Clinical Team

I just wanted to say that both Dr. Attai's and Jody's answers are great, and I wanted to offer confirmation of both based on my experience.

As Dr. Attai said, having an involved primary care doctor counts for a lot. I had been seeing mine for many years, and he recommended my surgeon because they work together a lot. I figured my surgeon would be good because my PCP is pretty picky, but I later found out he's very highly regarded and doctors send their own family members to him. I did find out he's board certified and did ask him if he does a lot of breast surgery as a general surgeon, and he said, "All the time."

To support what Jody said (great question!), bedside manner is a deal breaker for me, but I'll trade bedside manner for skills when you're wielding a scalpel in my direction. I was blessed to have both, as my surgeon is as famed for his bedside manner as his considerable surgical skill. (Nurses tell me how good my breast/gallbladder scars look and then say, "Oh, you had Dr. K.") And a big yes to those nurses! I had never had surgery before and was so relieved when my PCP's nurse told me how much my surgeon's patients like him. Every OR nurse I talked to said "He rocks" or "You hit the jackpot" or something like that, and I KNOW nurses are picky. I asked one OR nurse what she does when she hears about a doctor who's not so great, and she said there's not much you can do. She tries to casually bring up the name of someone good, as in "Oh, did you know Dr. So and So also does that?" (hint hint--so keep that in mind if a nurse says that to you :) )

Excellent discussion! Dr. Attai,I'm not sure we realize how lucky we are to have you explaining all this stuff. It's more helpful than you know.

When the radiologist called me with the news, she recommended two doctors and said I should call them right away. I hung up the phone, it rang again and it was my ob/gyn. He recommended the same two doctors. I enquired why neither had recommended a nearby particular big-name cancer center. He said “You have breast cancer, you need someone who will care for you with your best interests involved”. I was stunned. Apparently I thought this was the case at all cancer centers. I was wrong.

I researched both doctors. I needed to read that they were the best in their field. I needed to know that they were current in their methods. I needed to know they could help me.

I called the first doctor, gone for the weekend. my diagnosis was given to me on the Friday of a long weekend. Called the second office, gone for the weekend. Great. I then called back the radiologist and told her. She said she would make the call to the doctors..at home! she called me back and said one would see me that Monday, yes, the holiday. The other would take me the following week. My husband and I saw the first surgeon. A lovely man, quite paternal, who explained the cancer and the options to me. We liked him, but left scared. We had not expected to hear that mastectomy was really my only option and we thought perhaps his methods might be outdated, or the way things have always been done. We saw the second doctor. He walks into the room smiling, and the first thing he says is “First let me tell you, you are going to be fine.” And he meant it. No scary words, just a strong plan of action, one of which I was part of. I could see why he'd performed more mx's than any other surgeon in NY, this guy cares. Being part of the team and plan are a huge part of healing. We knew he was our ticket out of this mess. I asked him about options and he told me of some I was not at all aware of. I made requests and he listened to and agreed with me. He then asked if we would like him to go get the plastic surgeon, one he works with as she is fantastic. He says he will ask her to see us now so we don’t have to make another appointment. She comes in and allays more fears. I am to come out of this looking good and sans the cancer. I have found the right team. They care about me and my cancer.

Breast cancer treatment requires a team of doctors. The treating doctors include a surgeon (a breast cancer surgeon and sometimes a plastic surgeon), a medical oncologist, and a radiation oncologist. Together, we all decide the most appropriate treatment course for our patients. Despite the fact that the radiation oncologist is often the last clinician to see the patient, he or she is often consulted earlier in the treatment course for recommendations regarding the patient's eventual need for radiation therapy.