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Has anyone had to transfer a parent to a different doctors office while they were on Zytiga? Is it possible to transfer to a different doctors office when a patient is on a drug like Zytiga that is so specialized, it's only administered by the doctors office? Dad's prostate cancer has progressed, it's spread to his bones, he was referred to another urology office who could administer the Zytiga. Everything is good with the office, but the doctor. I've gone with dad on appointments even before he really needed me, because he asked. Dad is intelligent but poorly educated, has always had a hard time understanding medical terminology, couldn't fill out his paperwork, says yes to everything in a doctors office, even in regard to when he's asked about symptoms. Can't pronounce prostate. Dad has a minor speech issue, born that way. I've been his caregiver for five years, he's 83, hard of hearing, has difficulty walking, we use a wheel chair. This doctor does not acknowledge me as a caregiver, does not want me to ask questions, does not talk to dad about side effects to watch out for. The doctor has one chair pulled to his desk for the patient and three chairs on the side against the wall always. I ask questions, doc gets angry, like I've inconvenienced him and I'm taking up good air in his office by being there. Doctor has been asked about walking, why doesn't he walk? Dad tells him in his way, doctor doesn't understand or listen. Yesterday dad was asked about his dentures. I said "dentures?". The man leaned up on his desk from a sitting position, put his fists on his desk, leaned over wide eyed and glared me down, took a moderate scolding/correcting stance towards me because I asked why do dentures matter with prostate cancer. My dad leaned back in his wheelchair, and in all honesty the behavior frightened me. I've noticed this doctor was extremely tense from the first appointment. I want to find another urology office closer to home, see if they can request dads medical records, schedule an appointment and see if they can get his zytiga in time without a gap in treatment. I don't want to cause conflict with the current office either, but I feel this doctor will not work well with us when dad reaches a point he needs Xofigo (Radium 223) and he's radioactive and may need to be hospitalized for that reason. We need a doctor who works well with the caregiver as this progresses. Any ideas, or similar experiences?

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Complain to the doctor's office, and ask for a meeting with this doctor and an administrator present to clear the air. You're not causing conflict, you're resolving it.

I've no idea what the doctor's issue is, but he has to accept that you are acting on your father's behalf and asking legitimate questions, and answer you as though you were your father. And you can't afford to let his arse-y attitude get in the way.

Having said that, why challenge a question? I've no idea what dentures have to do with prostate cancer either, but that doesn't mean it wasn't a perfectly good question.

I'm sorry you have this stressful matter to deal with on top of everything else, but then that's the thing to do. Get it *dealt* with, and out of your way.
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jacobsonbob Apr 2019
Let's hope the urologist the OP described becomes a patient of a proctologist having a similar attitude..
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Some of the drugs and treatments for prostate cancer can cause periodontal bone loss, which in turn can cause problems with dentures.

I hope your doctor can become more responsive. As your father’s caregiver, medical staff should be willing to answer your question. Hope this all works out for you and your dad.
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Is this guy the only doctor in the practice? Or can you find another practice where a doctor has the authority to prescribe and administer the drugs your father needs? Perhaps you could ask the local hospital if they can recommend one. Send the question in writing so you don't get stuck with just the receptionist!
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Do you have POA? If so give the office a copy for Dads files.
Did you make the doctor aware of Dads hearing loss and speech problems? Doctors like to feel the patient out. They need feed back from the patient. The best thing you can do is just sit and let the doctor do this. When you come into the office, tell the doctor who you are, daughter and caregiver. Dads problems with hearing loss, speach and that as his caregiver you have concerns. If he acts the same way, ask him why.

Are you restricted to what Urologist you can use? Medicare allows you to use any doctor you wish but Medicaid and supplimentals tend to have a network. When you call another office, ask if they take Dads insurance and handle his Meds. Is this doctor an oncologist specializing in urology that is why only he can administer that particular med?

To be honest, now his cancer is in the bone, will chemo help at all?
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Helping77 Apr 2019
I understand the need to feel out the patient but just to say as someone who has had hearing problems (deaf and hard of hearin) since birth I would have a problem if a doctor did this to my mom as eventhough they may prefer to speak directly to the patient sometimes I need my mom to answer due to misunderstandings or lack of knowledge on my part. And as for making the office aware from my experience it should be in the patient's file and is poor review on the dr part if they aren't aware or even go as far as to ignore this since I have been in situations like this before (eventhough I haven't had it at a dr thankfully) but lots of people will spit it back in your face that you are an inconvenience if you try letting them know this.
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You dare to question the High Priest of modern society? You might as well dare to question the gods themselves!

But seriously, doctors are a sad bunch. Very few care about health, wellness, and side effects. They are just drug-pushing robots.

Don't let this doctor intimidate you. Hopefully you can find a better one.
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Countrymouse Apr 2019
Reminds me of this little joke:

Q: What's the difference between God and your doctor?
A: God doesn't think He's a doctor.

But the important thing is that this is a little *joke*. I don't know how many doctors you know, but I know quite a few. They might not be surprised by your insulting remarks but they would be saddened by them, and they might well wonder why they even bother putting in the hours, the care and the concentration that they do.
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I too was wondering about the cancer being in his bone at this point. What is his prognosis?
i agree with letting the doctor know up front your dad's disabilities and letting him know you are his caregiver and (I hope) Medical POA and that you will be asking questions. Do this outside the exam room before the doctor sees him. Some doctor's love to intimidate and patronize with their God complex. But if that doesn’t work, in the meantime you have searched out other options and have a fall back.
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What is this QUACK HERE FOR? Find another DOCTOR with Better Bedside Manners...How Rude and Crude, Inexcusable!!!!xx
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Helping77 Apr 2019
Agree! I'm grateful to have had plenty of good drs in my 27 years (and it's a lot) but I have had mainly I remember 2 psychiatrists before that honestly seemed they were more interested in insulting me (one while I was in school who seemed more interested in telling me ignore everything than my emotional state. Love to know how you ignore people (boys n girls) flicking you in the forehead or other things similar and another recently who was only interested in telling me everything I do is wrong, even simple things like I need to use this specific conditioner (or even use conditioner, which I told her I do) because I have such curly/frizzy hair it's hard to get through) like that's her business because?)
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You can always change.

We even changed in the hospital when Mom was near death. I reported the less-than-compassionate (also irresponsible) care to hospital administrators and websites alike. I wasn’t worried that the doctor was the hospital’s “superstar.”

When Mom recovered, she thanked me for advocating for her. She felt protected and loved.
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gdaughter Apr 2019
so many places want the $$$. Just had a friend who observed horrendous and non-helpful care with her dad in a local nursing home hospice program. Took energy and time, but she brought her dad home with another hospice program. She was grateful she did.
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I might try to find another urologist, make an appointment as soon as possible while you still have the medication, and go over everything with the new office and new doctor once you find one. A good doctor will understand the caregiver's need to know what is going on! Is there a hospital in the area that could refer you to another urologist? What about the regular GP? My mom had a "bad" doctor and I found another and it made a big difference. I wish you all the best in finding a new urologist!
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rovana Apr 2019
Be sure to check how your insurance plan(s) work so you know financially what to expect.
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I really despise doctors who act like this to their patients/caregivers. I definitely would check on finding another doctor but may be faced with a challenge of one accepting him with his condition. I totally understand what you are going thru with the terminology that needs to be explained in ”words that your dad can understand”.. I have to have it broke down for myself! But as a caregiver, you are doing what you need to do. You and your dad deserve the respect and the compassion from your doctor during this difficult journey he is on. As I have always been told, their is someone higher up to go to. If you find another doctor that will accept your dad, doctors have a “code of conduct”, I thought, they should go by. I certainly would report him for his actions. Good luck and stay strong❤️
word of mouth will hurt his reputation as a doctor...and his referrals...
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Remember: in any situation where you engage with another party to render services that you are paying for, YOU are the employer, and you can hire and fire at will. This means anything from lawn care to lawyers, and everything else in between. Health care providers are no exception.

If it's at all possible (insurance, scheduling, etc.), find another doctor, and then fire this one. Your dad doesn't need to feel uncomfortable with this guy - he has enough problems already - and you don't need the aggravation. And if you successfully engage another practice, be sure to tell this one why you're going elsewhere.
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cherokeegrrl54 Apr 2019
You are exactly right... because the Dr can “fire” a patient if they don’t follow his advice!!!! In most instances i think they truly care, but with all the governmental regs in the last 20 yrs, its almost impossible to get quality time wth your DR or PA.....always go with ur list of questions and if u have to stand in front of the exam room door til u get answers, then so be it!
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Complain to the clinic's administration -- due to satisfaction surveys facilities are penalized with poor scores. such complaints will usually resolve your issue. If this is not possible, or does not solve your issue, you can get another oncology doctor. now if he has some kind of HMO insurance, this transfer of services must be approved by his primary doctor *and* has to be on his insurance as a carrier.

As a note--if he really knows his stuff and a very good doctor, I'd keep him. I would much rather have a nasty doctor who knows his stuff than a very nice one who will give you less-than-optimum treatment. Anybody can be nice. Besides you only have to put up with him sometimes.
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gdaughter Apr 2019
LOL...if they respond to my satisfaction survey the penalties would probably result in them shutting down!
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I’ve been working in healthcare for over 30 years. I’ve seen the decline in the quality of care. It’s a real bad time to be a patient these days. Please find a different doctor. Do some research, talk to as many people as possible. There are many good doctors and I’ve seen many bad ones too. It will be a lot of work to find a new one but it’ll be so worth it.

Please do not worry about causing any problems with the current provider and his office. Your father deserves better treatment, most esp at this stage in life. You do not owe them anything. You don’t owe them any explanation. Gather up copies of his medical record with this practice. Ask the medical record dept for copies and just say, you want it for your records. So when you find a new doctor, there’ll be no need to deal with them.

I hope that you and your dad will finally find a doctor that believes in his calling.
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Try studying the terminology that doctors use. It usually gets their attention. Try getting straight to the point. Write your questions down before going in so you aren't intimidated. I would be concerned about his outrage though. He probably deals with too many patients and is burned out if he is the only specialist in this area. If there is any other MD that is on your Dad's plan and you can change do it. Research reviews first. That's the good thing about technology today.
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qattah Apr 2019
Good point -- to determine if another doctor would be covered under the plan.
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I have felt the same way, and it’s so hurtful. My grandma and I talk frankly, and she has requested that I help her speak for her if needed (she’s even given me permission to tattle on her! Because she realizes that she may not want to be completely honest with doctors.

I think doctors have been told a few years ago “patient centered” care or whatever where you look the patient in the eye, don’t speak around the patient but speak TO them. Unfortunately like many people they took that advice too far and now ignore the most loving and trustworthy person in the patient’s life. (I hate it when they flat out ignore me!)

I would ask for a different doctor/PA in the office if you can and then if that doesn’t work, switch companies completely.

As for doctors asking strange questions about dentures and things, I urge you to trust them in this case. My grandma has cancer too, and they have done some bone density treatments and dental health is paramount. Our dentist was kind enough to explain why and how the meds could effect bones in the jaw.

Still, if you have questions like “why do dentures matter” the jerk should at least answer you. Hello? Isn’t that what you pay them for?
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I think you have the right idea. Find a doctor closer to home and call and set up an appointment. The first appointment could be a consultation while still seeing the other doctor. After that appointment, the new doctor's office should be able to get the medical records transferred and go from there. They can advise on how to handle the RX without a gap. You obviously love your dad and are only looking out for what is best for him. Keep up the good work!
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Judysai422 Apr 2019
Although my dads cancer is not that advanced, I shopped for a new office when we moved him to be closer to us. Also had to time a monthly injection. Some of the offices told me by phone they could not get him in that fast...finally found one that said, of course; it's a priority.
Let your fingers do the walking, find one that can meet your need, then do a consult as listed said. You should not have to endure a doctor like that. And by the way, be sure you bring a copy of your medical POA with you to have on file so they know you have the right to act on your dads behalf.
One last thing, since your dad has some challenges, prepare a letter of introduction that explains all this to give to the doctor. I did this with my moms new neurologist and it helped greatly. Maybe if you do that with the current doc, he'll be more understanding. Worth a try...
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Yes and no on similar experience, this sounds pretty extreme but every patient and you as an extension of your dad the patient (I assume you have MPOA or authorization etc?) has the right to choose the doctors, including specialist's who are caring for them. Sometimes people just don't gel for some reason, it doesn't mean anything is wrong with one or the other, just because I love this doctor doesn't mean my neighbor will. We went through this actually with my mom, her cardiologist referred her to his first choice of vascular surgeon and his bedside manor just didn't work for her/us. We gave it close to a year but when she ended up in tears I simply contacted the Cardiologist to ask for a different referral, she loves this new one and he has given her better care too because he listens to her and as importantly, to us.

Now, you are talking about a specialty that may not be as easy to find in your area by the sounds of it which probably limits your choices a bit but there should be another specialist in your area that can and will administer the medication your dad needs. I would start by letting the doctor that referred you to this guy in the first place, you can let them know the details or not and simply ask for a different referral. I would urge you to let them know the issues so they are aware for the next patient that needs this specialty and maybe refer to someone else. Also there is no hope of this guy ever getting better if he isn't made a aware of the problem and sounds like the only way this guy might (I say might) hear the critique or care is if he stops getting referrals. Anyway I would start with the original referring doctor and then maybe ask any of your dad's other providers if they have suggestions too, his PCP or another cancer specialist of his might know the perfect provider with this specialty for your dad. People switch providers all the time so no worries about being proactive about this, being comfortable with your choice in provider is a very important part of the care equation.

All of that said, to some degree it depends on the specialty and situation as to what you might decide to overlook or put up with. Surgeons for instance are notorious for having crappy bedside manners but they don't interact with patients all that much so it may not be as important. I remember my grandmothers heart surgeon was one of those guys but he knew it and had a nurse or PA (I forget the exact credentials) who not only organized him but did 95% of the patient interaction, he was a master in the OR and his right hand was great with people, it worked for us. Sounds like this relationship is going to be a long important part of your dad's (and yours) journey so making sure you are happy with your choice in partners is critical and I am with you 100% on needing to feel heard, you and dad are in charge of choosing his provider, making sure they have all the information and carrying out their orders, which includes knowing what to watch out for and why and the provider is in charge of knowing the medical side, the best options for outcome, both sides are as important and need to be able to work together. Some people prefer to be left in the dark and blindly follow doctors it's what they need, others need to know the why's and what if's just like any relationship it's about providing each other what they need.
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jacobsonbob Apr 2019
When I was working in a med school, there was a surgeon who was known for being kind to his patients--but an absolute dictator who was very abrasive when dealing with his residents!
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I had this problem with a doctor when my husband had a serious infection. The doctor only wanted to converse with my husband (who has dementia and can't follow most medical conversations) and didn't want to hear what I had to say. Finally I looked him right in the eye and said "I'm responsible for his medical care, and I need all the information I can get to make sure he's getting the care he needs". The doctor looked shocked for a minute, and then his whole attitude changed. That phrase worked so well I wanted to have it printed up on cards to hand to other rude doctors we have had to deal with! Having said this, however, the doctor you described sounds hopeless. If you could get another doctor, it would make everything you are dealing with easier.
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Sorry if this is a repeat of others advice but it is so important to have a supportive partnership with your elder’s doctors. You don’t have that here and his attitude and bad mood isn’t your problem to bend to. I would contact the office that referred you to get another referral and let them know why. Plan the transition in such a way that dad doesn’t miss any needed treatment. I hope it goes well for you. You need kind knowledgeable support and care not bullying behavior. I find Most doctors want to give that.
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Trust your gut. You are right. Change doctors. He gets mad because he’s got an ego problem. He’s used to getting his way. He’s not giving proper care for your father. Do what you have to do document everything dates times what said what’s done not done and report him to a board as well. Remember, for every one person who speaks up there’s 10 or more that have the same problem. I’ve been a caregiver for two people with severe dementia for five years. Also my sister is a resident coordinator at Hospital. (That is a coordinator for the newbies who are learning to be doctors.) she can’t Advocate enough that people need to fight for their right to good medical care. Doctors are here to HELP US. I’ve change doctors as frequently as I felt needed until I found the one that I felt cared the way I wanted them to. Good luck!
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gdaughter Apr 2019
Oh my Liz, I can imagine the fun your sister has. I remember the day my elder mom was recuperating from an appendectomy. She was slow to recuperate and one day we walked in to find she had an N/G tube that had been place without our consent and in spite of frequent visits...she was showing signs of beginning dementia which no one picked up on so were able to do it with her consent alone. Denied her pain and fear. One day the resident and her puppies came in and mentioned a pic line if she wasn't eating because they miscalculated days since surgery. I raised hell and said over my dead body. Another night I came in and this witch and her tag-a-long were coming out of mom's room. Looked right at me and flew away taking cover elsewhere; I walked in the tube was spewing vile biohazard all over her linens...they had just left that. Required someone to clean up the mess, change mom and nursing staff to cap the tube. I filed a complaint for whatever good it did. You never know...but the MD in charge of this witch is no longer there. YOu just know he and she are elsewhere.
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So sorry this is happening to you & your father. Totally understand. I too can understand how doctors can have frustrations, etc. BUT...Quite simply...this is your father not this doctor nor does this doctor have "ownership". Nor does he have the right to treat you this way. Patients Rights are policy that every doctor has to follow!
According to what you have said & then he's placing his two fists on top of his desk then glaring at you?!?!?! He's fired! Get you a geriatric doctor. Other doctor's can adminster this specific medication. Do it right away.
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Go to the AMA to complain about the doc. Or threaten him with that and see if he changes. I threatened my husband's doctor with that if they didnt get their act together and refill my husbands meds and they finally got their act together. If they mess up again, Im going to the AMA, but I warned them.
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Zero tolerance good daughter. You are out of there as of now. Of course records can be transferred, for continuity of care so there is no charge to you. IF you are part of medical entity/system you may want to switch out completely and go to the competition. There will be time file complaints about this schmuck later. You are wise to get out now. If the current doc has a higher up, I'd be telling him. Any MD worth their salt knows the value of family members involved with care and never treats them that way. It's exhausting work being a medical advocate...good luck with it all...
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Ditto on all counts, you are responsible, intelligent and doing the right thing!!!! GET OUT of there. Good Luck!!!
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You don't need this doctor if he won't work with you. I wonder if this attitude is common among oncology docs? My mother had an oncologist who wouldn't answer her questions when she had breast and uterine cancer. He was in such an all-fired hurry to run in and out of the exam room. I told her I would accompany her to her next visit and, when I did, I stood in front of the exam room door, blocking it so he couldn't leave and telling him I'd move after he answered my mother's questions. He wasn't happy, but he answered the questions. His staff was just as miserable. Once when my mom called there to get some info while she was going through chemo, she started crying and the receptionist retorted "oh, get a grip, will you!" Mom told me and I called back, asked to speak to her and, told her that if I ever heard of her treating my mother or any other cancer patient with such disrespect again, I was going to raise hell with the office manager, the Department of Health, the local media, and anyone else I could think of - and I'd see to it she lost her job. SHE was the one crying when I hung up.
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Countrymouse Apr 2019
Get A Grip?

😮

Wow.
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Get to a different doc ASAP! check with insurance company to verify that they are in network, ask for top 3 names, research them independently, then switch. Have office request his files so no charge to you. Dad's care and wellbeing are what is important. We had an issue with an er doc who treated MIL poorly when he found out no surgery or invasive procedures. When asked about ekg and bloodwork results his answer was "I didn't read them, just signed off that they were done, she's on hospice care what do you think is going to happen." Thank God for shift change and much more caring and compassionate doc. At least he made sure she was comfortable, admitted her for observation, prescribed meds to alleviate vomiting. ER nurse was awsome too but their hands are also tied. You are his best advocate, not always easy, but you do need to shout out loud sometimes. Unfortunately some docs have "god" syndrome and feel that they should never be questioned. Run from this practice and find another dad deserves better.
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How horrible for you and your dad. You shouldnt have to put up with that. Ive experienced the same thing with a womens doctor group. Its horrible. They do that to stop questions and push you through like you are a number.

Definitely get your dad out of there. Start making phone calls immediately.
Here is some info. Maybe you can get in touch with them and get the ball rolling. You shouldnt have to be intimidated or silenced. Good luck.


https://www.cms.gov/medicare/appeals-and-grievances/mmcag/grievances.html
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Bdette144 Apr 2019
I didn’t know such a resource existed. Thank you!
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Find another doctor pronto! YOU have your dad's best interest in mind and understand him better than anyone on the "outside". There's no excuse for mistreating family caring for the patient. My dad's doctor would not discuss eliminating excess medications, even when I had seen two particular meds were no longer needed in his case. A new doctor was more interested in my dad's welfare. Be aware that advancing prostate cancer affects the bones first, then goes on to affect the brain. The cognitive ability will decline. Best to change doctors before further decline. I'm sorry you are going through this.
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At the next visit, rearrange the chairs in the office to get yourself upfront and center. Without emotion, explain to the doctor that you are primary caregiver and need to be part of the conversation and have not felt past visits have been handled this way. If you don't think you can address it calmly or it feels confrontational to you, call another urologist in your Medicare or health insurance plan. Ask to discuss the current health problems, medicines and his future Xofigo. Don't bash the old doctor other than to say you are looking for another doctor that can assist both of you in explaining things better so you and your father better understand. There is absolutely no reason for a doctor to put the caregiver in a position of feeling 'not a part of the conversation'. If you have to, make an appointment with the potential new doctor and go by yourself to explain what you need from a doctor in regard to conversation and being included in the plan. Then you can decide if you will both be a good fit for each other. I am a caregiver and provide all of the answers for my mother. Not because she cannot carry on a conversation, but I am more aware of her needs. I keep a current list of meds and written history of what has gone on. This seems to help with inclusion in the conversation.
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PattiRaeT123 Apr 2019
I went with my mother once I became her care giver. I gave every doctor instruction to NOT ask her question other than how she was feeling or where it hurt, etc. Example: Do you have high blood pressure? Mom: no. Me: mom you take med for HBP. Mom: That's why I don't have it. Dr: Have you had any surgeries? Mom: No Me: You've had 6 surgeries. Mom: Well, they were a long time ago.
Older people do not want to answer personal questions OR the question is not asked properly.
A doctor asked my mom about my dad being a fall risk. She said yes, the doctor was going to change his meds because of it. I found out and let the doctor know my dad was in a wheel chair in memory care. Mom said: Well, he fell all the time when he lived at home. 🤦‍♀️
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I know many drs are under a lot of stress. I believe they tell them that the first day of med school. Sick people are ALSO under a lot of stress.

HOWEVER....a HUGE part of their jobs is 'whole-person' treatment. I've had far too many encounters with far too many drs with my DH and all the crap he's been through.

Drs. WORK FOR YOU. Remember that.

After my DH's liver transplant (miraculously, he didn't die because ONE dr actually took charge and actually called us back and actually LOOKED at DH's thrice weekly blood tests....) I could not WAIT until we hit the end of the year mark and could 'fire' the entire team that was caring for him and moved to a different hospital, clinic and group of drs. The peace we felt from these drs was night and day.

There were plenty of things I could have complained about, but in the end, the surgeon (who was the doc who stepped in and really watched my DH, even though it's not part of his job) did in fact bring about a miracle with the transplant of an organ that was waaay too small for my big guy. I didn't want to burn bridges and be one of "those" people. We had enough stress in our lives.

4 months after we'd move to a new clinic , I got a call from the transplant coordinator (total waste of space)..she says "Oh, hey, we haven't seen B's labs since December. Did he die?" She was SERIOUS!!!!!!!!!! He was still having blood draws every single week. NOBODY in their clinic even noticed.

I told her we'd gone to a different hospital and she should have known that because he got copies of all his records and HAND CARRIED them to the new clinic. Also, I did tell her that she had been of absolutely no help whatsoever, and I said I hoped I never saw her again. Hung up on her with gusto.

As for myself, if I get a dr for some reason who is not listening to me, who doesn't bother to even listen to my heart and check the 'basics', I will fire them.
life is too short to be dealing with a jerk as a dr.

2 of my kids are Drs. I can say that they both take their oath very seriously. In fact, my SIL became a transplant specialist BECAUSE he watched the drama we went through with DH's transplant and the following issues. He gives amazing care, above and beyond. Even tho he tells me that only about 25% of his patients actually comply with care--he still works many hours to take care of them all.

I go with my DH to his cardiologist appts. The dr WANTS me there. Dh doesn't. but I go anyhow. I love that he includes me and asks me questions and lets me have a say in what'd going on. I do not go to the transplant clinics anymore--but he'll be seeing this cardio doc forever, so I am glad I have a good relationship with him.

Yes-everybody has a bad day now and then but you still have to buck up and DO YOUR JOB.
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PattiRaeT123 Apr 2019
What does DH mean?
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