Depending on your specific breast cancer diagnosis, you will probably see three types of cancer doctors: a surgical oncologist, a medical oncologist, and a radiation oncologist. The surgeon will do the biopsy that provides your original diagnosis and later either a lumpectomy or mastectomy. The medical oncologist administers chemotherapy and other drugs to kill the cancer and prevent its recurrence. The radiation oncologist does radiotherapy designed to kill even more cancer cells, usually after surgery.
How can you find the best doctors to save your life? Often patients find themselves in a medical referral pipeline without their preferences being consulted. In most cases your primary care doctor or the mammography clinic sent you to a general surgeon who did the biopsy that confirmed the diagnosis of breast cancer. That doctor refers you to another, usually in the same group practice or hospital system.
And suddenly you are in the pipeline! You don’t need to stay there, however, unless you want to. Once you have a minute to catch your breath, you need to ask yourself some questions about the kind of medical care you want.
What are your most important criteria for your ideal medical team?
Do you plan to work during treatment? If so, a local doctor in an office convenient to your home or workplace may be a priority. Are you willing to travel to a distant city to participate in a clinical trial or see a top medical researcher working on your type of breast cancer?
Is it important for you to have a doctor who is a good listener and who will answer lots of detailed questions? A doctor who will be willing to explain the treatment choices, and perhaps modify them because of your preferences and values? Would you prefer a doctor who tells you the best treatment plan without going into lots of details? A doctor you can trust to give you good advice without much input from you? Maybe you don’t care about bedside manner as long as you have the doctor with a great reputation for results.
Depending on where you live and the list of specialists in your insurance plan, you may not be able to find your ideal doctor, but thinking about what you want will give you a good start on find the right physician for you.
Compose a sentence or two that describes the doctor you want. You will need that sentence later!
Check your insurance
You probably have been given a list of doctors who are “in network” for you. Call your insurance company and make sure you understand all the limitations on which hospitals and doctors you can see. Sometimes a doctor will be on the list, but not all of the hospitals he or she uses are. Ask the insurance company what is required to see a specialist “out of network.” This information is especially important if you have an unusual form of cancer or if your cancer has advanced. In these cases, getting treatment at a comprehensive cancer center or from a specialist in your sub-type of cancer is more important, and you need to understand exactly what kind of paperwork will be necessary to submit.
Ask people for recommendations
Your friends and family may have ideas about good doctors. Doctors develop reputations that become established gospel. When people tell you about a doctor, ask some probing questions. What is it the person likes about this doctor? It may be that the very thing that turned off your friend is what would appeal to you. I have a friend who went to the same comprehensive cancer center for a second opinion where I went. We both saw the same doctor, but we have diametrically opposing views of him. I found his matter-of-fact analysis of my situation helpful. She found the same approach cold.
I have found nurses often have the inside scoop on doctors. They hear the scuttlebutt on doctors’ bedside manner and competence. They usually won’t badmouth a doctor. However, you may get good suggestions if you explain the kind of doctor you are looking for and say, “Do you know a doctor who would be a good fit for me?”
Enlist the help of the office staff. When you call a group practice or talk to the referral clerk about your next appointment, pull out that one-sentence description of your ideal doctor and ask which doctor in the practice sounds right for you. Again, people in a medical practice won’t put down doctors, but whether it’s using this method or just coincidence, I have been much happier with new doctors since I started using it.
Use “find a doctor” tools on the internet. My local hospital has a drop-down menu for finding medical specialists. You could use a general search engine, but you may get all kinds of ads for people with dubious qualifications. People review doctors these days just like they review restaurants and hotels, and you will probably find these ratings to be all over the map and not very useful. People don’t usually rate a doctor in public unless they have very strong positive or negative feelings, and you have no way of knowing what personal bias lies behind their rating.
Check out credentials
More important than convenience or bedside manner, is your doctor’s competence. You want a doctor in good standing with the appropriate professional organizations. For oncologists, that is the American Society of Clinical Oncology (ASCO). ASCO has a site for patients that includes a feature for finding an oncologist who is board-certified in oncology. You can use filters to find a doctor in your area within many different specialties. You can specify whether you prefer a male or female doctor, and even search for doctors who speak particular languages.
You can find a radiation oncologist by location and specialty on RTAnswers, the patient website of the American Society for Radiation Oncology, and then check if that specialist is certified by the American Board of Radiology at their website. The American College of Surgeons has a website page for finding certified cancer hospitals and surgeons. The National Cancer Institute has a page to find a comprehensive cancer center near you.
You can also find out more about the doctors you are considering on their office or hospital website. Almost all medical practices now list information about where their physicians went to school and their board certifications.
Trusting your primary care doctor’s recommendation for cancer specialists often works just fine, but don’t hesitate to be more proactive if that’s your way of coping with cancer. Also remember that the physician works for you. If after all your careful searching, you find that you want to make a change, you can. If your cancer progresses or other circumstances in your life change, you may need to change hospitals or doctors. Remember that you are ultimately in charge of your health and your medical team.
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Phyllis Johnson is an inflammatory breast cancer (IBC) survivor diagnosed in 1998. She has written about cancer for HealthCentral since 2007. She serves on the Board of Directors for the Inflammatory Breast Cancer Research Foundation, the oldest 501(3)© organization focused on research for IBC. She is a list monitor for an online support group at www.ibcsupport.org. Phyllis attends conferences such as the National Breast Cancer Coalition’s Project LEAD® Institute. She tweets at @mrsphjohnson.