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Old 01-01-2008, 03:48 PM
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Alkymst Alkymst is offline
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Join Date: Jan 2007
Location: Pennsylvania
Posts: 231
15 yr Member
Alkymst Alkymst is offline
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Alkymst's Avatar
 
Join Date: Jan 2007
Location: Pennsylvania
Posts: 231
15 yr Member
Default Dahlek, sorry this so long

but it's the consequence of more infrequent posts

1- What constitutes to YOU as a good neuro's qualities?
2- What constitutes to YOU a bad or indifferent neuro's qualities?
3- Worst of all, What constitutes the WORST qualities of some neuros?

I'll take a stab at 2 & 3 first although I'm sure I'm only echoing sentiments already expressed many times.

In my experience Drs in general not just neuros who approach me with an arrogant and condescending attitude are an immediate and permanent turn-off. I've found that these people
view me as the disease, syndrome or symptomolgy behind door #1 or curtain#2 not as a patient or a person
perform perfunctory, at best, physical exams
take an abbreviated history or leave that to a PA - I have nothing at all against PA's, rather I have a very high regard for them because, in many cases they are more thorough than the Dr.
do not review records prior to an OV or a consult
do not listen
do not ask leading questions that require a descriptive explanation and therefore a true dialogue and discussion
do not easily order diagnostic tests beyond those evident from their practices' own lab slips
discuss results as though I'm not present
are not interested in having a second, third or fourth opinion if necessary
give me a feeling of being rushed through an appointment - to keep the patient/hr or day ratio as high as possible
presume a diagnosis based on existing labs and test results which is the diagnosis regardless of future results, i.e. I'm right so don't confuse me with the facts
IS THREATENED BY A KNOWLEDGEABLE PATIENT, PARTICULARLY ONE WHO ACTS AS THEIR OWN ADVOCATE

As for number 1, to save space and time it would be the opposite of everything above with these additions.

Our PCP has worked with me for several years now to coordinate labs, tests, etc. has not only read several papers I've given her about IEDNF density, MDL and SFPN but she's also asked for some additional references which I had - she is genuinely cares about me as a person and has always been open and receptive to discussing my situation and symptoms with an eye towards what else can be done.

Among the 5 neuros I've dealt with my current one impressed me the most to start because our first appointment lasted 90 minutes and we've not had one for less that 45 minutes subsequently. At my first visit he DID NOT review the stack of records I brought prior to talking with me and my wife. Instead, he put them aside and he took his own detailed history, performed a very thorough physical exam, asked leading questions that required detailed answers from me and he took copious hand written notes, which I could read "up-side down". He also asked Vicki many detailed questions and used her input to both "corroborate" my responses but also to further refine and expand them with a different and perhaps more objective viewpoint.

He answered all of our questions thoroughly and in as much detail as we wanted, e.g. we've discussed immunohistochemistry and confocal microscopy in IENFD for skin punch biopsies. He suggested additional blood work, repetition of EMG/NCV studies which he performed himself, and then discussed the results with us immediately.
His office staff has always sent me the OV summaries, lab results, and all relevant info for my case at the same time they are sent to our PCP and other Docs usuually within 7-10 days.

He is not threatened by 2nd opinions, e.g. my recent trip to Johns Hopkins for more extensive blood studies and the skin punch biopsies - turns out the head of the EMG/NCV lab at JH was a student of my neuro. He sat with us and reviewed the NCV/EMG results from his lab and JH on a nearly line by line basis. Also, he's well aware of the importance of B-12, other vitamins, alpha-lipoic acid, acetyl-carnitine, etc on nerve regeneration and PN and suggested some additional supplements to see if they improve my situation.

All-in-all in my opinion, this neurologist is what I think most docs should be - reminds me of the doctor Wm Hurt became only AFTER his throat cancer and surgery and he was treated like a normal patient in the old movie, The Doctor.

Sorry this was so long-winded but it touched a nerve in me as it does in everyone else on the forum.

Alkymst.
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