On this go around, my urologist too affront to me seeing a radiologist and oncologist outside his practice group and said he could not "help" me because the two systems, aka, health portals...did not talk to each other...I looked in the eye and said:

OK, your ego is hurt because I was proactive and sought and obtained care elsewhere.

The correct response based on your hippocratic oath should have been - let me know how I can help...

So, this relationship doesn't work for me, while you are in affect "firing" me, likewise, I am doing the same.

Oh yeah, when asked by fellow travellers in this journey about you, I will not be recommending you...

I was already beginning to tire of him, my visits were perfunctory, he spent more time"charting" than he did looking me in the eye and talking during our consultations, their portal sucked as did his notes from our visits and the final straw was when a critical PSA test took over a week to get the results. I found out they misrepresented their lab, implying that they could do my labs vice having them done outside the practice. When I finally tracked down the results, they had sent the vials to Quest, who had sent them to the west coast (keep in mind, I'm in Kansas City).

Looking back, he was not the type I wanted on my medical team based on "my rules"...

1. Please know your stuff. As a member of my medical team, you should have a thorough knowledge of my cancer and of the latest developments in research, and be ready to formulate a plan of attack.

2. Please do your homework. I expect you to have reviewed my medical records prior to my appointment. You have looked at my x-rays; you have my pathology report; you know how many children I have. In the world of cancer care, every scrap of data must be scrutinized for its significance.

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

4. Be curious. Do not close your mind to new hypotheses and don’t ignore clues that might lead you toward the best results. Please rid yourself of the temptation to make your day easier by delivering perfunctory care.

5. When it’s decision time, decide! If you think treating my cancer is not worth it; if you think I am at the point where I should stop chemotherapy; if I have veered off the path you have cleared for me—then speak up! Care for me with a dogged determination to get me healthy and do not keep any secrets that might lead to regret. I want an oncologist who knows what is best for me and doesn’t chicken out in difficult times.

6. Be responsible. 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.

7. 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? Leaders welcome scrutiny of their communication skills. No one cares if a flunky is curt.

He's not the first I've fired, a Director of Urology at a NCCN Center and a major North American Urological Association did not actively listen to me and wanted to deliver standard of care vice specific treatment , I told his PA when I left, I won't be back.

So, right now you need a radiologist and oncologist, you have time to find another urologist that meets your rules for being a member of your medical team, not the other way around!

Kevin