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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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If they can't help they will certainly point you in the right direction. Life with cancer is hard enough, you don't need the added stress, neither does your father. Hugs.
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Let us know what you did. Im rooting for you. Hes not the only doctor in town. You can do this.
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First of all, contact the insurance company and ask if they allow this drug only via this doctor or could it be approved for dispensing by another physician. Get to know all of the facts involved. Then start searching for another doctor using the internet or asking the hospital for names. Interview them until you find one you feel comfortable with - you will sense a lot from that initial interview and you'll know who the right one is - then go to the new one at once.
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I work in medicine and recommend you consider the following:
Firstly, doctors are service providers...like your plumber or electrician..You are paying them for specialized knowledge. Mutual respect is essential
Hippocrates said it best
"Cure occasionally, treat sometimes, care Always"
Surely bedside manner is an important aspect of "Care"?!
Call your medical insurance provider and find someone else.
I suggest you get 2 or 3 doctors name and info. Then look up their reviews online. Consider all the 3 star and less reviews before making an appointment

2. Once you have a new practitioner, go to Yelp &/or google & write a review on this cad in hospital jewelry calling himself a doctor(think about it, would you have exposed your Dad to him if you had been pre warned?!).
"The way you start, is the way you end" it can only get worse.
He's not doing you a favor. He is getting paid

3. How do you know that the cancer has spread to the bones... Test results?
Some of the most common side effects of Zytiga are
i joint swelling or pain. Swelling in legs or feet. weakness. Which can also be signs of bone cancer.
Zytiga inhibits enzymes in the adrenal glands that are responsible for the body making male hormones (androgens). Lowering testosterone is helpful for cancer of prostate.
However,Zytiga also increases blood pressure, lowers potassium and increases fluid retention. Therefore prednisone should be given at the same time. Even so, Zytiga is not the medicine of choice when there is a history of heart problems
There are other medicine with the same benefits
You need to be able to communicate comfortably with your fathers Doctor.
Its essential for the wellbeing of your father, and yourself.
I worked in a cancer hospital where both standard cancer treatment and natural medicine treatments were given. With surprisingly good results. In so far as reducing the side effects and suffering of the patients.
I recommend you review some videos on YouTube of 'The Gerson Program" by Charlotte Gerson, the daughter of the Dr Max Gerson MD who invented the cancer program. It has been in existence over 90 years now in USA. If you prefer reading you can buy books on this program on Amazon.
Applying some or all of the principles could only serve to improve your fathers quality of life.
Best Regards
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Have you tried talking to the dr without your father being there? If you feel he is not getting the care he needs by all means switch drs. If it is just a communication issue try talking with him alone. I have had the opposite problems twice now, first with my brother a stroke survivor with aphasia who doctor totally ignored and only spoke with me ‘ too impatient to wait for brother to get the words out’ my brothers mind was fully functioning just couldn’t always retrieve proper words. I switched his doctor. he deserved to be treated with respect not ignored as if he was brainless.
Now I am dealing with a Dr that totally ignores my mother and directs all questions and comments to me, granted my mom is 94 and does have short term memory loss but again I feel she is being treated as if anything she could contribute would be insignificant in Drs eyes. There are a million Drs out there just need to find one that is qualified in field you need and a good bedside manner would be nice 😉. Goodluck to both you and your dad and remember you want your dad, the dr and yourself to be a team.
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Yeah, just look online and find a doctor who accepts your Dad's insurance. Then make an appointment. You don't have to deal with a doctor who obviously doesn't care about his patients. If your Dad needs a referral, call his PCP, they'll issue one over the phone if they know you and your Dad well enough.
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Ive never had a specialized med so i cant answer that part but ive changed docs without any problem because i didnt like the way they acted.

Call a hospital and ask for a referral to several docs who can give your dad his meds. When you speak to someone in the office reconfirm that again.

Also ask if the doc is willing to discuss patients with caregivers or patients only when the caregiver is present.

There is absolutely no necessity for being spoken to like that.
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Don't know anything about this medication. But what I do know? Is the treatment of this doctors patient is outrageous and unacceptable. Don't give up. Find another medical provider as soon as you can!!! Been through a similar situation...and I learned the hard way. Take a stand, while keeping your loved one safe. And...don't worry about other peoples feelings (medical providers). They'll get over it.
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jacobsonbob Apr 2019
Someone like the doctor in question probably doesn't HAVE feelings...
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I can only speak to being treated that way, though not quite as aggressively, by my Mom's PCP who also doesn't like me and dismisses virtually anything and everything I have to add to the discussion when I need to take her in. I even have her ALL of the legal documents giving me POA and Medical authority, but she STILL treats me poorly. I SURE HOPE that you'll be able to get another doctor, for your and your Dad's sake, VERY SOON!
Best regards, Michele
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mmcmahon12000 Apr 2019
Then why are you taking your Mom to this monster? Why haven't you checked her for her piss poor attitude? A doctor like that needs a reality check. Move your Mom to another PCP as this one's obviously too snooty to be bothered with talking to you.
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you need to find another doctor. how dare this so called doctor think hes better than anyone else. you have the right to ask whatever questions are on your mind. and for you to feel afraid of him is total BS.
find another doctor get the testing redone as it sounds like you cant trust this guy. if it was me once I found another doctor and had dad settled in with the new one, I would file a complaint against this man. remember if hes talked to you and treated you like garbage how many other patients is he doing this to.
I am a firm believer of reading reviews on doctors before deciding to use them , a review of your feelings and concerns can go a long way on a doctors web site, think about it.
don't lower yourself to this man. you have a right to know answers to your concerns about your parent ......
good luck........
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Bdette144 Apr 2019
Yes, find another doctor. Good point to file a complaint. Send letters with copies to everyone in organization. Send a review to Healthgrades, Yelp etc . He is unprofessional to treat you and your Dad this way.

I am fortunate, when my orthopedist was pontificating, my husband yelled, ‘get off your high horse and listen to the patient !!” That should be a patient motto.
Seriously, you have rights. Get another doctor!
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I would have walked out of his office & taken your Dad with you. Never go back there! & File a complaint against him. Probably doesn’t need to be on whatever drug he’s prescribed. Go find another urologist..there are plenty around. Also have your Dad Get new blood & urinalysis. Anyone who doesn’t respect you doesn’t get the time of day. Keep in touch & let us know how it goes. Hugs 🤗
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Get a backbone. Tell the miserable SOB off. It's not a knife fight.
Call another urologist office, explain the situation and I'm positive they will take your dad or refer you to another office.
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find out more about the drug. It may be that there are rules for it to be administered.
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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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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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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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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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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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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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Ditto on all counts, you are responsible, intelligent and doing the right thing!!!! GET OUT of there. Good Luck!!!
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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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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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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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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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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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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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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 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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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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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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