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Finding the Right Doctor

Posted 11/11/2016

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  That isn't quite the right title for this entry, but I thought it might make it more likely that you would read it. This is more an introduction to another wonderful essay by Susan Gubar who writes about the approaching shortage of oncologists and the increasing difficulty of finding and seeing the right doctors.

  In this chaotic world of rapidly changing medicine and health care, we know that there are growing shortages of physicians in a number of specialties. Many of us have come up against that problem when trying to find a new PCP or make an appointment with a specialist--and being told that we have to wait weeks or even months. Add the limits placed by most insurance companies, and it gets harder and harder.

  My personal experiences this week have been two. The first has been talking with an old friend who has just been diagnosed with a second breast cancer. Her surgeon and her medical oncologist from twenty years ago have both retired, and she has been having a very tough time making timely appointments with new people. The second enrolling for my own 2017 medical insurance and noting the higher costs for everything (premiums and co-pays and co-insurances and deductibles) as well as the squeezing limits on choices.

  Here is Ms. Gubar:

A Shortage of Oncologists
Living With Cancer

In the crucible of cancer treatment, the bonding of patients with physicians often makes the unendurable
endurable. The difficulty of finding and then keeping the right oncologist can therefore be fraught. Yet this
problem, not uncommon today, is on track to grow worse.
“My doctor is terribly overworked and isolated,” my friend Lucy said recently to the other members of our
cancer support group. She worried that her doctor, the only gynecologic oncologist left at Indiana University’s
Simon Cancer Center, would burn out. “He needs to have colleagues to help shoulder the patient load and also provide him a sense of community.”
Women with ovarian cancer are told repeatedly that we must find a specialist. Yet in many areas of the
country, it is impossible. There are no ovarian cancer specialists in my small town in southern Indiana. Upon
diagnosis in 2008, I was instructed to drive an hour and a half to the Simon Cancer Center in Indianapolis for
the debulking operation that would be performed by a gynecologic oncologist.
Afterward, I was told that I could choose my surgeon or one of three other specialists at my state’s premier
medical institution to oversee my chemotherapy regimen. At that time there were four experts treating patients with gynecological cancers there.

I picked a medical oncologist who specialized in ovarian cancer. When my doctor left for a position in
another city, I was in a Phase I clinical trial, as I am now. I was assigned to the principal investigator of that trial, who happened to be a breast cancer specialist. It was unnerving to be enveloped in pink — cover-ups, forms, you name it — and told by staff members, who mistakenly assumed I was there for breast exams, to undress from the waist up. Yet her research had extended my life. After that doctor also departed, I was given to another breast cancer physician who has promised to examine my breasts only once a year.

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