Choosing between a local hospital and a cancer center

Helen321
Helen321 Member Posts: 1,434 Member
I realize I am very lucky to have this option. My insurance company added Sloan Kettering, a cancer hospital this past January as an in network provider and so I won't have to pay 50% of the hospital bill if I choose them. Except copays, it will be free. It's about an hour and a half from my house.

My current surgeon is a reputable surgeon with 23 years experience working at a local hospital with a fairly large cancer departement. Sloan is very slow in getting appointments and it took me over a month just to get the tests required before they would even see me. Now I have to wait until the 18th for the initial appt. and I have to have the surgery by July 3 to avoid a 5 day penalty by my disability insurance. I would lose 5 days pay which I simply can't afford. I've already lost 7 days pay so far.

My family is angry that I am even considering the local hospital for this surgery (which is Northshore of Long Island, which has an excellent reputation). Several people have gone as far as to say I'm sorry but you are just being stupid. That the first surgery didn't work and now I'm willing to go back to the same surgeon. The surgeon did warn me that the surgery only works 90% of the time. It's also 90% of the time at Sloan so how is that logical? The same thing could have happened at Sloan.

My sister feels by not choosing Sloan I'm gambling with my life. She says I'm putting money before my health. I am still 100% going for my second opinion at Sloan but then I want to the do the surgery locally. If Sloan recommends any treatment other than surgery, I'd 100% go to Sloan. Putting money aside, does anyone have a strong opinion about going local versus waiting for a cancer hospital?
«1

Comments

  • Momof2plusteentwins
    Momof2plusteentwins Member Posts: 508
    I am going to local hospital
    Helen -
    I think you have to feel comfortable with the surgeon. Things happen at every hospital and just because you are at Sloan doesn't mean things can't go wrong. If you feel comfortable where you are you should stay there.
    Good luck, my surgery is the 19th also.
    Sandy
  • abrub
    abrub Member Posts: 2,174 Member
    If there are any oddities or
    If there are any oddities or special consideration, go with a Cancer Center, where they can deal better with any "curves" thrown at them.

    Yes, I'm very pro-MSK. I go there, and it's a 4 hour drive for me. My surgeon there was able to resect my colon in 3 places, and put the pieces back together so that everything works perfectly. Being treated by colorectal surgical specialists (and colorectal oncologists) has definite advantages.

    That being said, colon cancer is common enough that you can get excellent care for "standard" cases elsewhere. It's a tough decision. See what they say at MSK; they might even be able to get you in for surgery quickly.

    Good luck,
    Alice
  • dmj101
    dmj101 Member Posts: 527
    New Jersey can Relate
    I can totally relate to your dilemma,
    I live in Jersey and everyone wonders why I am not going to Sloan and choosing a local hospital..
    Well.. at my local hospital all my docters were trained at Sloan or put in many many years there.
    My surgeon are all NY surgeons.. just working in Jersey now as they discover the suburbs are a nice place to live.
    I believe I am getting the same treatment I would be getting at Sloan but less than 1 hr+ away..
    It is a hard decission to make. isn't it..
    We have to go with our gut and not regret our choice..
    Prayers and Huggs for successful surgery.
  • PhillieG
    PhillieG Member Posts: 4,866
    Sloan
    I was fortunate to be able to have surgery at SK. I had been having consultation with them (SK) but going to a NJ hospital that was in network. They were good, I've found Sloan to be better. My insurance situation changed so I was able to do everything at SK

    I've also found them to be fairly easy to work with. Have you explained your situation to them and the deadline (Opps! Bad choice of words...Time constraints) with having surgery?

    I don't know if I'd say you were gambling with your life, but they are the best (IMO) and what you do first makes a huge difference. That being said, screwups can happen anywhere at anytime and there are no guarantees but even if I'd miss a weeks pay (which I DON'T have $$$ to spare) I'd go to SK for peace of mind.

    BTW: I'm 50 miles North of NYC and don't mind heading into the city every other week.
    Hell, I'm worth it!
    Good luck
    -phil
  • neons356
    neons356 Member Posts: 57
    I chose local
    I live in an area where several large teaching institutions and many local hospitals were available to me. The cancer docs and surgeons at my local hospital are top notch, I trusted them explicitly, and got the best of treatment and care. All treatment basically follows the same protocol wherever you go. I personally feel that the local hospital gives a higher quality of care. In the bigger places you tend to get lost in the crowd. In my case I went thru 4 years of blockages and other problems, and I was 20 minutes away from getting help when it was needed. The staff knew me, understood my case, and started me on whatever treatment was necessary without any wait. So if you trust your care team at the local hospital I'd go with that.
    Carl
  • Helen321
    Helen321 Member Posts: 1,434 Member
    PhillieG said:

    Sloan
    I was fortunate to be able to have surgery at SK. I had been having consultation with them (SK) but going to a NJ hospital that was in network. They were good, I've found Sloan to be better. My insurance situation changed so I was able to do everything at SK

    I've also found them to be fairly easy to work with. Have you explained your situation to them and the deadline (Opps! Bad choice of words...Time constraints) with having surgery?

    I don't know if I'd say you were gambling with your life, but they are the best (IMO) and what you do first makes a huge difference. That being said, screwups can happen anywhere at anytime and there are no guarantees but even if I'd miss a weeks pay (which I DON'T have $$$ to spare) I'd go to SK for peace of mind.

    BTW: I'm 50 miles North of NYC and don't mind heading into the city every other week.
    Hell, I'm worth it!
    Good luck
    -phil

    Good play on wording.
    Good play on wording. That's what my sister said Phil. It's a hard one because my job won't split the pay among more than two paychecks, so this month I lost 7 days pay in just two checks. Then I'd lose another 5 in July which they will only take out of one check, not even two because they only do that when it's unexpected and this one would be expected. Add the copays that I didn't budget for this year for me and the kids and I'm screwed. I wish I had gone to Sloan to begin with but my cousin who is a nurse said a surgeon is surgeon (he's a colorectal oncology specialist) and that time was of the essence. She was wrong. I had time. I would have been registered. Once I did the surgery somewhere else, sloan wouldn't touch me until I had all my follow up tests completed which took time. I explained the situation to Sloan but the doctors are completely booked. I'm going to try to call each day and see if anyone cancels and if I can fill the slot. If you don't mind me asking, who do you see at SK. I'm being assigned to Jose Guilleme. I can switch to Weiser but I wasn't able to find enough info on him.
  • Helen321
    Helen321 Member Posts: 1,434 Member
    neons356 said:

    I chose local
    I live in an area where several large teaching institutions and many local hospitals were available to me. The cancer docs and surgeons at my local hospital are top notch, I trusted them explicitly, and got the best of treatment and care. All treatment basically follows the same protocol wherever you go. I personally feel that the local hospital gives a higher quality of care. In the bigger places you tend to get lost in the crowd. In my case I went thru 4 years of blockages and other problems, and I was 20 minutes away from getting help when it was needed. The staff knew me, understood my case, and started me on whatever treatment was necessary without any wait. So if you trust your care team at the local hospital I'd go with that.
    Carl

    Thanks Carl. I thought that
    Thanks Carl. I thought that since this surgery is very routine.
  • geotina
    geotina Member Posts: 2,111
    Dear Helen:
    Trust your gut. This is your cancer, your treatment and your decision. We live in Michigan and are only about 20-30 minutes from the University of Michigan and the Karmanos Cancer Institute. Both outstanding. George is not being treated at either one. He is being treated at Oakwood Hospital in Dearborn, MI. Our board certified colorectal surgeon was excellent. Out oncologist is outstanding and named one of the top 10 docs in oncology in Michigan. We have received excellent care. To be honest I wanted George to go to Karmanos or U of M but he said he felt very comfortable where he was so that is where we stayed.

    Family does try to be helpful because they care and if they are butting in a little too much and making you uncomfortable give them a hug and thank them for their concern and gently ask for the subject to be changed.

    Bigger is not always better. Go with whatever makes you comfortable and with docs that you are comfortable with.

    Take care - Tina
  • omrhill
    omrhill Member Posts: 125
    This is tough and i have
    This is tough and i have considered the same issues. In the end it came down to going with my instinct. I started at a local hospital and immediately trusted my oncologist, surgeon,and radiologist. I feel like i am receiving individual attention and ive done enough research (and read lots of stories here) to know that my treatment is following standard protocols. The other thing that helped was that each of my doctors told me not to be afraid to tell them if i wanted to seek a second opninion. I do wonder if i might be missing on cutting edge treatments or experimental options that may not be available outside a cancer center. But i keep coming back to my instinct and comfort level. Ive got the numbers for the cancer center in case i change but right now im happy. Not sure if this helps, just know that youre not alone in these doubts. Just something else we get to worry about!
  • abrub
    abrub Member Posts: 2,174 Member
    Helen321 said:

    Good play on wording.
    Good play on wording. That's what my sister said Phil. It's a hard one because my job won't split the pay among more than two paychecks, so this month I lost 7 days pay in just two checks. Then I'd lose another 5 in July which they will only take out of one check, not even two because they only do that when it's unexpected and this one would be expected. Add the copays that I didn't budget for this year for me and the kids and I'm screwed. I wish I had gone to Sloan to begin with but my cousin who is a nurse said a surgeon is surgeon (he's a colorectal oncology specialist) and that time was of the essence. She was wrong. I had time. I would have been registered. Once I did the surgery somewhere else, sloan wouldn't touch me until I had all my follow up tests completed which took time. I explained the situation to Sloan but the doctors are completely booked. I'm going to try to call each day and see if anyone cancels and if I can fill the slot. If you don't mind me asking, who do you see at SK. I'm being assigned to Jose Guilleme. I can switch to Weiser but I wasn't able to find enough info on him.

    Guillem has a superb rep
    I have a friend who went to him, and is doing very well. I know he's excellent.

    My MSK surgeon is Philip Paty, and I'm in love with him (don't tell my husband!)

    I've gotten mixed feedback on Weiser - some people adore him, another friend of mine wasn't thrilled with him. However, none of the drs is without his detractors, so that really doesn't mean much.
  • steveandnat
    steveandnat Member Posts: 886
    local if you feel comfortable
    I would choose local for the most part. If the local center is good then sometimes the convience of travel is worth it. If things get to complex then maybe another center would make sense. You are fortunate with your insurance paying for either. Jeff
  • steveandnat
    steveandnat Member Posts: 886
    local if you feel comfortable
    I would choose local for the most part. If the local center is good then sometimes the convience of travel is worth it. If things get to complex then maybe another center would make sense. You are fortunate with your insurance paying for either. Jeff
  • steveandnat
    steveandnat Member Posts: 886
    local if you feel comfortable
    I would choose local for the most part. If the local center is good then sometimes the convience of travel is worth it. If things get to complex then maybe another center would make sense. You are fortunate with your insurance paying for either. Jeff
  • herdizziness
    herdizziness Member Posts: 3,624
    Choices
    When it came to my surgery, I wanted it done at the big boys hospital and not the local. That's why I was happy my oncologist although affiliated with the local hospital and surgeons in our small town actually referred me to Stanford. The local surgeons wouldn't touch me anyway, so I was stuck with Stanford if I wanted the surgery. I like the fact at the big hospital with a large cancer center that all the surgeons only work in their department. My liver surgeon, only does cancer liver surgery, my colon surgeon only does colon cancer surgeries and the same with my urologist surgeon, each one has their own specialty and that gave me a lot of confidence in the surgery. While I like my little hospital for chemotherapy, and they sure did a great job putting a stent in and keeping my life going. But when it comes to my cancer surgery, I felt and still feel better about everyone having their specialty in surgeries.
    Just my thoughts,
    Winter Marie
  • Kenny H.
    Kenny H. Member Posts: 502

    Choices
    When it came to my surgery, I wanted it done at the big boys hospital and not the local. That's why I was happy my oncologist although affiliated with the local hospital and surgeons in our small town actually referred me to Stanford. The local surgeons wouldn't touch me anyway, so I was stuck with Stanford if I wanted the surgery. I like the fact at the big hospital with a large cancer center that all the surgeons only work in their department. My liver surgeon, only does cancer liver surgery, my colon surgeon only does colon cancer surgeries and the same with my urologist surgeon, each one has their own specialty and that gave me a lot of confidence in the surgery. While I like my little hospital for chemotherapy, and they sure did a great job putting a stent in and keeping my life going. But when it comes to my cancer surgery, I felt and still feel better about everyone having their specialty in surgeries.
    Just my thoughts,
    Winter Marie

    Had my perm colostomy done
    Had my perm colostomy done local & surgeon did a fine job, no problems.
    Now mets to lungs have been getting 2nd opinion work done at MD Anderson and they will be doing both surgeries there since they are so far advanced on this type of surgery compared to local team here. Fortunate not to far a drive from here for us & ins paying 100% as have met out of pocket ded expense.
  • PhillieG
    PhillieG Member Posts: 4,866
    Helen321 said:

    Good play on wording.
    Good play on wording. That's what my sister said Phil. It's a hard one because my job won't split the pay among more than two paychecks, so this month I lost 7 days pay in just two checks. Then I'd lose another 5 in July which they will only take out of one check, not even two because they only do that when it's unexpected and this one would be expected. Add the copays that I didn't budget for this year for me and the kids and I'm screwed. I wish I had gone to Sloan to begin with but my cousin who is a nurse said a surgeon is surgeon (he's a colorectal oncology specialist) and that time was of the essence. She was wrong. I had time. I would have been registered. Once I did the surgery somewhere else, sloan wouldn't touch me until I had all my follow up tests completed which took time. I explained the situation to Sloan but the doctors are completely booked. I'm going to try to call each day and see if anyone cancels and if I can fill the slot. If you don't mind me asking, who do you see at SK. I'm being assigned to Jose Guilleme. I can switch to Weiser but I wasn't able to find enough info on him.

    Sloan
    My surgeon was Dr (Bud) Weiser < sorry, can't help it >. I liked him. My colon wasn't a real big issue though. My bigger concern was my liver, I had Dr Jarnigan for that part and the HAI pump installation. Dr Nancy Kemeny is my oncologist. I haven't see Dr's Weiser or Jarnigan since Sept 2004 with the exception of running into Dr Jarnigan a few times in the main hospital. He did remember me too.

    Your health comes first, you can't make money to pay bills if you're not around!
    best of luck to you.
    -phil
  • Helen321
    Helen321 Member Posts: 1,434 Member

    Choices
    When it came to my surgery, I wanted it done at the big boys hospital and not the local. That's why I was happy my oncologist although affiliated with the local hospital and surgeons in our small town actually referred me to Stanford. The local surgeons wouldn't touch me anyway, so I was stuck with Stanford if I wanted the surgery. I like the fact at the big hospital with a large cancer center that all the surgeons only work in their department. My liver surgeon, only does cancer liver surgery, my colon surgeon only does colon cancer surgeries and the same with my urologist surgeon, each one has their own specialty and that gave me a lot of confidence in the surgery. While I like my little hospital for chemotherapy, and they sure did a great job putting a stent in and keeping my life going. But when it comes to my cancer surgery, I felt and still feel better about everyone having their specialty in surgeries.
    Just my thoughts,
    Winter Marie

    Yes that's it. My original
    Yes that's it. My original surgeon is also a colorectal specialist. That's all he does. He works in the cancer department (which is semi large). I wish there was a way to look up people's track records.
  • Helen321
    Helen321 Member Posts: 1,434 Member
    Kenny H. said:

    Had my perm colostomy done
    Had my perm colostomy done local & surgeon did a fine job, no problems.
    Now mets to lungs have been getting 2nd opinion work done at MD Anderson and they will be doing both surgeries there since they are so far advanced on this type of surgery compared to local team here. Fortunate not to far a drive from here for us & ins paying 100% as have met out of pocket ded expense.

    So glad your insurance is
    So glad your insurance is covering 100% at this point! One less thing to think about!
  • PhillieG
    PhillieG Member Posts: 4,866
    Helen321 said:

    Yes that's it. My original
    Yes that's it. My original surgeon is also a colorectal specialist. That's all he does. He works in the cancer department (which is semi large). I wish there was a way to look up people's track records.

    Track Records
    They should start Oncology Trading Cards that could be similar to baseball cards with the oncologists "stats" on them.
    How many No-Hitters, Strikeouts, Walks, and most important, How many SAVES!
    ;-)
  • Kenny H.
    Kenny H. Member Posts: 502
    PhillieG said:

    Track Records
    They should start Oncology Trading Cards that could be similar to baseball cards with the oncologists "stats" on them.
    How many No-Hitters, Strikeouts, Walks, and most important, How many SAVES!
    ;-)

    Good one Phil.
    Agree 100%