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@merpreb

@mpflood7- Good morning and welcome to Mayo Clinic Connect. Wow, what a fantastic question! And one that everyone should ask. I know that it's scary to go to a hospital, even if it's your one-hundredth time, never mind your first. Consumer Reports have a yearly report of all the top hospitals and their specialties so you might want to check there.
https://www.consumerreports.org/hospitals/HowToChooseAHospital/
I think that when you need to choose a hospital for specialty care it's important to find a teaching hospital. Teaching hospitals develop new and better ways to care for patients through outcomes-based research and the development of new technologies. The downside to this is that you will most likely be working with students along with your doctors. The second thing to look for is location. I'm an hour, by train, to Mass General in New England so I go there. When I had my first lung operation my pulmonologist recommended a young doctor who studied at Harvard who practiced in a local hospital. After he left for MGH to be closer to his home I followed him for my follow-up CT scans and a need for a second lobectomy for my second cancer. He has been my lead doctor for 23 years next month. The difference between hospitals and patient care was incredible.

You are right that ad hoc care doesn't work with patients because there is no real coordinated teamwork and for great care, there needs to be a coordinated effort of care between doctors who do get together in some sort of committee meeting to decide what to present to the patient as their best recommendations for care and survival and life quality. I have an Oncologist who is in charge of my care, a surgeon (who, because of our long term relationship ok's everything lol), a radiologist oncologist, and more for other problems. But my care is essentially coordinated by one doctor.

I think that when insurance companies took over patient care inpatient collaborative care for diagnostic purposes flew out the window. Because doctors who work in the type of system are lined up to work with each other they are selected because of their understandings of each others specialty. I don't think that it would work otherwise, and it's one of the reasons that ad hoc care doesn't work.

When I made my decision to follow my doctor to MGH I made it knowing that it was the best care that I could get and that I could be an out of state patient because I had insurance that paid for it. Have you checked to see if your insurance covers out of state medical care?

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Replies to "@mpflood7- Good morning and welcome to Mayo Clinic Connect. Wow, what a fantastic question! And one..."

My name is Jennifer and I have just joined the Mayo Connect. I was first Diagnosed with gastroparesis in 2/19. Before that I had/have the following: SOUND SENSITIVITY, CANT TALK/CANT TALK LOUD, CANT SWALLOW WELL, HANDS AND FEET STAY COLD, TIGHTNESS IN RIGHT SIDE OF NECK/FACE, ARNOLD CHIARIA MALFORMATION, CONSTIPATION, SEVERE WEIGHT LOSS (over 30 lbs n a yr), BAIN PAIN (L4-S1), ARTHRITIS, SI DYSFUNCTION, RT ARM SURGERY AND PAIN AND NUMBNESS, SORES IN MOUTH (can’t think of word), DENTAL ISSUES. I could go on. I’ve had every blood test my PCP can think of. Been to multiple drs. Most recent news is a feeding tube. I know my body well enough to know that the drs are missing something. Not much support from family. Single mom with a 16 yr old daughter. Still barely holding down a job (been warned that my production is low and next step is written warning then termination). Clueless as to what to do or where to go😢

Thank you Merry. You sound very knowledgable and yes, my insurance covers out of state care. I didn’t think of Consumer Reports. Great suggestion. I also over-looked that Mayo would presumably have student doctors as guided by more seasoned doctors. To confirm though, is this the case at Mayo? I had been to teaching dental schools and actualy find them better. I would guess that the same would hold true with teaching hospitals - that is, because the students are being graded, they are more vigilent and thorough (unlike many doctors who have been in practice for a long time and become lazy) as well as supervising doctors who I again would guess would be more enthusiastic due to such positions attracting experienced doctors who enjoy helping doctors in training. All in all, the younger student doctor combined with the more experienced teaching doctor would seem to be a synergistic relationship. Is that your view as well?