How to find a breast surgeon
My wife had a biopsy on 11/20 and was diagnosed on 11/25. We are still waiting on the final details from the pathology report to let us know ER/PR/HER2 status. The waiting is agonizing because we can't imagine what the journey will be like until we get some more results.
We were referred to her BS by our gynecologist -- the BS came highly recommended but we have not been impressed with her. She does not have attention to detail, does not explain things fully, and actually missed some details by not reading the pathology report carefully enough -- in short, we are not going to go forward with her. We have an appointment with her on Weds to get the results of an MRI she ordered to see whether there is possible lymph node involvement. I am not sure whether to discuss our concerns at that time or not? She is affiliated with Baptist Hospital but is part of a small practice of three surgeons. I imagine if we tell her our concerns she will just refer us to another doc in her practice which is not our ideal.
At any rate I feel like now we have to start from scratch and find another BS. I have scheduled a second opinion with a doc from Vanderbilt Breast Center (we live in Nashville) who looks excellent. However I am not sure if he will automatically accept her as a patient just because we scheduled a second opinion with him? I imagine if he does not have availability he would refer us to one of the other surgeons at the Vanderbilt Breast Center and I am sure they are all very good, although I am worried about getting a very young doc since Vandy is a teaching hospital. I know that Vanderbilt-Ingram is an NCI designated cancer center so I imagine that the Vanderbilt Breast Center is NCI as well but am not sure... I can paste in links to his profile or either of the centers if that helps.
Any ideas or advice? Thanks in advance.
Comments
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If you look at the information for Vanderbilt-Ingram it lists the Vanderbilt Breast Center as affiliated. I would imagine all the same certifications apply. Unless the second opinion surgeon was booked specifically as a second opinion I don't think they would give you an appointment unless they were willing to take you on as a patient. Most surgeons have availability - it is more of a question of how long is efficacious to wait, and how long until this surgeon has an opening in the OR schedule. Also important to note - if doing simultaneous reconstruction (or beginning it) you will need to coordinate with a plastic surgeon, so that is another consult, and a coordination of schedules between both doctors. If you are having surgery at a teaching facility you need to be prepared for residents to be in the OR and potentially participating in the surgery, even if your surgeon is the one "doing" the surgery, this is pretty common. If you are unwilling to agree you need to specify this from the outset.
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Hi Special,
Yes we will definitely specify from the outset that we want "no kids" doing hands-on work (my apologies to any residents or interns out there). An interesting book to read is Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande -- basically explains how surgeons pretty much learn on the job and consistently have to practice on real live people to get better at what they do. Kind of scary.
The appointment with the Vanderbilt BS was specifically scheduled as a second opinion which is why I am not sure if he will be able to take us... but surely they can't say no to a new patient right? And surely all of the surgeons there are good? -
I suggest the NCI for sure. I went to one that was also a teaching hospital. The one thing I did find beneficial about having residents and the surgical oncology fellow was every time I went to see my surgeon, I would first see the resident or fellow. They would review everything with me and allow me to ask questions. Then the surgeon would come in and review everything with me and allow me to ask questions. I found between meeting with both of them each time it provided a lot more information.
I am sure Vanderbilt has some excellent surgeons through the breast center. Try to find one that specializes just in breast surgery - not every type of surgery. Good luck!
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Hi Laurawarrior
I also suggest going to the website healthgrades and putting in your information on hospitals and physicians. Interesting info and ratings from patients. Sorry you had to join us but we will answer questions if we can -
LauraWarrior - how is anyone ever to get experience if they never get 'hands on' under supervision? I had an anesthology student for my MX but the anestheologost was right there. Last Jan, whenI had surgery on my wrist, there were students brought in (with my approval) to be instructed/learn about the nerve block being done.
I do understand we ALL want the BEST! The 'best' of today were once the "kids" with "no hands on". Also some of the so called 'best' of today afe just skating on whag ghey once could do.
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I also went to a teaching hospital, in the paper work they gave me to sign, you agree to have the residents operate on you. So I crossed off each line and initialed so the could not operate on me. I also discussed this with my doctor prior. I understand they need to practice I just did not want them practicng on me. -
Deciding to be a "teaching" patient or not is a personal decision.
One caveat-If you are in one of the larger places some of the MDs are in fellowship programs to specialize in the area of medicine/surgery or whatever. Fellows are done with medical school and residency but doing "more".
If you are not comfortable its best to opt out because that way if you have anything unexpected happen you won't be thinking its attributed to the teaching aspects of having medical students an residents. Do know however that in the middle of the night if you have an issue it will more than likely be a resident who responds at least initially. Many hospitals have MDs called "hospitalists" but surgical issues are not their specialty unless they are surgeons who are on-call for hospital patients- somewhat rare but can be found.
There are plenty of us out there who are perfectly okay letting them gain experience so its not a "must" for anyone who is not okay with it. -
Thank you all for the thoughtful replies. Kicks, you are absolutely right and I should not have been so cavalier referring to interns and residents as kids.... I think that for us I would rather have an experienced surgeon operating because like wyo said you don't want to be second-guessing yourself down the road if something were to happen.
Hugs
Laura
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