Physician quality and experience

Questions on how we spend our money and our time - consumer goods and services, home and vehicle, leisure and recreational activities
Topic Author
sawhorse
Posts: 3460
Joined: Sun Mar 01, 2015 7:05 pm

Physician quality and experience

Post by sawhorse » Thu Aug 22, 2019 11:19 pm

One of my specialists, the only doctor that I've seen for this condition at my current location, left the practice with only a week's notice.

The practice has hired someone straight out of fellowship. She hasn't started because "she has to get her credentials sorted out" according to the office. I don't know what this means, but regardless, she's very inexperienced.

By switching over to the new doctor, I can get an appointment within a couple months. If I want to switch to another doctor in the practice, I would have to wait longer. I could also try moving to another practice, but who knows how long I would have to wait.

Am I justified in feeling reluctant to switch to the new doctor? My condition is rare. I doubt she saw many cases in her training.

Is there a "peak period" for physicians in cognitive specialties, or does experience not really matter in terms of physician quality? I imagine there are good and bad doctors at all levels of experience. But is there a general trend?

BionicBillWalsh
Posts: 142
Joined: Sun Oct 21, 2018 1:56 am
Location: Sandwich Islands

Re: Physician quality and experience

Post by BionicBillWalsh » Thu Aug 22, 2019 11:24 pm

Meet with her. See what she has to say. Coming out of fellowship, she'll be competent. You just have to determine if she's a good fit for you.

If not, you're not married to her. Move on.
Saltwater has an amazing ability to wash away many of life’s troubles

Topic Author
sawhorse
Posts: 3460
Joined: Sun Mar 01, 2015 7:05 pm

Re: Physician quality and experience

Post by sawhorse » Thu Aug 22, 2019 11:29 pm

BionicBillWalsh wrote:
Thu Aug 22, 2019 11:24 pm
Meet with her. See what she has to say. Coming out of fellowship, she'll be competent. You just have to determine if she's a good fit for you.

If not, you're not married to her. Move on.
I don't know if the practice allows patients to switch to another doctor in the same practice. With my primary care practice, I wanted to switch to another doctor in the same practice, but they didn't allow it. So if I have a poor experience with the new doctor, I might not be able to see someone else there.

User avatar
Christine_NM
Posts: 2699
Joined: Tue Feb 20, 2007 1:13 am
Location: New Mexico

Re: Physician quality and experience

Post by Christine_NM » Fri Aug 23, 2019 12:24 am

sawhorse wrote:
Thu Aug 22, 2019 11:29 pm
BionicBillWalsh wrote:
Thu Aug 22, 2019 11:24 pm
Meet with her. See what she has to say. Coming out of fellowship, she'll be competent. You just have to determine if she's a good fit for you.

If not, you're not married to her. Move on.
I don't know if the practice allows patients to switch to another doctor in the same practice. With my primary care practice, I wanted to switch to another doctor in the same practice, but they didn't allow it. So if I have a poor experience with the new doctor, I might not be able to see someone else there.
My plan allows switching docs easily at specialty clinics but I could not change my PCP. One data point for you.

The new doc is worth a try. It's not as if she is really inexperienced, just new to you. At least find out what she knows about your condition.
16% cash 48% stock 36% bond. Retired, w/d rate 2.85%

Topic Author
sawhorse
Posts: 3460
Joined: Sun Mar 01, 2015 7:05 pm

Re: Physician quality and experience

Post by sawhorse » Fri Aug 23, 2019 12:41 am

Christine_NM wrote:
Fri Aug 23, 2019 12:24 am
sawhorse wrote:
Thu Aug 22, 2019 11:29 pm
I don't know if the practice allows patients to switch to another doctor in the same practice. With my primary care practice, I wanted to switch to another doctor in the same practice, but they didn't allow it. So if I have a poor experience with the new doctor, I might not be able to see someone else there.
My plan allows switching docs easily at specialty clinics but I could not change my PCP. One data point for you.

The new doc is worth a try. It's not as if she is really inexperienced, just new to you. At least find out what she knows about your condition.
For clarification, when I couldn't change primary care doctors, it was due to a policy of the clinic, not of the insurance plan.

Emilyjane
Posts: 146
Joined: Sat Jul 27, 2013 6:39 am

Re: Physician quality and experience

Post by Emilyjane » Fri Aug 23, 2019 5:20 am

Family doc here. I wouldn’t have any reluctance to see new fellowship trained doc. Years of residency training and years of fellowship. The credentialing thing is paperwork, not really her doing. I’d say meet with her and find out if you two communicate well.
"Real knowledge is to know the extent of one's ignorance", Confucius

cone774413
Posts: 14
Joined: Sun Jan 08, 2017 8:22 am

Re: Physician quality and experience

Post by cone774413 » Fri Aug 23, 2019 5:25 am

Current fellow here. I think it depends what type of practice you are currently in. If anything, I expect to have more exposure to the complex "zebras" in fellowship than I would being in the community. At least in my field (non surgical) I think years of fellowship and residency has me comfortable with anything walking through the door.

User avatar
msi
Posts: 523
Joined: Sun Feb 17, 2008 11:15 pm

Re: Physician quality and experience

Post by msi » Fri Aug 23, 2019 6:46 am

Can you follow your current doctor to whatever new practice (s)he moved to, if that's what happened? I've done that in the past.

fasteddie911
Posts: 286
Joined: Fri May 16, 2008 3:13 pm

Re: Physician quality and experience

Post by fasteddie911 » Fri Aug 23, 2019 6:54 am

Just try it out. Fresh grads can vary greatly. Some are like a savvy veteran, others need some time. Some trained in small, community fellowships that don't see the rare stuff, others train at the major centers that see it all the time. Even then, some major centers push their trainees into research and non-clinical tasks instead of honing their clinical acumen. Typically most say 5-10yrs is when a doc is near peak, but even then I've seen 'experienced' docs practice out-of-date or weird medicine, not being formally trained in certain things, but their patients don't know the difference.

Nowizard
Posts: 2339
Joined: Tue Oct 23, 2007 5:33 pm

Re: Physician quality and experience

Post by Nowizard » Fri Aug 23, 2019 8:10 am

With several relatives who have just entered private practice after years of internships, residencies and fellowships, I can definitely say that they are excited and go far beyond what might be expected when seeing what are basically routine cases for more experienced docs. Their attention to and consultation about, along with eagerness for more unusual ones, is amazing. Surgery might be different, but issues that require knowledge that is already present or can be obtained with case-by-case consultation may be more likely with new grads than older ones based on my anecdotal information. This might be particularly accurate with new docs who have completed prestigious fellowships in addition to residencies.

Tim

Swansea
Posts: 756
Joined: Sat Feb 13, 2016 5:16 am

Re: Physician quality and experience

Post by Swansea » Fri Aug 23, 2019 8:29 am

I rely heavily on where the doc did residency for my choices.

ohai
Posts: 1127
Joined: Wed Dec 27, 2017 2:10 pm

Re: Physician quality and experience

Post by ohai » Fri Aug 23, 2019 8:41 am

Unless you have some rare complication, I'm sure it is fine.

In fact, in some ways, it might be better to have a new doctor, as their training might be a bit more up to date and they might be more enthusiastic to spend time with you.

carolinaman
Posts: 3883
Joined: Wed Dec 28, 2011 9:56 am
Location: North Carolina

Re: Physician quality and experience

Post by carolinaman » Fri Aug 23, 2019 8:43 am

I would find another doctor who has more experience. This new doc may be fine in time but I would not take the risk. It sounds like with your rare condition you need to find someone who has experience treating it.

halfnine
Posts: 986
Joined: Tue Dec 21, 2010 1:48 pm

Re: Physician quality and experience

Post by halfnine » Fri Aug 23, 2019 8:46 am

I've had numerous doctors across various cities and countries. I now prefer ones that are naturally very bright (not all of them are) but lack the ego that sometimes comes with that kind of intellect. They seem to perform the best work. Age and residency aren't contributing factors.

User avatar
Doom&Gloom
Posts: 3019
Joined: Thu May 08, 2014 3:36 pm

Re: Physician quality and experience

Post by Doom&Gloom » Fri Aug 23, 2019 10:35 am

I have a strong preference for younger docs with more recent education and training--particularly for specialists.

I would see the new doc without hesitation. After seeing her, if I had doubts about her competency, I would also not hesitate to move on.

sil2017
Posts: 407
Joined: Mon Jan 23, 2017 7:25 am

Re: Physician quality and experience

Post by sil2017 » Fri Aug 23, 2019 11:37 am

Sawhorse-

I also have rare conditions (2 to be exact). I am almost in the same boat as you. I have HMO right now but may change to a PPO so I have access to in network at Mayo Clinic, Cleveland clinic etc.

If it were surgery, I much rather go with an excellent quality hospital and surgeon with tons of experience. Too much to risk if not experienced.

If primary doctor, not a big deal to have a new doctor. In fact, my primary physician is relatively young and new. Anything I request, she will do for me. She is all about preventive care (MRI, CT scan, blood Test , referrals to specialists )

Topic Author
sawhorse
Posts: 3460
Joined: Sun Mar 01, 2015 7:05 pm

Re: Physician quality and experience

Post by sawhorse » Fri Aug 23, 2019 11:50 am

Thanks for your responses. Do you think a brand new doctor would be more or less willing to try more aggressive treatments and off label medications?

User avatar
dm200
Posts: 22280
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Physician quality and experience

Post by dm200 » Fri Aug 23, 2019 12:02 pm

sawhorse wrote:
Thu Aug 22, 2019 11:19 pm
One of my specialists, the only doctor that I've seen for this condition at my current location, left the practice with only a week's notice.
The practice has hired someone straight out of fellowship. She hasn't started because "she has to get her credentials sorted out" according to the office. I don't know what this means, but regardless, she's very inexperienced.
By switching over to the new doctor, I can get an appointment within a couple months. If I want to switch to another doctor in the practice, I would have to wait longer. I could also try moving to another practice, but who knows how long I would have to wait.
Am I justified in feeling reluctant to switch to the new doctor? My condition is rare. I doubt she saw many cases in her training.
Is there a "peak period" for physicians in cognitive specialties, or does experience not really matter in terms of physician quality? I imagine there are good and bad doctors at all levels of experience. But is there a general trend?
Especially as I get older and have more "specialists", I wonder about the same kinds of things.

I suppose, "being inexperienced" certainly has many disadvantages, but maybe such a new (to him/her) condition within that specialty could lead to him/her doing a lot of work and research. He/she also, I assume, will have all of your records of this condition.

Another factor would be whether, and to what extent this new, inexperienced specialist would or could, as part of researching your case, consult with more experienced specialists in the practice (or outside?)

Good luck!

User avatar
dm200
Posts: 22280
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Physician quality and experience

Post by dm200 » Fri Aug 23, 2019 12:06 pm

Doom&Gloom wrote:
Fri Aug 23, 2019 10:35 am
I have a strong preference for younger docs with more recent education and training--particularly for specialists.
I would see the new doc without hesitation. After seeing her, if I had doubts about her competency, I would also not hesitate to move on.
I see that point.

According to my PCP, dealing with Cardiologists, she noted that younger cardiologists tend to order and want more tests and more invasive types of theses - such as CT scans. In my case, I did not want to be unnecessarily bombarded with excess X-Rays from a CT scan. My PCP then made a referral for me to see an older cardiologist, who did not believe a CT scan of my heart was needed. :happy

User avatar
Munir
Posts: 2553
Joined: Mon Feb 26, 2007 4:39 pm
Location: Oregon

Re: Physician quality and experience

Post by Munir » Fri Aug 23, 2019 12:15 pm

carolinaman wrote:
Fri Aug 23, 2019 8:43 am
I would find another doctor who has more experience. This new doc may be fine in time but I would not take the risk. It sounds like with your rare condition you need to find someone who has experience treating it.
+1

I prefer the board-certified physician who has been in clinical practice for 10-15 years. A fellowship usually is an add-on 1-2 years in a sub-specialty and follows the usual residency training and board-eligibility or certification.

DecumulatorDoc
Posts: 191
Joined: Sun Jan 28, 2018 7:48 am

Re: Physician quality and experience

Post by DecumulatorDoc » Fri Aug 23, 2019 12:18 pm

dm200 wrote:
Fri Aug 23, 2019 12:06 pm
Doom&Gloom wrote:
Fri Aug 23, 2019 10:35 am
I have a strong preference for younger docs with more recent education and training--particularly for specialists.
I would see the new doc without hesitation. After seeing her, if I had doubts about her competency, I would also not hesitate to move on.
I see that point.

According to my PCP, dealing with Cardiologists, she noted that younger cardiologists tend to order and want more tests and more invasive types of theses - such as CT scans. In my case, I did not want to be unnecessarily bombarded with excess X-Rays from a CT scan. My PCP then made a referral for me to see an older cardiologist, who did not believe a CT scan of my heart was needed. :happy
Everyone is different. For myself, I clearly became a better physician with more experience under my belt than I was right out of training. Sure I was book smart early on, but I didn't know what I didn't know. Medicine is as much an art as a science. If I could pick a sweet spot, it would be after about 10 years in practice.

Also there is equal consideration on the back end of one's career. As far as decline in motor and cognitive skills, everyone ages differently.

User avatar
lthenderson
Posts: 4356
Joined: Tue Feb 21, 2012 12:43 pm
Location: Iowa

Re: Physician quality and experience

Post by lthenderson » Fri Aug 23, 2019 12:54 pm

sawhorse wrote:
Thu Aug 22, 2019 11:19 pm
Is there a "peak period" for physicians in cognitive specialties, or does experience not really matter in terms of physician quality?
As the spouse of a doctor who once was "fresh" out of fellowship, I found that they were often on the cutting edge of new treatments having "recently" learned them versus some of the doctors who had been out in practice for awhile. It is a huge time commitment for doctors to read through literature and attend conferences to stay current in latest treatments and many of them don't want to spend the time doing so.

DecumulatorDoc
Posts: 191
Joined: Sun Jan 28, 2018 7:48 am

Re: Physician quality and experience

Post by DecumulatorDoc » Fri Aug 23, 2019 1:03 pm

lthenderson wrote:
Fri Aug 23, 2019 12:54 pm
sawhorse wrote:
Thu Aug 22, 2019 11:19 pm
Is there a "peak period" for physicians in cognitive specialties, or does experience not really matter in terms of physician quality?
It is a huge time commitment for doctors to read through literature and attend conferences to stay current in latest treatments and many of them don't want to spend the time doing so.
Not my experience...I have been associated with hundreds of physicians in my career and never met one that wasn't dedicated to spending the time to stay current. Certainly not in this day and age.

fposte
Posts: 1722
Joined: Mon Sep 02, 2013 1:32 pm

Re: Physician quality and experience

Post by fposte » Fri Aug 23, 2019 1:31 pm

DecumulatorDoc wrote:
Fri Aug 23, 2019 1:03 pm

Not my experience...I have been associated with hundreds of physicians in my career and never met one that wasn't dedicated to spending the time to stay current. Certainly not in this day and age.
I realize this is shifting the thread a bit from what you're responding to (but more in line with what the OP was asking), but in my experience they're likelier to be keeping up on the horses than the zebras. Which makes good sense, as that's what repays the time, but I have at least one zebra and have not found that experienced practitioners are up on current research for it at all. I'm sure some are, but I would be a little bit likelier to try the younger doctor if the OP's situation is unusual even within the specialty.

Though at base I'd be pretty unhappy with a practice that wouldn't let me change doctors. I can understand limiting the number of changes, but never?

User avatar
ResearchMed
Posts: 9372
Joined: Fri Dec 26, 2008 11:25 pm

Re: Physician quality and experience

Post by ResearchMed » Fri Aug 23, 2019 1:38 pm

Munir wrote:
Fri Aug 23, 2019 12:15 pm
carolinaman wrote:
Fri Aug 23, 2019 8:43 am
I would find another doctor who has more experience. This new doc may be fine in time but I would not take the risk. It sounds like with your rare condition you need to find someone who has experience treating it.
+1

I prefer the board-certified physician who has been in clinical practice for 10-15 years. A fellowship usually is an add-on 1-2 years in a sub-specialty and follows the usual residency training and board-eligibility or certification.
I think "in general", there is a sweet spot like this.

But for a *specialty*, depending upon the degree of familiarity/dealing with any particular sub-issue, IF there is a "match" (the physician DID include/experience this particular sub-issue/complication), then I'd definitely want to start with the one with the most up-to-date knowledge/techniques.

But a LOT depends upon the individual... will someone "look further behind the scenes" or "consult colleagues/specialists", etc., and --> Do they LISTEN to you!?

We are very fortunate, getting our care at a major teaching hospital environment. Additionally, we no longer need referrals to specialists as long as they are in our (large!) multi-hospital network.
And, we can change PCP's at any time, including "PCP For A Day" if we want to double check with someone else who is a PCP and not a specialist. We just call insurer, change name of PCP before seeing said person, then after, call back and switch back. All of that can even be "same day".

The more we read here, especially about health insurance, the more fortunate we feel!

[But nothing is perfect, no surprise. I've suffered from two serious surgical errors, one of them truly catastrophic.]

RM
This signature is a placebo. You are in the control group.

newdoc
Posts: 64
Joined: Wed Mar 13, 2013 8:21 pm

Re: Physician quality and experience

Post by newdoc » Fri Aug 23, 2019 2:10 pm

I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly. That said, obviously there is a lot of variability with newly trained docs and some are truly spectacular, but you simply don't know going just off of their experience and no new doc goes without some hiccups when starting out. Also, years of experience does not necessarily translate to familiarity with a rare condition and someone fresh out of training may have trained at a place where they see a lot of that condition and have a leading expert in it. You don't know one's expertise unless and until you ask.

I'll also add that generally it is incredibly difficult for the public to gauge who is and is not a "good doctor," and in many instances it's also a matter of who is good for you. I can tell you that it absolutely is NOT as simple as going off of where they trained and what institutions you think are or are not "prestigious," nor is it as simple as going off of internet reviews or who has the best advertisements. I'll even add that the doctor with the highest IQ isn't necessarily the best doctor either. Doctors are generally pretty good at keeping the dirty laundry contained amongst ourselves and a famous surgeon or a surgeon at a reputable university is in many instances not as skilled as the surgeon at a small community hospital. Frankly, I think the best way to find a doctor is to have friends/family who are doctors and sort of in the know a bit and have them tell you who they'd send their family to. Short of that, find a doctor that you are close with and trust, it may be your previous specialist or your PCP, and have a candid discussion: tell them about your worries and ask who they'd send their loved one to. Even if they can't drop a name off the top of their heads, they'll usually ask around and be able to get back to you with better vetted information than what you'd find online.

All that said, it certainly does not hurt to talk to both the new doc and the other doc first. Ask them your questions, over the phone first if possible. The phone call is a big thing for me, as it's much more difficult for people to fake compassion over the phone. If you feel comfortable with them over the phone, then this is good. You basically want someone who will care for you with the level of intensity that they would a family member.

User avatar
JPH
Posts: 938
Joined: Mon Jun 27, 2011 8:56 pm

Re: Physician quality and experience

Post by JPH » Fri Aug 23, 2019 2:43 pm

A complicated question, but most evidence suggests a slow decline in quality of care as years in clinical practice increase. However, I don't know of any study focusing on recent fellowship graduates. Medical information increases at a tremendous rate, and the half life of medical knowledge is relatively brief. A lot of continuing medical education is woeful. See for example the study summarized here: https://www.ncbi.nlm.nih.gov/pubmed/15710959
While the moments do summersaults into eternity | Cling to their coattails and beg them to stay - Townes Van Zandt

User avatar
dm200
Posts: 22280
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Physician quality and experience

Post by dm200 » Fri Aug 23, 2019 3:20 pm

I suspect that there is a wide range of the current/updated education/training received or done by different specialists - in the same field for the same number of years.

Sometimes, as a patient, you can glean that a specialist is keeping up to date - but that is difficult.

I believe that Kaiser offers or requires older/experienced Specialists to receive updated specialty training.

One specialist that I know personally - in her late 50's or early 60's attended an out of town full week - all day very intensive specialty training from A to Z.

As far as Primary Care Physicians, with 20/20 hindsight I concluded that my previous PCP (Internal medicine) was often a bit "out of date" when I went to Kaiser and my new Kaiser PCP (also Internal Medicine) did some things differently. Doing some checking on a few of these things (as a lay person), I concluded the new Kaiser Doctor was up to date and my previous PCP (who was about 40 years old) was behind the times.

newdoc
Posts: 64
Joined: Wed Mar 13, 2013 8:21 pm

Re: Physician quality and experience

Post by newdoc » Fri Aug 23, 2019 3:34 pm

dm200 wrote:
Fri Aug 23, 2019 3:20 pm
I suspect that there is a wide range of the current/updated education/training received or done by different specialists - in the same field for the same number of years.

Sometimes, as a patient, you can glean that a specialist is keeping up to date - but that is difficult.

I believe that Kaiser offers or requires older/experienced Specialists to receive updated specialty training.

One specialist that I know personally - in her late 50's or early 60's attended an out of town full week - all day very intensive specialty training from A to Z.

As far as Primary Care Physicians, with 20/20 hindsight I concluded that my previous PCP (Internal medicine) was often a bit "out of date" when I went to Kaiser and my new Kaiser PCP (also Internal Medicine) did some things differently. Doing some checking on a few of these things (as a lay person), I concluded the new Kaiser Doctor was up to date and my previous PCP (who was about 40 years old) was behind the times.
Yeah, some docs are very aggressive about keeping up to date and others aren't. That said, this is not always indicative of the quality of their work. An older surgeon who does a procedure the same way he/she has done it for 20 years because he/she knows it works and gets great results is far preferable to one trying out a new "flavor-of-the-month" technology every time some new research study comes out. Many a physician have been burned on this before. New information often turns out to be wrong, sometimes catastrophically so (see "Metal on metal hips"). The older doc can still do a great job without being able to rattle off the most recent research data. I think the trick is that they should be at least somewhat familiar with newer technologies and should be able to explain why they do or do not use them. Also, generally, in most instances it is wise to wait until that newer technology is time-tested as being effective, safe and better than older technologies. Usually for there to be a paradigm shift in Medicine, there needs to be overwhelming evidence of this which can take several years or even a decade or more. I think this thread is really illustrating how much gray there is in the medical profression.
Last edited by newdoc on Fri Aug 23, 2019 3:37 pm, edited 1 time in total.

User avatar
Munir
Posts: 2553
Joined: Mon Feb 26, 2007 4:39 pm
Location: Oregon

Re: Physician quality and experience

Post by Munir » Fri Aug 23, 2019 3:35 pm

JPH wrote:
Fri Aug 23, 2019 2:43 pm
A complicated question, but most evidence suggests a slow decline in quality of care as years in clinical practice increase. However, I don't know of any study focusing on recent fellowship graduates. Medical information increases at a tremendous rate, and the half life of medical knowledge is relatively brief. A lot of continuing medical education is woeful. See for example the study summarized here: https://www.ncbi.nlm.nih.gov/pubmed/15710959
As a retired surgeon in his eighties, I respectfully disagree with the sentence stating "most evidence suggests a slow decline in quality of care as years in clinical practice increase". I have never met that in my years of practice unless you are referring to physicians in their seventies or over. The peak is after being in practice about 10-20 years. Most health-trained individuals know it is the clinical judgment that is most important in the practice of medicine followed by technical skills for a surgeon- and not necessarily what the latest article is in the "New England Journal of Medicine". Good clinical judgment occurs after years of practice and less so during training so a physician just out of training does not yet have it. However, all these criteria are generalizations and individuals vary. Another guide (which is not easy to identify) is to use the doctors that other doctors use for themselves and their families.

User avatar
Munir
Posts: 2553
Joined: Mon Feb 26, 2007 4:39 pm
Location: Oregon

Re: Physician quality and experience

Post by Munir » Fri Aug 23, 2019 3:41 pm

newdoc wrote:
Fri Aug 23, 2019 3:34 pm
dm200 wrote:
Fri Aug 23, 2019 3:20 pm
I suspect that there is a wide range of the current/updated education/training received or done by different specialists - in the same field for the same number of years.

Sometimes, as a patient, you can glean that a specialist is keeping up to date - but that is difficult.

I believe that Kaiser offers or requires older/experienced Specialists to receive updated specialty training.

One specialist that I know personally - in her late 50's or early 60's attended an out of town full week - all day very intensive specialty training from A to Z.

As far as Primary Care Physicians, with 20/20 hindsight I concluded that my previous PCP (Internal medicine) was often a bit "out of date" when I went to Kaiser and my new Kaiser PCP (also Internal Medicine) did some things differently. Doing some checking on a few of these things (as a lay person), I concluded the new Kaiser Doctor was up to date and my previous PCP (who was about 40 years old) was behind the times.
Yeah, some docs are very aggressive about keeping up to date and others aren't. That said, this is not always indicative of the quality of their work. An older surgeon who does a procedure the same way he/she has done it for 20 years because he/she knows it works and gets great results is far preferable to one trying out a new "flavor-of-the-month" technology every time some new research study comes out. Many a physician have been burned on this before. New information often turns out to be wrong, sometimes catastrophically so (see "Metal on metal hips"). The older doc can still do a great job without being able to rattle off the most recent research data. I think the trick is that they should be at least somewhat familiar with newer technologies and should be able to explain why they do or do not use them. Also, generally, in most instances it is wise to wait until that newer technology is time-tested as being effective, safe and better than older technologies. Usually for there to be a paradigm shift in Medicine, there needs to be overwhelming evidence of this which can take several years or even a decade or more. I think this thread is really illustrating how much gray there is in the medical profession.
+1.

User avatar
JPH
Posts: 938
Joined: Mon Jun 27, 2011 8:56 pm

Re: Physician quality and experience

Post by JPH » Fri Aug 23, 2019 3:58 pm

Munir wrote:
Fri Aug 23, 2019 3:35 pm
JPH wrote:
Fri Aug 23, 2019 2:43 pm
A complicated question, but most evidence suggests a slow decline in quality of care as years in clinical practice increase. However, I don't know of any study focusing on recent fellowship graduates. Medical information increases at a tremendous rate, and the half life of medical knowledge is relatively brief. A lot of continuing medical education is woeful. See for example the study summarized here: https://www.ncbi.nlm.nih.gov/pubmed/15710959
As a retired surgeon in his eighties, I respectfully disagree with the sentence stating "most evidence suggests a slow decline in quality of care as years in clinical practice increase". I have never met that in my years of practice unless you are referring to physicians in their seventies or over. The peak is after being in practice about 10-20 years. Most health-trained individuals know it is the clinical judgment that is most important in the practice of medicine followed by technical skills for a surgeon- and not necessarily what the latest article is in the "New England Journal of Medicine". Good clinical judgment occurs after years of practice and less so during training so a physician just out of training does not yet have it. However, all these criteria are generalizations and individuals vary. Another guide (which is not easy to identify) is to use the doctors that other doctors use for themselves and their families.
Point taken. I should have said "most studies attempting to employ objective measures." That is what the cited review does. I agree with your bolded statement above. There is no question that good clinical judgment comes with experience. However, I hold to my conclusion that there is an age related decline when objective quality of care measures are the outcome.
While the moments do summersaults into eternity | Cling to their coattails and beg them to stay - Townes Van Zandt

sil2017
Posts: 407
Joined: Mon Jan 23, 2017 7:25 am

Re: Physician quality and experience

Post by sil2017 » Fri Aug 23, 2019 4:32 pm

Not sure if best to start a new thread or just ask a question .....
Discussing best doctor....Are doctors from HMO such as Kaiser just a good as the well know clinics such as John Hopkins?
Do you have better doctors from a PPO plan as opposed to a HMO plan?

newdoc
Posts: 64
Joined: Wed Mar 13, 2013 8:21 pm

Re: Physician quality and experience

Post by newdoc » Fri Aug 23, 2019 5:09 pm

sil2017 wrote:
Fri Aug 23, 2019 4:32 pm
Not sure if best to start a new thread or just ask a question .....
Discussing best doctor....Are doctors from HMO such as Kaiser just a good as the well know clinics such as John Hopkins?
Do you have better doctors from a PPO plan as opposed to a HMO plan?
I'll say again that it's not as simple as going off of a particular institution. You really have to investigate doctors individually.

megabad
Posts: 2487
Joined: Fri Jun 01, 2018 4:00 pm

Re: Physician quality and experience

Post by megabad » Fri Aug 23, 2019 5:26 pm

sawhorse wrote:
Thu Aug 22, 2019 11:19 pm
Is there a "peak period" for physicians in cognitive specialties, or does experience not really matter in terms of physician quality? I imagine there are good and bad doctors at all levels of experience. But is there a general trend?
Not a doctor but I am inclined to think doctors are no different than other professionals. Some are good and some are bad. I don't think there are "general trends" that apply to everyone. Are 25 year old factory workers better than 35 year old factory workers? I don't think we can definitively say.

I would be inclined to evaluate a doctor just as I evaluate anyone else--by their resumes. What is your education? What is your experience? Are you properly licensed/certified? Most doctors offices have bios on all the doctors with all this info. Takes a few minutes to verify the licensure, but not long.

I can confirm that I have had some bad doctors in all age groups/experience levels. I can remember a time when a younger doctor once laughed out loud at a much older doctor's diagnosis of a family member's condition. The older doctor's initial diagnosis was cancer, the younger's was an allergic reaction. The cancer still hasn't materialized in my cousin 10 years later....but the allergic reaction has subsided. I was a bit shocked that an experienced doctor could be so wrong and provide such a diagnosis directly to a small child. But i learned my lesson that age wasn't enough.

DesertDiva
Posts: 616
Joined: Thu Mar 01, 2018 12:49 pm
Location: In the desert

Re: Physician quality and experience

Post by DesertDiva » Fri Aug 23, 2019 5:35 pm

newdoc wrote:
Fri Aug 23, 2019 2:10 pm
I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly.
I'm not a doctor, but I've had plenty of experience on the consumer side of things. And I have stayed at a Holiday Inn Express a few times.

I like NewDoc's approach to find someone who isn't fresh out of med school. Even with 5 years experience, I would be happier (> 10,000 hours of real world experience). I would even be more content with a Physician's Assistant who had some years under his/her belt.

Personal experience: our family practice clinic (in another state) hired a new grad. My husband had some odd symptoms and Dr Youngster dismissed them as a side-effect of medications. About 5 months later we moved across the country, and the symptoms never changed but steadily worsened. Our new family practice doctor, probably in her mid-40's, followed up with some tests. As a result, my husband learned he had a rare and aggressive form of lymphoma and was given days to live. Thankfully he did survive, but the journey was traumatic and difficult. I often wonder if his treatment would have been less severe if either 1) Dr Youngster had been a bit more experienced, or 2) if my husband had seen an older, more seasoned doc.

My $0.02 worth. Peace.

User avatar
ResearchMed
Posts: 9372
Joined: Fri Dec 26, 2008 11:25 pm

Re: Physician quality and experience

Post by ResearchMed » Fri Aug 23, 2019 6:12 pm

DesertDiva wrote:
Fri Aug 23, 2019 5:35 pm
newdoc wrote:
Fri Aug 23, 2019 2:10 pm
I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly.
I'm not a doctor, but I've had plenty of experience on the consumer side of things. And I have stayed at a Holiday Inn Express a few times.

I like NewDoc's approach to find someone who isn't fresh out of med school. Even with 5 years experience, I would be happier (> 10,000 hours of real world experience). I would even be more content with a Physician's Assistant who had some years under his/her belt.

Personal experience: our family practice clinic (in another state) hired a new grad. My husband had some odd symptoms and Dr Youngster dismissed them as a side-effect of medications. About 5 months later we moved across the country, and the symptoms never changed but steadily worsened. Our new family practice doctor, probably in her mid-40's, followed up with some tests. As a result, my husband learned he had a rare and aggressive form of lymphoma and was given days to live. Thankfully he did survive, but the journey was traumatic and difficult. I often wonder if his treatment would have been less severe if either 1) Dr Youngster had been a bit more experienced, or 2) if my husband had seen an older, more seasoned doc.

My $0.02 worth. Peace.
Ouch! But so glad it worked out "well", given the other possibility.
Did you even give feedback to Dr. Youngster, by way of helping Y "learn"?

RM
This signature is a placebo. You are in the control group.

DesertDiva
Posts: 616
Joined: Thu Mar 01, 2018 12:49 pm
Location: In the desert

Re: Physician quality and experience

Post by DesertDiva » Fri Aug 23, 2019 6:24 pm

ResearchMed wrote:
Fri Aug 23, 2019 6:12 pm
DesertDiva wrote:
Fri Aug 23, 2019 5:35 pm
newdoc wrote:
Fri Aug 23, 2019 2:10 pm
I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly.
I'm not a doctor, but I've had plenty of experience on the consumer side of things. And I have stayed at a Holiday Inn Express a few times.

I like NewDoc's approach to find someone who isn't fresh out of med school. Even with 5 years experience, I would be happier (> 10,000 hours of real world experience). I would even be more content with a Physician's Assistant who had some years under his/her belt.

Personal experience: our family practice clinic (in another state) hired a new grad. My husband had some odd symptoms and Dr Youngster dismissed them as a side-effect of medications. About 5 months later we moved across the country, and the symptoms never changed but steadily worsened. Our new family practice doctor, probably in her mid-40's, followed up with some tests. As a result, my husband learned he had a rare and aggressive form of lymphoma and was given days to live. Thankfully he did survive, but the journey was traumatic and difficult. I often wonder if his treatment would have been less severe if either 1) Dr Youngster had been a bit more experienced, or 2) if my husband had seen an older, more seasoned doc.

My $0.02 worth. Peace.
Ouch! But so glad it worked out "well", given the other possibility.
Did you even give feedback to Dr. Youngster, by way of helping Y "learn"?

RM
My husband had the opportunity to talk to him on a later visit to our home state to visit family. While there, he needed to see a doctor and called our previous Family Practice clinic. So yes, that conversation happened.

jayk238
Posts: 612
Joined: Tue Jan 31, 2017 1:02 pm

Re: Physician quality and experience

Post by jayk238 » Fri Aug 23, 2019 6:41 pm

Swansea wrote:
Fri Aug 23, 2019 8:29 am
I rely heavily on where the doc did residency for my choices.
That really depends on what you rely on. If its based on name then often it doesnt necessarily translate into real clinical acumen. If its for a rare condition then maybe. If its about whether they are competent then the smaller programs force trainees to be a jack of all trades. Within my first intern year i put in more central lines and intubations than some second years at the 2 hrs away academic center. The larger places see more rare diseases but often refer more readily for consults while small places like mine forced us to learn more.

jayk238
Posts: 612
Joined: Tue Jan 31, 2017 1:02 pm

Re: Physician quality and experience

Post by jayk238 » Fri Aug 23, 2019 6:43 pm

DesertDiva wrote:
Fri Aug 23, 2019 5:35 pm
newdoc wrote:
Fri Aug 23, 2019 2:10 pm
I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly.
I'm not a doctor, but I've had plenty of experience on the consumer side of things. And I have stayed at a Holiday Inn Express a few times.

I like NewDoc's approach to find someone who isn't fresh out of med school. Even with 5 years experience, I would be happier (> 10,000 hours of real world experience). I would even be more content with a Physician's Assistant who had some years under his/her belt.

Personal experience: our family practice clinic (in another state) hired a new grad. My husband had some odd symptoms and Dr Youngster dismissed them as a side-effect of medications. About 5 months later we moved across the country, and the symptoms never changed but steadily worsened. Our new family practice doctor, probably in her mid-40's, followed up with some tests. As a result, my husband learned he had a rare and aggressive form of lymphoma and was given days to live. Thankfully he did survive, but the journey was traumatic and difficult. I often wonder if his treatment would have been less severe if either 1) Dr Youngster had been a bit more experienced, or 2) if my husband had seen an older, more seasoned doc.

My $0.02 worth. Peace.
I find it almost absurd to recommend a pa w few years experience over a new doctor.

Im an internist and most often the comment i receive from patients is that i am more up to date and aware of recent therapies than experienced docs.

jayk238
Posts: 612
Joined: Tue Jan 31, 2017 1:02 pm

Re: Physician quality and experience

Post by jayk238 » Fri Aug 23, 2019 6:45 pm

newdoc wrote:
Fri Aug 23, 2019 2:10 pm
I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly. That said, obviously there is a lot of variability with newly trained docs and some are truly spectacular, but you simply don't know going just off of their experience and no new doc goes without some hiccups when starting out. Also, years of experience does not necessarily translate to familiarity with a rare condition and someone fresh out of training may have trained at a place where they see a lot of that condition and have a leading expert in it. You don't know one's expertise unless and until you ask.

I'll also add that generally it is incredibly difficult for the public to gauge who is and is not a "good doctor," and in many instances it's also a matter of who is good for you. I can tell you that it absolutely is NOT as simple as going off of where they trained and what institutions you think are or are not "prestigious," nor is it as simple as going off of internet reviews or who has the best advertisements. I'll even add that the doctor with the highest IQ isn't necessarily the best doctor either. Doctors are generally pretty good at keeping the dirty laundry contained amongst ourselves and a famous surgeon or a surgeon at a reputable university is in many instances not as skilled as the surgeon at a small community hospital. Frankly, I think the best way to find a doctor is to have friends/family who are doctors and sort of in the know a bit and have them tell you who they'd send their family to. Short of that, find a doctor that you are close with and trust, it may be your previous specialist or your PCP, and have a candid discussion: tell them about your worries and ask who they'd send their loved one to. Even if they can't drop a name off the top of their heads, they'll usually ask around and be able to get back to you with better vetted information than what you'd find online.

All that said, it certainly does not hurt to talk to both the new doc and the other doc first. Ask them your questions, over the phone first if possible. The phone call is a big thing for me, as it's much more difficult for people to fake compassion over the phone. If you feel comfortable with them over the phone, then this is good. You basically want someone who will care for you with the level of intensity that they would a family member.
Most studies show 10 years as the preferred time for experience.

DesertDiva
Posts: 616
Joined: Thu Mar 01, 2018 12:49 pm
Location: In the desert

Re: Physician quality and experience

Post by DesertDiva » Fri Aug 23, 2019 6:48 pm

jayk238 wrote:
Fri Aug 23, 2019 6:43 pm
DesertDiva wrote:
Fri Aug 23, 2019 5:35 pm
newdoc wrote:
Fri Aug 23, 2019 2:10 pm
I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly.
I'm not a doctor, but I've had plenty of experience on the consumer side of things. And I have stayed at a Holiday Inn Express a few times.

I like NewDoc's approach to find someone who isn't fresh out of med school. Even with 5 years experience, I would be happier (> 10,000 hours of real world experience). I would even be more content with a Physician's Assistant who had some years under his/her belt.

Personal experience: our family practice clinic (in another state) hired a new grad. My husband had some odd symptoms and Dr Youngster dismissed them as a side-effect of medications. About 5 months later we moved across the country, and the symptoms never changed but steadily worsened. Our new family practice doctor, probably in her mid-40's, followed up with some tests. As a result, my husband learned he had a rare and aggressive form of lymphoma and was given days to live. Thankfully he did survive, but the journey was traumatic and difficult. I often wonder if his treatment would have been less severe if either 1) Dr Youngster had been a bit more experienced, or 2) if my husband had seen an older, more seasoned doc.

My $0.02 worth. Peace.
I find it almost absurd to recommend a pa w few years experience over a new doctor.

Im an internist and most often the comment i receive from patients is that i am more up to date and aware of recent therapies than experienced docs.
Not trying to be insulting - I have respect for anyone who makes it out of med school - but what good is recommending the latest therapies/treatments if you don't have the acumen to properly diagnose a problem in the first place? That's the crux of the matter.

Personally, I believe that a doctor should have "critical thinking" abilities to get to the root cause of a matter. Experience would enable a doctor to develop this skill more effectively.

Topic Author
sawhorse
Posts: 3460
Joined: Sun Mar 01, 2015 7:05 pm

Re: Physician quality and experience

Post by sawhorse » Fri Aug 23, 2019 8:36 pm

jayk238 wrote:
Fri Aug 23, 2019 6:43 pm
Im an internist and most often the comment i receive from patients is that i am more up to date and aware of recent therapies than experienced docs.
Do you think there's a tendency for new physicians to gravitate toward the newer therapies as the first choice rather than trying an old medication first? There have been plenty of instances in which a new drug has later been shown to not be any more effective than an old drug, but the newer drugs cost far more and might be difficult for patients to afford.

Do you find one group to be more cost conscious than another?

fposte
Posts: 1722
Joined: Mon Sep 02, 2013 1:32 pm

Re: Physician quality and experience

Post by fposte » Fri Aug 23, 2019 10:54 pm

DesertDiva wrote:
Fri Aug 23, 2019 6:48 pm

Not trying to be insulting - I have respect for anyone who makes it out of med school - but what good is recommending the latest therapies/treatments if you don't have the acumen to properly diagnose a problem in the first place? That's the crux of the matter.
I think there are a few different matters with a few different cruxes happening in this conversation overall, though. The OP started by talking about a medical specialist to manage an ongoing/chronic condition, then somehow surgery entered the conversation, and now you're talking about diagnostic skills. I think that the value of experience may well peak differently in each of these three different situations.

TheNightsToCome
Posts: 452
Joined: Fri Jun 30, 2017 11:48 pm

Re: Physician quality and experience

Post by TheNightsToCome » Fri Aug 23, 2019 11:48 pm

A physician fresh out of training may be very good. How good depends on the individual and the training rec'd.

However, any physician who isn't better after 5-10 years of practice is doing something wrong.

User avatar
leeks
Posts: 783
Joined: Thu Apr 07, 2011 4:33 pm
Location: new york

Re: Physician quality and experience

Post by leeks » Sat Aug 24, 2019 12:15 am

sawhorse wrote:
Thu Aug 22, 2019 11:19 pm
By switching over to the new doctor, I can get an appointment within a couple months. If I want to switch to another doctor in the practice, I would have to wait longer. I could also try moving to another practice, but who knows how long I would have to wait.
Could you just call and make an appointment at another practice as a back-up, since you expect that couldn't be scheduled until after you would see the new specialist anyway? If you are satisfied with the new one, you cancel the other appointment. If you aren't satisified - or just want a second opinion - you can keep the appointment at the alternative practice.

Topic Author
sawhorse
Posts: 3460
Joined: Sun Mar 01, 2015 7:05 pm

Re: Physician quality and experience

Post by sawhorse » Sat Aug 24, 2019 2:21 am

TheNightsToCome wrote:
Fri Aug 23, 2019 11:48 pm
A physician fresh out of training may be very good. How good depends on the individual and the training rec'd.

However, any physician who isn't better after 5-10 years of practice is doing something wrong.
That was my thinking too. I imagine every physician with 5-10 years of practice would say that they're better than when they first started.

User avatar
JPH
Posts: 938
Joined: Mon Jun 27, 2011 8:56 pm

Re: Physician quality and experience

Post by JPH » Sat Aug 24, 2019 7:30 am

DesertDiva wrote:
Fri Aug 23, 2019 6:48 pm
jayk238 wrote:
Fri Aug 23, 2019 6:43 pm
DesertDiva wrote:
Fri Aug 23, 2019 5:35 pm
newdoc wrote:
Fri Aug 23, 2019 2:10 pm
I'm a new doc and I have to say, personally I generally advise my family members to seek someone with around 15 years experience, particularly if it's in a procedure based specialty. At 15 yrs a doc is young enough to be familiar with newer technologies but experienced enough to, well, know what they're doing, frankly.
I'm not a doctor, but I've had plenty of experience on the consumer side of things. And I have stayed at a Holiday Inn Express a few times.

I like NewDoc's approach to find someone who isn't fresh out of med school. Even with 5 years experience, I would be happier (> 10,000 hours of real world experience). I would even be more content with a Physician's Assistant who had some years under his/her belt.

Personal experience: our family practice clinic (in another state) hired a new grad. My husband had some odd symptoms and Dr Youngster dismissed them as a side-effect of medications. About 5 months later we moved across the country, and the symptoms never changed but steadily worsened. Our new family practice doctor, probably in her mid-40's, followed up with some tests. As a result, my husband learned he had a rare and aggressive form of lymphoma and was given days to live. Thankfully he did survive, but the journey was traumatic and difficult. I often wonder if his treatment would have been less severe if either 1) Dr Youngster had been a bit more experienced, or 2) if my husband had seen an older, more seasoned doc.

My $0.02 worth. Peace.
I find it almost absurd to recommend a pa w few years experience over a new doctor.

Im an internist and most often the comment i receive from patients is that i am more up to date and aware of recent therapies than experienced docs.
Not trying to be insulting - I have respect for anyone who makes it out of med school - but what good is recommending the latest therapies/treatments if you don't have the acumen to properly diagnose a problem in the first place? That's the crux of the matter.

Personally, I believe that a doctor should have "critical thinking" abilities to get to the root cause of a matter. Experience would enable a doctor to develop this skill more effectively.
Actually, accreditation agencies only recently have forced medical schools to include critical thinking skills in their curricula. When this happened at my institution many of the older faculty had a hard time getting with the program. Students actually started asking them to defend some of the things they were teaching.
While the moments do summersaults into eternity | Cling to their coattails and beg them to stay - Townes Van Zandt

fasteddie911
Posts: 286
Joined: Fri May 16, 2008 3:13 pm

Re: Physician quality and experience

Post by fasteddie911 » Sat Aug 24, 2019 7:31 am

dm200 wrote:
Fri Aug 23, 2019 12:06 pm
According to my PCP, dealing with Cardiologists, she noted that younger cardiologists tend to order and want more tests and more invasive types of theses - such as CT scans. In my case, I did not want to be unnecessarily bombarded with excess X-Rays from a CT scan. My PCP then made a referral for me to see an older cardiologist, who did not believe a CT scan of my heart was needed. :happy
Not sure of the details of your case, but this could also be an example of younger doctors being more up-to-date and/or older doc stuck in their ways. Something like a cardiac CT is relatively new (non-invasive btw) test, whereas old school method could be a cath, stress test, etc. Nevertheless, I haven't seen older docs practice any more or less aggressively than younger ones. In fact, I know a great veteran doc who started practicing more aggressively (ordering tests, etc.) after he lost a malpractice case. Every doc has their own style and it's about finding one that suits you.

cresive
Posts: 342
Joined: Sat Nov 26, 2016 12:12 pm
Location: Virginia, USA
Contact:

Re: Physician quality and experience

Post by cresive » Sat Aug 24, 2019 7:54 am

sawhorse wrote:
Thu Aug 22, 2019 11:19 pm
One of my specialists, the only doctor that I've seen for this condition at my current location, left the practice with only a week's notice.

The practice has hired someone straight out of fellowship. She hasn't started because "she has to get her credentials sorted out" according to the office. I don't know what this means, but regardless, she's very inexperienced.

By switching over to the new doctor, I can get an appointment within a couple months. If I want to switch to another doctor in the practice, I would have to wait longer. I could also try moving to another practice, but who knows how long I would have to wait.

Am I justified in feeling reluctant to switch to the new doctor? My condition is rare. I doubt she saw many cases in her training.

Is there a "peak period" for physicians in cognitive specialties, or does experience not really matter in terms of physician quality? I imagine there are good and bad doctors at all levels of experience. But is there a general trend?
Credentialing, Is basically a paperwork process where the state demands proof that the physician has a proper license to practice in the state, has the correct insurances, and has a place to practice and refer patients. It is a process that ALL physicians have to go through. Even if your new doctor had 20 years of experience, he would have to go through the credentialing process before he could see patients at a new hospital, etc.

I am cautiously optimistic that the new physician would be able to treat whatever you have. She has completed a fellowship, which is extra training AFTER her residency so she is obviously interested in the area of her expertise. Since you haven't given any information on your condition, or the fellowship, I can't comment on how they align. You may be lucky and your new physician completed her fellowship in an area that makes here an expert in treating your condition.

As for Peak Periods, yes everyone in every career has that. As for physicians, there are many factors such as experience, real life experience, how diligent they are at maintaining their skills, etc. Fortunately, you have already been diagnosed, so much of your care will be maintenance or preventing complications. For many rare conditions, the hardest part can be diagnosing the condition, itself. If that is true in your case, you may enjoy having a new doctor who will get to really know you and help with your progress. Since you have some experience with your condition, you have a good position from which to ask questions about any changes, or new tests. The upside of having a new doctor is that she is probably NOT going to leave or retire on you.

Good luck,
Ben

Post Reply