[ColdNoMore]

Originally Posted by Bigben007

I have something serious, I’m heading of to Pittsburgh. Go where you feel comfortable.

Good luck.

[golfing eagles]

Originally Posted by biker1

This is a very strange question (highlighted below). I would actually prefer Moffitt and I am actually going there. They are a bit over an hour away and are ranked #6 in the US, which is better than Roswell Park. I do not have a good handle on exactly what factors go into the rankings but at some point you are choosing the actual Drs you feel comfortable with and not so much the institution. If you have some specific information to share as to why someone should go to NY then please do so. I could have also chosen U of Florida/Shands or Mayo (and have actually been to both for other issues and the outcomes were fantastic).

Not a strange question at all. The statement was in response to the post that claimed health care "here" (I assume Central Florida) was better than "there" (Western NY). It was not a suggestion to travel 1200 miles and bypass Moffit when you live here. I wouldn't either, since the difference in most of the top places is the furniture in the waiting room, not the quality of care.

Beware "rankings", they mean very little. The individual oncologist you work with is far more important than the building they work in. Sloan is always ranked very high, but having done several months of rotations there, you couldn't pay me to be a patient there. They have good and not so good oncologists, like everywhere. But they also make you sign a document that you agree to any experimental treatment protocol they choose. That's great for a stage 4 rhabdomyosarcoma, but not so good for a stage 4 Hodgkin's, where the current CURE rate is about 99%

Also beware of a "name". I hope no one believes that Mayo clinic in Jacksonville (or Phoenix for that matter) is the same as Minnesota, or that MD Anderson in Orlando is identical to Houston. The best example of this is Joselin Clinic, located near Beth Israel in Boston and acknowledged as the world leader in diabetic care. However, about 20 years ago they "franchised" out their name and protocols so there are now "Joselin Clinics" all over the place. Usually these franchises were gobbled up by endocrinologists that weren't making out so well, aka "B players". Not all, but a fair share.

This is very scary to me because you never know until something happens if you have made a good choice or not. As long as you are healthy all you can judge about your doctor is if he is personable.

[golfing eagles]

Originally Posted by fw102807

This is very scary to me because you never know until something happens if you have made a good choice or not. As long as you are healthy all you can judge about your doctor is if he is personable.

Which I can only imagine is quite scary for the average lay person, since your statement is generally true. You can look up any licensure issues, but they are quite rare. You can look up malpractice actions, but many of the best physicians attract the most malpractice cases (they take on more difficult cases, their patients may have unreasonable expectations, lawyers like picking off an expert, etc.). You can see where they went to medical school, but won't know if they graduated 176th in a class of 154 at Harvard and took 6 years to do it. I will say this---beware the doc who went to Harvard Med and then did a residency at Podunk Community Hospital. Likewise, don't dismiss a doc who went to the East Las Vegas School of Medicine and Bartending, but did his residency at Mass. General. The good news is that physician skills and judgement tend to follow a bell shaped curve, so while you may not catch the top 10%, you are just as unlikely to get the bottom 10%.

My only advantage is that I can sniff out the clowns in about 90 seconds of conversation. I ran into one 2 years ago, who was spouting out the biggest crock of BS I had heard in years, and claimed he had learned this from Dr. "X". Unfortunately for him, Dr. "X" was one of the interns I had trained 30 years earlier, so I knew none of this garbage had come from him.

So while it seem like a bit of a crap shoot to find a good doctor, the odds are still in your favor.

Originally Posted by golfing eagles

Which I can only imagine is quite scary for the average lay person, since your statement is generally true. You can look up any licensure issues, but they are quite rare. You can look up malpractice actions, but many of the best physicians attract the most malpractice cases (they take on more difficult cases, their patients may have unreasonable expectations, lawyers like picking off an expert, etc.). You can see where they went to medical school, but won't know if they graduated 176th in a class of 154 at Harvard and took 6 years to do it. I will say this---beware the doc who went to Harvard Med and then did a residency at Podunk Community Hospital. Likewise, don't dismiss a doc who went to the East Las Vegas School of Medicine and Bartending, but did his residency at Mass. General. The good news is that physician skills and judgement tend to follow a bell shaped curve, so while you may not catch the top 10%, you are just as unlikely to get the bottom 10%.

My only advantage is that I can sniff out the clowns in about 90 seconds of conversation. I ran into one 2 years ago, who was spouting out the biggest crock of BS I had heard in years, and claimed he had learned this from Dr. "X". Unfortunately for him, Dr. "X" was one of the interns I had trained 30 years earlier, so I knew none of this garbage had come from him.

So while it seem like a bit of a crap shoot to find a good doctor, the odds are still in your favor.

Thank you that is somewhat comforting. Our doctor did his residency at New York Methodist Hospital which is why I picked him.

[golfing eagles]

Originally Posted by fw102807

Thank you that is somewhat comforting. Our doctor did his residency at New York Methodist Hospital which is why I picked him.

Methodist in Brooklyn??? I did my first clinical rotation there.

Originally Posted by golfing eagles

Methodist in Brooklyn??? I did my first clinical rotation there.

Yes, Dr Swietarski

[golfing eagles]

Originally Posted by fw102807

Yes, Dr Swietarski

Don't know him, but then again since I was there in 1981, I probably pre-date him.

[biker1]

I have never been a believer in such blanket statements. It is sort of like saying that Harvard is better than Yale. The department and the people are what matter. My own experience at Mayo in Jacksonville in the orthopedic department could not have been better and I don't believe it is possible to have had a better outcome anywhere, and that was after two well respected sports medicine practices could not diagnose, let alone, repair the problem. I sort of look at Mayo as the "place you go when nobody else has a clue".

It would be more useful to state which departments at which facilities are the best since it is doubtful that one facility has all the best departments. Having been in the "biz", you are in a position to state "if you have this problem, the best people are here". Thanks.

Originally Posted by golfing eagles

I hope no one believes that Mayo clinic in Jacksonville (or Phoenix for that matter) is the same as Minnesota

[golfing eagles]

Originally Posted by biker1

I have never been a believer in such blanket statements. It is sort of like saying that Harvard is better than Yale. The department and the people are what matter. My own experience at Mayo in Jacksonville in the orthopedic department could not have been better and I don't believe it is possible to have had a better outcome anywhere, and that was after two well respected sports medicine practices could not diagnose, let alone, repair the problem. I sort of look at Mayo as the "place you go when nobody else has a clue".

It would be more useful to state which departments at which facilities are the best since it is doubtful that one facility has all the best departments. Having been in the "biz", you are in a position to state "if you have this problem, the best people are here". Thanks.

Sounds good in theory, but not that simple. It's like asking who is the best surgeon for an appendectomy. Well, just about anyone since a surgeon who can't perform a great appendectomy needs a career change. Who has the best orthopedic dept.? Who is the best orthopedist? For what? A knee arthroscopy?---just about all of them. For a lateral approach TKR? The list gets shorter. For a repeat TKR in a patient who had an infected prosthesis with osteomyelitis and recurrent sepsis, bone loss and weighs 350#. Very short list. And in the latter case, probably half the orthopedists who might be able to do it wouldn't attempt it, since "the powers that be" are keeping statistics on bad outcomes.

One of the country's best cardiac surgeons of the 80's had a mortality rate approaching 5% while his peers were at 1.5%. Why? Because Randy would take on cases that no one else would touch---meaning he gave those patients a chance while the others would let them die. Remember, statistics don't lie, people lie with statistics

Mayo in Jacksonville may be an excellent facility with a superb medical staff, maybe Phoenix is as well. But if they do, it is because they built a great institution and staff, not because they share a name with a famous clinic/hospital.

[biker1]

You have essentially agreed with me that the people are most important. Remember, this started with your rhetorical question of where would you rather go; Moffitt or Roswell Park. That's a "facility centric" statement, not a "who has the best person for what ails you" statement. I don't think anyone is suggesting that the name of the facility alone is a guarantee of quality care but, again, you asked the rhetorical question about which facility would you rather go to.

Thanks for providing some insight. My own experience is to keep hunting around until I find a physician who I have confidence in. I often find the starting point to be the bigger "named" facilities. A couple of procedures that I have had done in the past worked out well but it took some hunting around to find a guy I was comfortable with. I have another surgery coming up - hopefully I have picked the right guy.

Originally Posted by golfing eagles

Sounds good in theory, but not that simple. It's like asking who is the best surgeon for an appendectomy. Well, just about anyone since a surgeon who can't perform a great appendectomy needs a career change. Who has the best orthopedic dept.? Who is the best orthopedist? For what? A knee arthroscopy?---just about all of them. For a lateral approach TKR? The list gets shorter. For a repeat TKR in a patient who had an infected prosthesis with osteomyelitis and recurrent sepsis, bone loss and weighs 350#. Very short list. And in the latter case, probably half the orthopedists who might be able to do it wouldn't attempt it, since "the powers that be" are keeping statistics on bad outcomes.

One of the country's best cardiac surgeons of the 80's had a mortality rate approaching 5% while his peers were at 1.5%. Why? Because Randy would take on cases that no one else would touch---meaning he gave those patients a chance while the others would let them die. Remember, statistics don't lie, people lie with statistics

Mayo in Jacksonville may be an excellent facility with a superb medical staff, maybe Phoenix is as well. But if they do, it is because they built a great institution and staff, not because they share a name with a famous clinic/hospital.

[golfing eagles]

Originally Posted by biker1

You have essentially agreed with me that the people are most important. Remember, this started with your rhetorical question of where would you rather go; Moffitt or Roswell Park. That's a "facility centric" statement, not a "who has the best person for what ails you" statement. I don't think anyone is suggesting that the name of the facility alone is a guarantee of quality care but, again, you asked the rhetorical question about which facility would you rather go to.

Thanks for providing some insight. My own experience is to keep hunting around until I find a physician who I have confidence in. I often find the starting point to be the bigger "named" facilities. A couple of procedures that I have had done in the past worked out well but it took some hunting around to find a guy I was comfortable with. I have another surgery coming up - hopefully I have picked the right guy.

Absolutely agree. My only point was that, in general, the health care in western/central NY is better than central Florida, IMHO. Good luck with your surgery, just by reading yours posts I'm pretty sure you've picked the right guy.

Originally Posted by golfing eagles

Absolutely agree. My only point was that, in general, the health care in western/central NY is better than central Florida, IMHO. Good luck with your surgery, just by reading yours posts I'm pretty sure you've picked the right guy.

We come from the Boston area. The healthcare here is definitely not what we had up there but the lifestyle here is infinitely better. It's all about choices. Are you more worried about living or dying.

[NYGUY]

Originally Posted by fw102807

....Are you more worried about living or dying.

I'm more worried about living while I am not dying.

[2BNTV]

I am happy with the healthcare rendered by TV Health Center and Dr. Saul Rosenblum. I haven't had any serious health issues and I like the fact that I'm able to spend 1/2 hour for an appointment and never feel rushed.

I used to call my Dr. back in the northeast, Dr. Death. He had the personality of an ashtray.

Generally, I think healthcare in the northeast to be superior to most of the country but that's me. I'm sure there are some specialty hospitals that are worth going to for difficult problems. IMHO

Those that have encountered serious health issues will probably disagree strongly so don't throw tomatoes.