This doctor let me know right out of the gate that he did not agree with Dr. Turner’s treatment plan.  He thought it was far too aggressive and that he would not advise it.  He had statistics and studies to back up his argument.  I think that he had my “best interests” at heart, letting me know that the side effects of chemotherapy can be quite harsh that is why he utilizes this protocol further along in the journey.

I listened to his argument, and understood where he was coming from, but I realized that he, like many doctors was more interested in treating the disease and not the person.  Good medical schools can probably be quite proficient in teaching doctors how to select the right treatment modality off the shelf for any particular disease.  But behind the disease is a person – me – who might present some unique aspects of the disease that require thinking outside the box and perhaps a more aggressive approach to treatment than the “standard of care”.

Convention says that the English alphabetical order begins with and ends with Z.  But if we are treating the person rather than just the disease it might be called for to end the alphabet with WZYX.  We haven’t left out anything, just changed the order a bit.  I think for those of us who might be facing (prostate) cancer with perhaps some unusual factors, it behooves us to find expert physicians who will manage the treatment of US and not just the disease.  And then if necessary, find a local doctor who will coach on the field.  And yes, I did find my man!

Editor’s Note – this is not a new problem to us. Just recently another of our participants asked his local oncologist to speak with his QB doctor at a renowned Center of Excellence in another state. The call took place in the patient’s presence, they waltzed around each other and appeared to arrive at the same conclusions, when in fact they did not agree at all. The call was not conducted on a speakerphone.

The lesson here is to make sure you are party to 3-way conversations. Doctors may accord each other professional courtesy before considering the patient’s interest. At least be sure what each one is suggesting before they speak so you can challenge an unexpected final recommendation.

Remember, YOU are your best advocate!