When to switch doctors? Anyone take this step?

I met him in May 2024, he did the biopsy in August and the Surgery in November. I've talked with him in televisits but not seen him in person for 15 months. Oddly that changes today. I complained about being assigned to different people including a PA this time, and I'll get in to see him in person this afternoon. I'm also scheduling a visit to Mayo Clinic (I live in Phoenix) to see if what my guy is doing lines up with what another expert says should be happening with my pathology.

keep insisting on seeing the best you can
if you live near a teaching hospital you may want to check out an additional opinion
I did this in the Maryland Washington DC area and was surprised how easy it was for me to get an opinion from a GW urologist and my insurance covered it

Thinking they put you with a PA instead of a doctor post surgery during the watch period. Hopefully your doctor was in front of you post surgery to answer all of your questions. I would think your PA could answer all of your questions if they work full time in the prostate cancer world. If that is the case I would be ok with that. If your numbers start rising they probably won't do anything until you hit .2 in the US. My liver PA was well qualified to manage my serious liver condition. She always consulted through notes with my doctor. He was always there for my treatments and biopsies. If it stays at .02 based on my experience just keep watching it through regular psa tests. It could settle there. RP's have many patients that have to go back for salvage radiation in a year or two if the psa rises.

Don't hesitate to switch doctors. They usually understand and you need to do what is in your best interest.

I switched doctors after 5 years of treatment (or lack thereof). I happily drive 11 hours one way to Mayo in Rochester, though I do have a new local urologist who is willing to work with Mayo instead of against them.

I've posted these before...

Over the 11+ years of my journey I've developed rules for my medical team...

Know your stuff. As part of my medical team, you must have a thorough knowledge of my cancer and of the latest developments in research and be ready to formulate a plan of attack. If what I ask about based on my research is not familiar with you, then admit it, say you will look into it and discuss on my next consult. Better yet, you will call me!

Do your homework. I expect you to have reviewed my medical records prior to my appointment, talked with other doctors I have seen that day.... You’ve looked at my x-rays; you have my pathology report, labs. I can tell when you're looking at my clinical data from tests for the first time !

Respect my point of view. Listen to all sides thoughtfully before reaching a conclusion. With patience and finesse, I’m sure you can help me to feel confident about the plan you and I have shaped for me.

Don’t close your mind to new hypotheses and don’t ignore clues that might lead you toward the best results. Rid yourself of the temptation to make your day easier by delivering perfunctory care.

When it’s decision time, please decide! Care for me with a dogged determination to get me healthy

Follow up on promises and follow through on tasks. I can tell you with absolute certainty that there is no greater disappointment than realizing that you cannot rely on your doctor.

Please talk to me. I need your advice, comfort, and expertise; I am scared and discouraged—are you willing to take a seat, look me in the face, and answer my questions?

And yes, the front desk is key, sets the tone, pleasant, efficient on check in and scheduling on the way out...a kind word, smile...and don't call me "honey." You have my records, I am ok with you calling me by my first name or Mr.___

After surgery, then BCR and the failure of SRT, I consulted with the Director of Urology at a NCCN here in Kansas City. This individual was also the head of a major north american urology organization with an impressive resume. I laid out my clinical history, then talked about the recent STAMPEDE and CHAARTED studies and how triplet therapy might be a feasible treatment decision. He dismissed the idea, said he would start me on continuous ADT monotherapy....

He left the consult, turned me over to his PA. I looked at the PA and said, you know I'm not doing that and I'm not coming back!? He nodded.

It was not that I disagreed that at the present I did not fit the clinical criteria in those studies, but given my PSAT and PSAV, I soon would.

I left, went to Mayo, had the C11 Choline scan done, did triplet therapy, changed my life.

I "fired" another urologist when his ego and wallet got in the way. He was out of country, my PSA results came back and based on our decision criteria for imaging, he had ordered a PSMA scan. I reached out to my radiologist while he was out of office vacationing, she saw me, we agreed to SBRT and to see an oncologist she recommended to discuss systemic therapy.

When my urologist got back and I came into to see him, laid out the treatment plan and asked what he thought, his answer, I can't help you, you've gone outside this practice...! I said wrong answer, I asked what you thought about the treatment plan. I left.

So, if your medical team's doctor style doesn't fit your patient style, find someone who does!

Thank you

I changed doctors after he became extremely angry after I asked him four simple yes or no questions. I have read for years that a person should make a list of questions to ask your doctor.
I saw my new doctor just once. That was over a year ago.

I changed doctors after my first biopsy. I thought the doctor was outstanding but the hospital was problematic. The biopsy came back negative. This doctor, realizing that I wasn't pleased, told me I should get a 2nd biopsy ('cause MRI PIRADS 5) even if I go elsewhere. "My ego is not what's important." He has my lasting respect!