Doctor changes

Things change in the medical field. Some are good. Better techniques. Quicker recovery. Good diagnostic tool.s

Some not so good. Targets to meet. Lots of paperwork. Efficiency doesn’t allow time.

Yesterday I had the last office visit of my annual cancer checkup routine for this year. I already knew the mammogram was clear so there wasn’t anything to anticipate except meeting my new doctor.

My beloved cancer surgeon retired at the beginning of this year. He was very well-known for his expertise not only in our area but in a larger multi-state area. He was a true specialist. He only handled breast cancer.

Besides his skill, he was known for his manner. He was amazing. Confronted by women and some men too who received bad news, he gave hope. He did cutting edge techniques. My therapy was new. I was the 65th person to receive it.

Most of my friends with breast cancer had him. One who was diagnosed at age 33 (she had 3 kids under 10 and had just adopted an Asian baby) bawled when he walked in. He sat down, put his arm around her and said “We’ll get through this together.”

One of my husband’s work colleagues was diagnosed with Stage 4 cancer. When he saw her test results, he cleared his calendar and operated the next day. She is still alive although she had two recurrences after that. She’s more than 20 years out from her original diagnosis. People still die from breast cancer. I lost two friends in the past 8 years.

I knew I would miss him. I also knew he would retire. He’s a surgeon. Hands get shaky. He’s my age. It’s time. What I didn’t know was how that would affect my annual checkup.

Yesterday I met his replacement. She’s nice enough. She’s young. So young. Like him, she only does breast cancer. She’s pleasant but there isn’t any old people banter. I didn’t think it would matter. Quick, efficient and matter of fact.

There were two questions to ask. She answered although she didn’t agree with one of my assessments. However, she didn’t ask me questions to understand my point of view. No matter. It wasn’t germane to the checkup.

Just like brands, styles, music, and TV shows, change is eternal. I damn well better get used to it.

Only my primary care doctor is older (not older than me, just older). All the rest are considerably younger. Yes, there are other doctors. Everyone has a specialty!

Maybe it takes time (or an illness) to develop relationships.

Maybe the good news is that I don’t see any of them enough to develop a relationship.

Maybe I’ll chew on that.

72 thoughts on “Doctor changes

  1. I think it really is difficult to shift relationships to a new doctor. My primary doctor of more than 30 years recently retired, also. I’ve learned from many of my friends, however, that some of the strongest bonds between doctor and patient are with Cancer surgeons and survivors. I think I can understand how that relationship would develop. I hope that as you have also noted there simply won’t be any reason to need to know your new surgeon all that intimately! Sounds like a plan!

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    • Your friends are right. It’s a very vulnerable point in life. I had choices with treatment. He was reluctant to push me in either direction. I remember saying, “What would you tell your mother to do?” He answered that question. Since that was the way I was leaning I felt way more confident. My oncologist was fabulous too and I lost him to a stroke at an early age (60 is too early) several years ago. He’s the guy I could tell about my nightmares and he’d help me work them through.

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  2. I pretty convinced good “comfortable” doctors are born not trained. It’s takes a certain personality – but sadly far too many used to get into med school looking for supposed financial or parental approval. And now most docs are hospital system employees who are told 7 min. per patient (and be sure to fill out all the forms/check lists mandated by feds within 24 hrs or face reprimands.
    Our primary doc retired; his daughter took over the practice, but she doesn’t have his experience, or listening style and it seems she spends more time coding in on the computer than talking – much less listening. Sigh. Not sure it’s worth looking for a new one since we do know the family and that seems to count for something.
    Stick with the plan: take care of yourself and stay well! (But we deal with cancer checks, too. Knock on wood…)

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  3. I have had the same problem with my foot tumor doctor (orthopedic oncologist) and my gynecologist. I miss my old guys who I trusted completely. Now I don’t have that sense that I am being taken care of properly.

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  4. I hope that you’ll be able to develop a relationship over time. One of the nice things about my place in Indiana was that I got to know my main doctor as he lived just around the corner. I hadn’t had that sort of relationship with a doctor in a long time, and who knows if I will ever have it again.

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  5. I am glad all is well with your health, Kate. It’s tough to deal with the fact that the Doctors we love for being competent and compassionate retire or leave their practice. I had been seeing a surgeon every year since 1987 for breast cysts and he did 4 biopsies. He retired two years ago. I don’t have the words to say how much I miss him. I have another Dr. that cut me loose because they won’t take medicare. Lost two other of my Docs to “just fed up with it all”… 😦 We do have a wonderful GP!

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    • MY GP is great too. He’s kind and patient. He knows what is covered under Medicare and what isn’t. There are no surprises. However he refers off specialties. I suppose that’s good but you end up with different docs and some don’t know your history.

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  6. That’s a tough one..really. Your last paragraph should be the focus but you can’t change what was and that relationship and all that went with it is difficult to lose. Is there another specialist who may be older and more understanding? If you have to change anyway, why not to someone who will understand the banter.

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  7. My doctor still makes house calls. If he meets you in the supermarket and you look under the weather, he makes an appointment FOR you. If he is worried about you, he’ll always call from home in the evening to see if you’re okay. Through the years he has become more than just a doctor. He’s a friend. He and I were born just two months apart, and I know that retirement age is swiftly approaching, and the thought almost panics me. What if I get a young doctor like my brother’s who scratches her head and says things like: “I don’t know what to do about it. What do you think’s wrong?”

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  8. That’s so tough. I mean, you went through hell with your old doctor. How do you replace that experience without going through it again?

    I was really upset when my optometrist died. I can’t imagine losing your oncologist!

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    • He was my oncology surgeon. I lost my oncologist to a stroke a few years back and I was devastated. He was a unique guy. I’d come in and tell him about my dreams (which were bizarre and related to my illness). He would talk me off the ledge but at least I still had my surgeon. Fortunately I don’t need talking off the ledge anymore so I was lucky to have them. I’m with a new optometrist for about 2 years now. I like him enough but with only one visit a year there’s no connection.

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  9. I’m so glad your mammogram came back ok. Goodness, it’s tough to change doctors, especially when one so beloved steps aside. Yes, different times, different bedside mannerisms, not necessarily good. What are the rest of your friends doing, are they staying with the new doctor? Are there other breast cancer specialists around your area? New docs often don’t realize how their bedside manner is off-putting yet it really is important to have confidence in the dr, a must if you are trusting her with your life.
    Wishing you continued good health, my friend!

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  10. I wonder if having a more compassionate approach is more of a factor of personality and (maybe) training than of age. I’ve had some very impersonal doctors who were older and more empathetic doctors who were younger. Some medical schools are teaching “bedside manners” as part of their curriculum, some not so much. And, even if those skills were taught, if it isn’t part of the person’s natural way of relating to others, our modern medical system (with 5-minute appointment allotments) would probably suck every bit right out.

    I’m glad you are doing well and that you have a competent (if not warm and fuzzy) physician following your health needs. Who knows, maybe in time you’ll develop a special relationship with her too.

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    • You are right about the personality thing. Most surgeons are tech people and a lot less fuzzy than primary care docs. That’s what made him stand out. Right now I’ll settle for competent. Back when I had the diagnosis my radiologist was the most off-putting doc I had ever had, yet he was hailed as brilliant and talented. Just couldn’t relate to people. Fortunately, I didn’t need to follow up with him long after treatment.

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  12. We had to get all new doctors when we moved, and we’ve been blessed. We’re already beginning to have relationships with them. Wonder if it has anything to do with moving from New York to North Carolina???? John and I both carry lists of medications with us, and I have a very short medical history on my phone. These days you have to be prepared. That doesn’t make it fun.

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    • Better to be prepared. When I was young I moved to different states a few times. I was very healthy so changing doctors wasn’t too big a deal. After my cancer many years ago, I want to be sure everyone understands that as it may have an impact on something else. It is good to keep a history and drug list. You can tuck it in a pocket for an ambulance ride if necessary.

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  13. Hi, Kate – First and foremost, I am glad that you are well.
    On a secondary note, I TOTALLY agree with you, change is tough — especially when it comes to people we are depending our lives on! I also agree with you about different character attributes across generations. Two of my sons are Millennials, two are Gen X, I’m a Boomer and my husband is on the cusp of Boomer/Traditionalist (leaning heavily to the Traditionalist). Although you can’t paint everyone with the same brush, I find that charts like this (http://www.wmfc.org/uploads/GenerationalDifferencesChart.pdf) are helpful. At least I find it true in my immediate family!

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    • I’ve seen this in the work place. It’s helpful in understanding although nothing eases the change except the acceptance and changing expectations. Your family is very diverse! As a boomer I grew up with the revolution of the 60s-70s. I sometimes worry about the sheltered kids with tons of meaningless trophies. Everyone finds themselves eventually but we all have a different outlook.

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  14. I worked for a group of internists for 18 years and then a husband and wife ophthalmologist team for another 6. I definitely noticed a change in the internist group when we added some doctors toward the end of my stay there. They would come out and count the number of patients they had that day and compare it to other doctors on the shift. It was a pay by the numbers game. The older doctors on staff still had that same compassion – but we weren’t computer based at that time, we still had the old paper charts. When the husband and wife team saw the increase in insurance burdens, instead of giving up on compassion, they retired.

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    • It’s a tougher professional in many ways. The tools are better but the paperwork is worse. My vet talked about the requirements that have increased their workload, ending in higher costs. This doc who retired had an independent practice when I started with him. Now the big health networks own all the doc practices and there are performance standards. I’m not sure what all that means but it has it’s affect.

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  15. I hear you, Kate. My oncologist and primary care doctors both retired several years ago. The surgeon who handled three of my oncology surgeries moved to another practice. I especially missed the personal relationship that had developed with both my oncologist and primary care doctors, which spanned several years of working with them through some very scary times. They knew the names of my children. They asked about my Mom. And my oncologist? He would invite you into his office for a “pep-talk” chat if you were feeling particularly vulnerable.

    That level of care seems to be a thing of the past. Now it’s about lots of waiting, then seeing someone that knows nothing about you, (and is often a new face every time around). I’ve never even actually met my primary care doctor (having only met either an RN or a PA working in their office). And the forms. Ah, yes, the forms. Same information, over and over and over again.

    Even so, I am well aware that I’m more fortunate than most, in that I’m presently also under the care of the very same RN that helped me through my mother’s declining health and ultimately, her death (in 2009). To have that sort of personal rapport with a medical professional just makes everything more comfortable and less frightening. I jokingly tell my siblings that my mother personally made sure this RN crossed paths with me again. In part I’m teasing, but the truth is, I often offer up a prayer of thanks (to my Mom, and to anyone else up there that’s listening) for bringing this sweet woman back into my life. We smile and chat, and hug, and often speak of my mother, who I still miss so much, even after all these years.

    Sorry to hear that your situation has transitioned to such a clinical baseline of care. Sufficient and competent are both good, but without that personal connection layer also thrown into the mix, it’s hard to have any enthusiasm for those necessary interactions with caregivers. I am, however, very happy to hear that you are still doing well, medically speaking. Many more years of that, please! 🙂

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    • You have said it all perfectly! My PC doc is maybe 60-ish so I have this worry that he will retire soon too. He takes time. My annual exam may take close to a whole hour as he visits new concerns and revisits old one. I think it’s time well spent. I rarely see him more than once more during the year so I keep a running list of minor concerns or questions. He is a great help in advice and referrals too.

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  16. My experience has been that younger docs aren’t in it for the relationships. They are more problem solvers than interested in getting to know you as a person. Not a bad thing, exactly. I go with it, but realize that any visit I have now requires that I am prepared to explain myself… yet again.

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    • At least not relationships with people who are their grandparents age! It’s not a bad thing, just different. Change. As for filling out that thing yet again, maybe I should ask for a copy to complete and just take copies to all the offices. Save me time.

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      • I made my own list on the computer of all the procedures I’ve had done, with dates and locations. I take a copy of my typed list with me whenever I go to any doc in case I have to fill out any of their forms. I also keep a list of my prescription meds in my phone under each docs name so I can access that info quickly if needed. I do not expect any doctor to know anything about me any more.

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        • I have that too plus all the docs I see with their phone numbers although most times they can find them on their computer list. I get tired of filling all of it on the forms only to have no one look at it or it’s already in the system.

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    • Sometimes it doesn’t matter and sometimes it’s painful. This one was painful because I liked him and he saw me through a hard time. I missed my dentist when he retired too. Although I like the new dentist, we don’t have anything in common. I know it shouldn’t matter but it makes a difference when you get to know someone over the years.

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  17. YES! Mom and dad have talked about this. Some of the better doctors are now close to retirement age. They had the best bedside manners and compassion. It seems like they are not teaching that in medical school these days which is awful! I hope you find someone that you can connect one. It’s so important!! Hogs and snout kisses my friend. XOXO – Bacon

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  18. My doctors have to spend so much time typing info into their computers during the exam that there’s no time for personal interaction. And even though they have my paper records for the last 20 years, if it isn’t in the computer (and nothing past the last few years is) they can’t access anything. Hate it all.

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    • In the past year I’ve been to three different doctors in the same large network with the same database. Each time I am given a 3 page, small print check off list of all my systems including all surgeries (I had a few going back to tonsils when I was a kid). The doc never looks at it and I wonder why I complete it. This last time I finished it after my appointment. Next time I get it I’m going to complain. Maybe they can explain why I keep filling it out over and over.

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    • You are so right. There is a connection. I had a new doc earlier this year. He could have been my grandson. He was very good. Not overly friendly but intuitive and caring. At the end of the visits (took 3 to figure out nothing was wrong) I apologized for not waiting out the symptoms and he said, “No you did the right thing. Some people sit on these things for 6 months and you find advanced cancer.” He was a specialist. If I had an issue with that body part again, I’d seek him out.

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  19. It’s so difficult to find a doctor we feel comfortable with and one we trust. I had a wonderful gastro doctor who retired and then my awesome primary care doctor jumped ship. My new gastro guy is great, but I’m still searching for the primary care replacement.

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    • I have yet to find a gastro that I connect with. My PC is good though. On my next visit I’ll see if he can recommend. The gastro I use is part of the biggest game in town. There is a really good PA there though. I try to get her.

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  20. I think they are teaching compassion out of the practice now. It’s all about moving us through like cattle. I sit in my back doctors office for 2 hours, just to see him for 2 minutes while he rattles off a couple questions and ends with |I’ll see you in 3 months then”. You can almost hear a cha-ching sound.
    I hope your new doctor softens some as time goes on, even better I hope you don’t even have to see her.

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  21. The difference between a doctor that is actually present with you and listens and the doctor who is efficiently getting points checked off on their tablet is HUGE.

    My primary care doc just quit. I assumed he just went to another practice and so I googled him. Nope. Went to teach art at the University. Left practice ENTIRELY. Finding that out made me feel like the field is culling the ones who try to be humans.

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