How to Choose a Doctor and a Hospital
After you receive your initial cancer diagnosis, you may need to choose an oncologist to treat your cancer. The following tips can help you decide how to pick your oncologist.
Your health insurance may limit your choices. Even if your insurance allows you to pick an out-of-network doctor, cancer treatment is expensive enough that the higher co-pays may not be affordable.
Ask other doctors, such as your primary care physician, for their recommendations.
Ask other cancer patients for their recommendations.
Also ask for the names of the best oncology nurses. The oncology nurse will be responsible for your day-to-day care.
When you have a list of possible doctors, identify the hospitals where they have privileges. The best doctors will have offices inside or adjacent to a major hospital. This will let you get your care at a single location, instead of driving all over town.
US News & World Report publishes an annual guide to the best hospitals for cancer.
If you expect to be hospitalized for more than a few days, you may want to pick a hospital that has a dedicated oncology ward and nicer rooms. Oncology wards provide better care for cancer patients and are better at giving you your antinausea medication on-time. A hospital that is convenient to family and friends may also be a consideration.
If you have to have surgery to remove the tumor, laparoscopic surgery is generally better than open surgery because it will take you less time to heal. If the surgery is exploratory in nature (e.g., examining lymph nodes), open surgery may be better.
Regardless of the type of surgery, you want to use a surgeon who has considerable experience with the specific procedure you will be undergoing (e.g., at least 50 past surgeries, with more than 100 preferred).
Note that expertise with one type of laparoscopic surgeries does not generally transfer to a different type of laparoscopic procedure, so the surgeon should have sufficient experience with the specific procedure you will be undergoing. It usually takes at least 25-35 surgeries before a surgeon becomes proficient at a particular minimal access procedure, although this number can vary by procedure (e.g., lap-cholecystectomy takes only 15-20).
A complication rate of 2% to 3% on a laparoscopic procedure is normal for an experienced surgeon. The expected length of the surgery is another indication of experience; 2-3 hours is indicative of an experience surgeon, while 4-6 means the surgeon has less experience. (These figures can vary with the procedure, as certain types of laparoscopic procedures are inherently more difficult.)
You may have to talk to several different types of oncologists, depending on the type of treatment. A radiation oncologist specializes in radiation therapy, while a medical oncologist specializes in chemotherapy, hormone therapy, and surveillance. Each type of oncologist will have their own biases.
Copyright © 2005-2009 by Mark Kantrowitz. All rights reserved.
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