How do I know I have the best doctors

cabbott said:

Hospital Rules
Duke is a wonderful facility. (I say that even though I'm a Tarheel and they were our arch rivals!) You can check with the surgeon you talk to about what the rules are on who does the surgery: the surgeon or the interns. At the teaching hospital I went to where I now live, the surgeon was required to do all surgery. Interns and residents were present during my operations and often accompanied the surgeon during hospital visits. They never showed up for office visits before or after the surgery. Also, I was asked if I minded them coming in when they followed the surgeon around for "rounds". I didn't. It seemed like the least I could do to help them with their education when their hospital had helped me with cancer. Sometimes students are allowed to do non-operating procedures like monitor your pulse and such, but hospitals don't like to take risks with their patients. It's too expensive! Insurance companies frown on that sort of thing too according to my breast surgeon.

You can also consider what operations you are having. I was in a small town where the general surgeon was fairly skilled at lumpectomies, competent at mastectomies though he only did about 12 to 15 a year, and had little to almost no practice at sentinel node operations. I read up on lymphadema that often results from the standard node dissection and didn't need much convincing to go with the teaching hospital breast surgeon who did 14 to 20 sentinel node operations a week as well as several mastectomies a month when I had to have a mastectomy and nodes checked. I knew going in that my kind of cancer was non-aggressive but had to have a mastectomy because the cancer was in 2 spots and I was too small for two lumpectomies. Another thing that convinced me to go to the breast surgeon was that he called for a simple mastectomy and the first surgeon wanted to do a modified radical mastectomy. More doesn't make it better when it isn't necessary and I had very tiny spots. I checked with Susan Love's the Breast Book a lot and it looked like a simple mastectomy made sense to me even before the breast specialist gave me his opinion that that was all that was necessary. That was back in 2002 and so far I'm still doing well. Now maybe that same general surgeon I saw first could do a sentinel node operation. And maybe the modified radical would have been okay. Who knows? But I have read that the guys who do the most of any given operation tend to get the best results, so I bet I would still be better off with the breast specialist. So ask for the stats on the surgeons you see or search their website for the information. They keep records just like ball players and often post them for the public, especially if they are proud of their work.

So look for track records, training, their recommendations and how they fit with current gold standard practice, and finally how the doctors relate to you. Good luck!