Finding A Doctor

The hardest part of IBC is diagnosing it. Once you have the diagnosis, it is probably less challenging to find the right person to treat it.


I live in a rural area and was not expecting to get adequate care here. However, I was referred to one of the five oncologists in town, and she is fantastic. She trained at MD Anderson in Houston, which I would argue is the premiere place for inflammatory breast cancer treatment. But I have since learned that as long as you are in the care of a knowledgeable oncologist, there is no reason to travel to a place like MD Anderson. I received the same treatments here that I would have received at MD Anderson.

In short, of primary importance is finding an intelligent and caring oncologist to supervise your care. You might not have to travel very far at all.

Secondly, find a surgical oncologist who you trust to remove all breast tissue. I understand that some surgeons and patients are more concerned with the cosmetic outcome of the mastectomy than with the mastectomy itself. But with inflammatory breast cancer, you do not have that luxury. Make sure you have a surgeon who understands the importance of a careful and thorough mastectomy.

Again, both of these points have less to do with location than with individuals. You can find crappy doctors at major cancer centers just as well as at rural cancer centers. Don't be afraid to try out a dozen different doctors in search of the right one for you. You just have to make an appointment and meet them!

Hi Debbie,

You ask an excellent, important question. There are many clues that can indicate it's time to fire a doctor. Sometimes you know immediately that a doctor is not the right fit, but other times, it may take awhile. Here are some tell-tale signs that may indicate a doctor should be fired:

-- He/she doesn't return your phone calls in a timely manner (for me, this is within a day or two).
-- He/she comes to your appointment, armed with statistics printed from the Internet.
-- He/she is dismissive of your concerns.
-- Put out an emotional prompt, such as "I am scared." If the doctor is not compassionate and doesn't address your emotional needs immediately, this could be a sign he/she is not the right one for you.
-- He/she does not allow you to have a say in your own medical care.
-- He/she does not answer your questions in a way you can best understand the answers.
-- He/she interrupts you and/or scolds you, is rude, and is arrogant.
-- He/she contradicts him/herself and keeps changing his/her mind.
-- He/she doesn't listen to what you have to say.

These are just some indications that a firing is in order. I fired doctors who had a combination of several qualities. I have encountered doctors with all the aforementioned qualities. As upsetting as it is to let a doctor go, you have to make the decision to choose a doctor who is right for you.

In my new book, one physician I interviewed recommended asking one physician whom you trust and feel confident in for a referral . He said that good doctors know other doctors like themselves.
Call a doctor's office who you trust and like and ask the doctor's nurse there who she/he sees.
Ask friends and colleagues who they see and like.
Call or go to your closest hospital ER. Ask the primary nurses there (RNs) and ask who they think are good doctors. They see who actually visits patients in the hospital, who responds to pages, and who care about their patients.
You can go to the AMA website and seek out doctors you are interested in. It is better if a doctor is board certified in his or her specialty.
Good luck!

Davis Liu, MD just made a fantastic post related to your question (http://davisliumd.blogspot.com/), which links to the recently published New York Times piece “How to Find a Quality Doctor.”(http://tinyurl.com/3ug937p).

Dr. Liu takes the question a step further, addressing fundamental questions that should be asked by health care consumers seeking more patient-centric care, such as, “Does your doctor listen and explain? Do they know your medical history? Do they partner with you in your health? Do you have confidence in the care they provided you?” Questions like these are fundamental. They’re the crux of successful, patient-centric care.

I’d worry less about the performance of the mammography than about the read of the actual image. The actual mechanics of performing the mammography, while important, are less important than having a well-qualified radiologist. A good radiologist will know both whether the mammography was set up correctly in the first place just by looking at the image (and will re-order another one if not), and whether it’s being read and interpreted correctly.

Selecting a doctor that suits your individual needs and situation can be difficult, especially if you have moved and are living in a new community. Start by asking co-workers, neighbors, and friends for recommendations, but ultimately rely on your own intuition and research when making the final decision.

Do some preliminary research about the doctor’s specialty interests, credentials and history. And don’t let concern about ruffling anyone's feathers keep you from doing your homework. Richard Klein, M.D., author of "Surviving Your Doctors: Why the Medical System Is Dangerous to Your Health and How to Get Through It Alive", said in a recent interview that "arrogance and ego are real problems in the medical profession, but good doctors welcome involved patients.” http://tinyurl.com/3mhr98t

When you meet or speak with the doctor for the first time, listen carefully for the tell-tale signs that will suggest whether or not he or she is a good fit. Does he demonstrate a genuine interest in you? Is she taking the time to get to know you, your medical history and that of your family? Does he try to put you at ease and encourage questions, or do you feel so rushed you can’t even remember what questions you meant to ask?

If you want to dig deeper before settling on a doctor, there are several sources beyond simply asking your friends and neighbors. First you should check the physician directory for your insurance plan to see who accepts your insurance and is taking new patients. You can often access this list online or through calling the customer service number on your insurance card. After you have a few names of physicians in your area you can check their credentials with the following resources:

FamilyDoc.com has a list of questions about what a family doctor is and good questions to ask when looking for a family doctor. http://familydoctor.org/online/famdocen/home/pat-advocacy/healthcare/836.html

The American Board of Medical Specialties has a resource to look up if your doctor is board certified. Finding a doctor that is board certified ensures that he or she meets nationally recognized standards for education, knowledge, experience and skills to provide high quality care in a specific medical specialty. http://www.certificationmatters.org/

If you have questions on health ratings for physicians, health plans, nursing homes, hospitals, home health agencies or other health care providers ConsumerHealthRatings.com offers a variety of links to other rating services. http://www.consumerhealthratings.com/

Medicare.gov can assist with finding a Medicare provider, comparing hospitals, home health agencies, nursing homes, and dialysis facilities. The resource locater at the bottom of the Medicare home page allows for various searches. http://www.medicare.gov/

For more resources check out the Prepared Patient 411:http://www.preparedpatientforum.org/patient411/findingdecentcare.cfm#FindingDoctor