Monday, November 30, 2009

How to get the best care

The smartest way to get the very best medical care is to take charge of your own health. This is common-sense advice, yet I’m constantly amazed by how often people I know—smart, educated people—simply accept what their local docs dish out. They often have poorer outcomes as a result.

We’ve had enough medical emergencies in the Ogle family to know that Doc A is not interchangeable with Doc B. I don’t accept the myth that we live in a medical Lake Wobegone, where all the hospitals are excellent, all the care provided is superior, and all the doctors are above average. If community-based specialists were tested like college students, many of them would flunk out. Every medical community, including the one in which I live, has pockets of excellence, surrounded by a sea of mediocrity. Medicine is no different from the rest of the world in that regard.

In cancer care, it’s not that hard to gain expert guidance. When I got nervous last year about the apparent lack of knowledge displayed by my local medical oncologist, I identified a specialist in melanoma at a major oncology center in Portland. It’s not M.D. Anderson, but Providence Cancer Center is the largest oncology practice in the state and the doc I saw seemed to know his stuff. I established a relationship that should I ever need his care, I don’t have to dither over where to go.

This article on cancer care in the latest U.S. News & World Report backs up my contention that coordinated care between the specialists at major centers and generalists in the local community is a good strategy. If your health condition is serious and/or unusual, go to someone who treats the hard cases. Don’t take chances with someone whose opinion of their own skills may exceed their actual ability.

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