Perhaps people are too polite to say it, but any MD who says "we don't do prostatectomies anymore" is either misinformed, lying, or marketing (and perhaps more than one of those three?!) The MDs I'm looking for are able to talk about nuance, ambiguity, and relative values. They can discuss situations where certain treatment plans are preferable and situations where they are less desirable. They have experience as well as familiarity with research following clients who have had different presenting profiles and treatment plans over extended periods of time, including those for whom initial treatments proved inadequate and/or undesirable. They know not only their own opinions but those of their colleagues in the field, whom they respect. They have had patients die and grieved the loss. They have personally wrestled with tradeoffs between quality of life and length of life for people they care about, if not themselves. Those are the MDs I'm looking for, and they will generally be happy to provide the treatments they are best qualified to provide and familiar with colleagues who can provide the treatments they are not best qualified to provide. Any urologist of excellence, given the shortage in the field, has plenty of work and should not need to push people toward their own specialties. And an MD who is ethical in the consultation room is more likely to be ethical in the operating room, the radiology lab, and the chemo protocols, not to mention the billing protocols.