Going the distance

Navigating health care's choppy waters

By Edward T. Creagan, M.D. March 15, 2016

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As a medical specialist with a focus on medical oncology, I see people with cancer every day. Let me share with you the situation of a patient who complicated an already complex situation.

The gentleman was a businessman from a Central American country. He was a prominent member of his profession and well connected in political and medical circles in his country. He developed a serious abdominal problem, and a CAT scan identified a mass in his kidney.

He was told by the health care providers in his country that he would require major cancer surgery on that kidney. He agreed to the operation, which was performed by a surgical team that wasn't used to treating this sort of problem. As you might expect, things didn't go well.

The patient developed a series of complications, and it was unclear exactly what type of cancer he had. At this juncture, rather than going to a major cancer center, which the patient had the resources to do, he went to another medical group in his country. Unfortunately, this group was likewise unfamiliar with his problem. They advised another operation as well as extensive treatment with chemotherapy and radiation.

Despite the efforts of the second group of doctors, the man's condition continued to deteriorate. He finally sought guidance at a major medical center with a focus on cancer care. The cancer center wasn't able to obtain all of the patient's records from the previous providers. The pathology slides were lost. And the scans they did receive were of such poor quality that the patient had to undergo multiple additional, often uncomfortable, procedures.

So what are the teaching points?

  • Don't jump from clinic to clinic. Getting a second opinion is wise, but once you have a diagnosis and treatment plan, it's imperative to obtain comprehensive care under one health care system. This minimizes confusion and makes it easier for providers to share information about your case. Getting treatment at institution A, then following-up at institution B and then seeking additional tests at institution C is a recipe for disaster, as this gentleman discovered.
  • Take matters into your own hands. When dealing with a complex health problem, keep a copy of your medical records, including test results. That way you can be sure that key information gets delivered to the appropriate providers.
  • Be your own advocate. Be proactive and assertive about your health care. Ask lots of questions. Make sure you understand the answers. After all, at the end of the day no one has a greater stake in your health and wellness than you do.

Originally published May 20, 2015.


Edward T. Creagan, M.D.

Follow on Twitter: @EdwardCreagan

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March 15, 2016