No hurry, it's just cancer.

My father has prostate cancer and he’s had surgery scheduled for a few weeks now and it’s set for the 26th, less than two weeks from today. Yesterday, my mother was in the office and the nurse said the doctor wanted to talk to her. He said he’d wanted to speak to them since conversing with them last week, that he didn’t feel, didn’t want, to conduct the surgery, that he wasn’t comfortable with their doctor-patient relationship.

WTF?

Here’s the whole scoop, as far as I have the details:
A few days before Christmas, my father got his latest PSA results and they were elevated. He has them checked every 6 months because of a study he was part of a few years back. So, New Years rolls around and my mother breaks her ankle in four places and my parents have to deal with that, and drive back to Florida from my sisters place in Michigan.

Back home, which is another detail- they are building a house and are about 40 days from closing, mom starts physical therapy and dad starts visiting doctors. Sure enough, the PSA levels are up because he does, in fact, have cancer. A fun side effect of the study he was part of years ago- the study was for an anti-prostate cancer drug and while people were on the drug, they did have a much lower incidence of developing the cancer, BUT, once they were off the drug, if they did develop prostate cancer, it had a much greater chance of being the more aggressive form. Woohoo. So, yeah.

So dad was checking with radiologists and cutters, seeing as how this needed taken care of. They are down in Ocala, Florida, doing the retired people thing, and it turns out that there is supposed to be a clinic there that has a new robot-guided surgery for prostate removal that is supposed to greatly reduce the effects of surgery (hospitalization time, physical trauma, time to recovery, etc.) so after weighing the pros and cons of each method, they chose the robot option.

A week or so ago they find out that the doctor they had been consulting with is not yet Board Certified for the surgery, but his associate is, so they ask if he can perform the operation. “Sure,” they said, “would you like to meet with him?” My parents, figuring they had already gotten the low-down from the first guy, didn’t really see a need to talk to the second guy, which I guess he was insulted by. But they eventually do go to meet with him, last week, and since they were meeting him, they went ahead and asked a slew of questions, as they always do. Further, my father had been having issues with bowel movements lately, surely due to nerves since he’s frankly scared senseless, but since he was in the doctors office anyway, he asked about that. The doctor told him it wasn’t due to the cancer in his prostate but my father asked about it again, to see if there was something going on down there that he should be concerned about. The doctor again told him it wasn’t due to the cancer and started getting huffy. They moved on to other things and that was that.

Until yesterday. My other was in the area for a mammogram and went by the doctors office to ask them if they could write a script for my father for something to help him sleep, since he is so wound up, he just isn’t able to get a moments rest. Cut to the scene above- the nurse asks her to meet with the doctor, who first chides her for asking for something for my father, nevermind that the guy is beside himself with worry, and then telling her that he “doesn’t feel comfortable” with my father as a patient. It comes out that he was put off that they didn’t want to meet with him and was further upset that my father kept asking questions once they finally did meet. Then he has the balls, the unmitigated gall to tell my mother that his malpractice insurance carrier has instructed him not to take difficult patients or risky patients.

It should be noted that to date, my fathers records show only that he has prostate cancer, it has not spread and it hasn’t shown to be overly aggressive, it’s just plain old prostate cancer. He’s 69, active, non/never-smoker and in good health, a few, 15 maybe 20 pounds over weight, so he’s really no more of a risk than any other patient as far as the actual cancer goes. The thing that it seems to me is that he’s a bit more informed, having been part of the study years ago and generally very well read on subjects of interest to him. So yeah, both of my parents have spent much time reading up, talking to people and otherwise researching this thing, I guess an informed patient constitutes a risk to this guy.

My father has already filled out and filed all the paperwork, he’s started giving blood, he has been preparing for his surgery that was schedule in twelve days and this touch-feely doctor gets his precious nose bent out of shape that someone would have the nerve to ask him questions and cancels the operation.

I mean, it’s not like it’s important, right. Hell, cancer? Yeah, that’s an elective surgery these days, right? Cosmetic, almost. I’m sure it won’t be a big deal for them to change their whole choice of procedure, find another clinic and start the process all over again, right? Sure, he can do that whenever he gets around to it, no hurry.

The forum rules state “no wishing death on someone” and I don’t wish death on this prick doctor- I wish pain on him. Long, drawn-out, agonizing pain. Sleepless nights of wailing and worrying, of doubt and fear, of anger and helplessness. I don’t want him dead, I want him to suffer.

So I hope you rot, Dr. Paub, of the Associates for Urology Care, 1901 SE 18th Ave, Ocala, Florida.

PS: I just got off the phone with my folks and they had just left the doctors office- it turns out that the first guy they had been talking to, who had originally told them that he’d been involved in 15-20 of these surgeries admitted that he had only done 5. Nice. A cock-punching for you, too, Dr. Rao.

I am so sorry your dad is going through all this! My FIL had this surgery some years back, but he went to a doctor at Duke (they were living in NC at the time) Everything came out fine and he’s just had his 74th birthday.

I can’t believe the urologists reacted like that!! I hope your dad finds someone better right away. Seems to me if you’re going to need surgery for conditions that affect older folks, Ocala is the place to have it.

Good wishes going out to you and yours…

I have a feeling, from my families experience in Florida, that the health care for older folks down there just sucks.

One doctor told my mom, who was vacationing there and her back was killing her, that she would be in a wheelchair the rest of her life. He was really snotty about it. ( No one gets snotty with my mom, she’s just a nice person.) Naturally she ignored him, came home and took care of matters and is not in a wheelchair or anything.
Why would a doctor get all huffy if a patient is asking questions and is rather informed? I wouldn’t view this as difficult at all. Bowels tell us lots of things about our bodies, which is why TMI POOP threads are so durn popular around this place. If you aren’t scared shitless about cancer, then you are in denial. That doctor is an ass.

Maybe they are use to older patients ( especially down there) just accepting whatever the doctor tells them and that there is no use fighting it …kinda a doormat mentality. The age of computers and instant medical reference at their finger tips is something most older people shy away from. I think now, as the computer generation gets older, Doctors are not going to be considered GOD-Like anymore. Naturally, this information will open up a whole new barrel of monkeys and every patient will think they are EVE on Northern Exposure.

It sounds as if the doctor is pussywhipped by his insurance company as well as the other doctors in their practice.

He needs to find a practice that comes highly recommended, like who do those doctors recommend their family and friends too?

What about calling your doctor in Ohio ( or your parents doctor in Ohio) to get more info and references and counciling.

It has to be frustrating for everyone in your family.

I think this is the biggest problem, that and the doctors in question are assholes. My grandma never questions a doctor’s care even if it’s horrible, because they’re doctors. Fortunately she’s in basically good health. But even if said doctors are used to not being questioned, they’re still being assholes. Find a new doctor ASAP. Please.

Any doctor who gets pissed because I ask questions will never see me again. End of story.

I know they are training doctors differently these days; for a psych class once I posed as a patient for a class in patient relations (or something like that) at a local medical school. I am thrilled that they are teaching medical students to listen and otherwise treat patients like human beings.

thinksnow, though the time-delay is just awful and agonizing, I wonder if your father might not end up being better off for not having surgery by these doctors. I got an oogy feeling reading your OP. Hopefully he will find a better doctor that will treat him quickly and will take the time to make him feel comfortable and confident in the doc’s treatment.

Wishing that this works out for the best.

I have found this to be the case for most geriatric care providers I’ve encountered. They just don’t give a shit. It makes me crazy. They told my mother her rectal bleeding was just “a touch of diverticulitis” and to take antibiotics for a couple months. It was cancer and she’s dead. They never did a scope or anything.

I hate this motherfucker with every fiber of my being. And I’ll never believe anything an elder care doctor says without at least getting a second opinion. They’re out for the money, and their patients die before they can put up a decent fight.

My wife did some legwork and it seems I got the primary assholes name wrong- it’s Dr. Taub. Dr. Rao, though, is newer, so I suspect he just hasn’t made the cut for the web page yet.
I spoke to my folks again and found that they are meeting with a third, un-associated, doctor on Friday, so that is certainly some good news. They also found out that Dr. Rao, who had said he had been involved in 15 or more procedures has actually only done 5. Huh, go figure.

There is a place in Michigan where the robot surgery was pioneered and I suggested to my parents that since they are mobile, they are uniquely able to take advantage of the opportunity to go there instead of staying in Florida (my folks sold their house last July and have been motorhoming since, so they can pretty much go anywhere.)

I also pointed out that The Ohio State University Medical Center is tops, too, as is the The Ohio State University Comprehensive Cancer Center.

Either way, if they went to Michigan or came to Ohio, we would be much better able to provide suppert to them, and since the surgery is getting backed up anyhow, the closing on the house is a non-issue since, at best, my father would be in recovery then.
So, it sounds like they are dropping the AfUCs and looking at different clinics/doctors/options, which is very good to hear, even if they don’t come up North. Still, though, I am harboring ill thoughts for Dr. Taub.

Kalhoun, I am sorry to hear about your mother, that is tragic and so very sad.

Thank you, everyone, for your comments. It’s scary to see that this isn’t a localized phenomenon, though. I suspect you are all right- that they are used to pushover patients and being faced with knowledgeable ones concerns them, rather than delights them.

On that note, I can see how my parents would be a malpractice risk- my father might actually, gasp, survive long enough to find out the doctor messed something up and my mother might actually know enough to realize that it wasn’t simply a “complication during surgery.” Yeah, I can see where not being able to ride roughshod over your patients would be a risk.

Grr.

My father-in-law has prostate cancer and his doctors had a similar lack of urgency about the whole thing. He went in to get bloodwork done (he has a whole host of health problems). Although they knew his PSA levels were through the roof, they didn’t call him to tell him about it and to get him in. They waited until his next regularly scheduled doctor’s appointment a couple months later.

I will say his doctor has been very good since then, including faxing my husband very detailed summaries of all check-ups & tests (at my FIL’s request). This is especially nice, considering we live in a different country.

Anyway, I’ll be thinking about you and your family. My FIL is not having surgery (see above health problems, including an aortic aneurysm that probably will require surgery very shortly). He is going through chemo/radiation right now and is miserable, but his PSA is down to 1.

thinksnow, I’m glad to hear that your dad was willing to stand up to that doctor.

My sweet great aunt saw her doctor over a year ago because she was having headaches. He told her that everything was fine. She went back several more times and reported that she was still having headaches, and they were growing worse. The doctor hemmed and hawed and treated her symptoms.

This spring she felt that something just wasn’t right. She was having some dizzyness and sometimes forgot things. Again her doctor waved off her concerns. This sweet, uneducated woman finally went to see another doctor (who immediately ordered a CAT Scan and an MRI).

They quickly found a brain tumor. Due to it’s size and location, it is inoperable. Due to the date of diagnosis, she will likely be dead before medicare (I believe) would have started payment. She was doing pretty well when I saw her 3 weeks ago, but since then she has become bedridden and is asleep most of the time. She is expected to slip into a coma at any time. She was only diagnosed about 1.5 months ago.

So thanks to a condescending doctor, this wonderful woman had been robbed of possible treatments or at least the opportunity to better prepare and say goodbye to family and friends.

That happened to me, with an endocrinilogist I went to see about my thyroid disorder. After telling me that he guessed I’d be a pretty smart and well-informed young woman, he asked me to tell me everything I knew about the disease and the treatments I wanted to try. Then he proceeded to tell me that everything I’d just said was a load of shit, and accused me of drug-seeking (thyroid medication, of all things). I walked out, and wrote him a nasty letter when I got home.

thinksnow, your parents absolutely do not have to put up with this kind of treatment. They deserve respect, not to be treated as they have. I really hope things go well for your dad with the new doctor.

My mom was treated like that by the pediatrician. I’d had a history of ear infections, so she brought me in to the regular pediatrician when she suspected another one. I’d been crying and rubbing my ear, and running a fever, and those were the symptoms with my previous ear infections. The doctor asks what the problem is, and my mom said, “I think she has an ear infection again.” The doctor’s response was, “Oh really? Have you gone to medical school?” Mom was aghast but said nothing in response, other than noting what symptoms I’d been showing. Of course, I had an ear infection.

thinksnow, this kind of shit with doctors makes me so angry I could spit. I’m so sorry to hear your parents are having to go through this nightmare (having lost my mother to cancer, I know first-hand how scary all the waiting is).

Harvey Taub is a member of the American Medical Association (you have to click on “search for a physician” and agree to their “terms & conditions,” so I can’t provide you a direct link to his page), and as such, “agree[s] to subscribe and adhere to the AMA Principles of Medical Ethics,” the very first one of which states (bolding mine):

Additionally, they are charged with the duty…

It is utterly irresponsible to abandon your father’s care immediately before a scheduled cancer surgery. It is my recommendation that you have your parents call and WRITE to the AMA and file a complaint against this prick.

I was unable to search for Dr. Rao without a first name (there are several listings for physicians named Rao in Florida, but either not the right specialty or not the right city, but if he’s new to the practice, his listing might be showing in a different city or even state than current.)

I wish you and your parents the best of luck and hope to hear good news about his successful surgery and recovery soon!

I have read the entire thread, and I am still burning up over the fact that the doctor was “huffy” about being asked questions. WTF!?!?!? My mother has based her entire career on teaching women to take control of their health, and guess what she teaches them first? Don’t be afraid to ask questions. If I had a doctor who wouldn’t answer me, got angry, and otherwise expected to be revered as one who is godlike, I would be out of there so fast there would be a me-shaped hole in the door.
That kind of behaviour is completely unacceptable and goes against everything a doctor-patient relationship should be.
He can’t be an effective urologist, he has his head so far up his own ass I don’t know how he can examine anyone else’s.

thinksnow, that is a horrendous story. I agree with Shayna, PLEASE make a complaint to the AMA about this guy, and copy him on the complaint.

Write a letter.

I understand your dad’s jitters, the “C” word down there is a scarey prospect. hell, the “C” word anywhere is.

Good that they’ve determined it’s not the aggressive type, you have time to find a good doctor.

the thing that rang my alarm bells was the statement from this guy “My malpractice folks told me…” um. Perhaps there’ve been claims? In any event, if a doctor started sharing his conversations w/his insurers w/me, I’d be assuring said Doctor that I’d lost confidence in their abilities to provide care, so no need for them to drop me.

No. Don’t waste your time writing to the AMA. The AMA has no disciplinary powers over physicians. The worst it could do is suspend his membership, which is no big fucking deal since MOST physicians are not AMA members anyway. Direct your complaints instead to the Florida State Board of Medicine, which CAN discipline a negligent physician or (in the most severe cases) revoke his license. Also complain to the hospital where your father was scheduled to have his surgery performed; the physician has admiting and OR privileges there, and the hospital is in a position to suspend those privileges.

If you’re going to complain, complain to the right people.

This is an excellent point. Why is this guy talking with his insurance people, AFAIK & IANAD, et al, they wouldn’t talk to their insurance provider all that much unless there was a reason too. Lawsuit pending, possibly.

The interaction, as least as far as I can ration, would be miminal.

Thinksnow, re-directing your parents is the best thing you can do right now.

Good luck to your dad and everyone in your family.

Hey, that sounds like some of my mom’s experiences. Mom’s an RN (trained thanks to the US Army) and when she brought us into pediatrics she knew what she was talking about when asked what was wrong. Like the time either I or my brother had strep throat and it was immediately assumed that Mom was overreacting or something. Now, I can understand that not everyone has formal medical training and that lots of things can produce similiar symptoms, especially when the description is coming from a four year-old. I also understand that it is important to check and verify and that parents, especially new parents tend to overreact, but it’s not like you have to come out and tell them you don’t believe them and be rude about it.