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Oncologist says dismissive, unresponsive attitude could signal need for new physician

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By Adam Smeltz
Sunday, Sept. 30, 2012, 12:05 a.m.
 

Darshell Bennett had just left work when her doctor dropped the bomb.

She had breast cancer, he announced brusquely over the phone as she drove.

A nurse called back to ask if she was OK, but the damage was done.

When Bennett went back for pre-surgery tissue tests, she said, her provider's rough bedside manner and rushed style were the final straw.

“They didn't even act like I was a person,” said Bennett, 39, of Penn Hills. She found another, reassuring doctor who left critical decisions to her.

“It takes a great doctor, I think, to hold your hand but also to give you the knowledge you need to make an informed decision about your life,” said Bennett, who elected a double mastectomy in February. “You're going to have to live with this the rest of your life.”

Breast-cancer survivors encourage other patients to take control if they feel uncomfortable, disrespected or hurried through diagnoses and treatments. Oncologists agree.

“I think the worst thing for a patient is to keep on seeing a doctor if they don't feel they're getting the personal care, attention or management that makes them comfortable with where they're going,” said Dr. Jane M. Raymond, an oncologist at Allegheny General Hospital.

She said a dismissive and unresponsive attitude toward patient concerns may be red flags that should send women elsewhere. In some cases, Raymond said, a patient simply might have a personality clash with a physician.

“I guess the longer I do this, the more I realize there's usually never one way to treat a patient or one way to do anything,” Raymond said.

Given that, she almost never needles a patient to pick one treatment path over another. Instead, Raymond said, she outlines possibilities, risks and benefits. “The last thing I want to do is talk someone into chemotherapy if they really don't want it.”

For patients who want to switch doctors, it's usually better to do so early on, around the time of the diagnosis, said Dr. D.L. Wickerham, chief of cancer genetics and prevention at Allegheny General.

“It becomes more difficult to get second opinions or arrange for a transfer” as treatments progress, said Wickerham, associate chairman at the National Surgical Adjuvant Breast and Bowel Project in Pittsburgh's North Side.

He said doctors seldom take requests for second opinions or case transfers as an affront.

A California-based study this year found 90 percent of surveyed black women were satisfied with their breast-cancer treatments. Nearly 25 percent of them, however, thought their doctors could have offered more information and treatment options.

Black support-group leaders said trends are similar in Western Pennsylvania. Blacks long have felt disrespect in the health care system, though that tension is easing, group leaders said.

“I think there certainly was a feeling, generally, that they weren't receiving the same care,” said Marlene von Friederichs-Fitzwater, an administrator at the University of California-Davis Comprehensive Cancer Center and lead author of the California study.

“If you're not given all the information about the disease and your treatment options, maybe the treatment option you chose doesn't work out as well. Or maybe you don't follow it because it wasn't your choice,” she said.

The availability of information was critical for Sylvia Lowery-Lewis, 59, who dumped her oncologist between treatment phases. She didn't “feel I was getting the information I needed,” she said.

“I don't need 5 or 10 minutes. Sometimes I may need half an hour to talk” with the oncologist, said Lowery-Lewis, of Highland Park. “You have control. This is your body. These are things for your life. Only you know how you feel.”

' Jasmine Goldband | Tribune-Review - Medical oncologist Dr. Jane Raymond gets an update on Sharon Herring-Turner, 61, of Perry Hilltop — a stage two breast cancer survivor — before a chemotherapy in Allegheny General Hospital. Raymond suggested women switch doctors 'if they don't feel they're getting the personal care, attention or management that makes them comfortable with where they're going.
<div style='float:right;width:100%;' align='right'><em>' Jasmine Goldband  |  Tribune-Review</em></div>Medical oncologist Dr. Jane Raymond gets an update on Sharon Herring-Turner, 61, of Perry Hilltop — a stage two breast cancer survivor — before a chemotherapy in Allegheny General Hospital.  Raymond suggested women switch doctors 'if they don't feel they're getting the personal care, attention or management that makes them comfortable with where they're going.
Jasmine Goldband | Tribune-Review - Sharon Herring-Turner, 61, of Perry Hilltop speaks with Sandy Kagle, a radiological technologist, in Allegheny General Hospital before getting a mammogram. Experts advise cancer patients to ask a lot of questions and educate themselves.
<div style='float:right;width:100%;' align='right'><em> Jasmine Goldband  |  Tribune-Review</em></div>Sharon Herring-Turner, 61, of Perry Hilltop speaks with Sandy Kagle, a radiological technologist, in Allegheny General Hospital before getting a mammogram. Experts advise cancer patients to ask a lot of questions and educate themselves.
Jasmine Goldband | Tribune-Review - Sharon Herring-Turner, 61, of Perry Hilltop — a stage two breast cancer survivor — grips her daughter's hand as an IV is started before undergoing a partial mastectomy at Allegheny General Hospital. 'The physical pain-it doesn't bother me. I have a high tolerance for pain and I can take it,' she said. Dori Wallace (left) CRNA (certified registered nurse anesthetist) and Dr. Florin Orza (who is starting the IV), both are from the Anesthesia Department at AGH.
<div style='float:right;width:100%;' align='right'><em> Jasmine Goldband  |  Tribune-Review</em></div>Sharon Herring-Turner, 61, of Perry Hilltop — a stage two breast cancer survivor — grips her daughter's hand as an IV is started before undergoing a partial mastectomy at Allegheny General Hospital. 'The physical pain-it doesn't bother me.  I have a high tolerance for pain and I can take it,' she said.  Dori Wallace (left) CRNA (certified registered nurse anesthetist) and Dr. Florin Orza (who is starting the IV), both are from the Anesthesia Department at AGH.
Jasmine Goldband | Tribune-Review - Surgical oncologist Dr. Kathleen Erb (right) and breast oncology fellow Dr. Shavani Duggal perform a partial mastectomy on Sharon Herring-Turner, 61, of Perry Hilltop — a stage two breast cancer survivor — in Allegheny General Hospital. Research that popularized less-disfiguring breast surgery was pioneered in Pittsburgh.
<div style='float:right;width:100%;' align='right'><em> Jasmine Goldband  |  Tribune-Review</em></div>Surgical oncologist Dr. Kathleen Erb (right) and breast oncology fellow Dr. Shavani Duggal perform a partial mastectomy on Sharon Herring-Turner, 61, of Perry Hilltop — a stage two breast cancer survivor — in Allegheny General Hospital. Research that popularized less-disfiguring breast surgery was pioneered in Pittsburgh.
Jasmine Goldband | Tribune-Review - Darshell Bennett, 39, of Penn Hills undergoes a bone mass density — or DEXA — scan in Forbes Regional Hospital in Monroeville. 'When you get cancer, you have to have a backbone,' she said.
<div style='float:right;width:100%;' align='right'><em> Jasmine Goldband  |  Tribune-Review</em></div>Darshell Bennett, 39, of Penn Hills undergoes a bone mass density — or DEXA — scan in Forbes Regional Hospital in Monroeville.  'When you get cancer, you have to have a backbone,' she said.
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