You will need a doctor who specializes in breast cancer care to coordinate your treatment after diagnosis. This doctor is called an oncologist or a medical oncologist. Choosing a doctor with experience in the type of breast cancer you have is one of the first treatment decisions you will have to make. This can be a nerve-wracking experience for some women. Yet there are a few basic steps that can make the process easier:
- Ask around. Get recommendations from your gynecologist, your primary care provider, your radiologist and the nurses in their offices. Talk to friends or family members who have been through breast cancer treatment about whether they liked their oncologist. It is OK to have two or three names at this point.
- Check with your health insurance plan. Ideally, the doctor you choose will be a member of your plan so that services and prescriptions will be covered with minimal hassle. However, in some cases you may be able to get coverage for out-of-network physicians if you and your primary care provider can make a good argument in favor of coverage. For example, if you are suffering from a rare type of breast cancer and the only doctor in your area with the experience to treat it is out-of-network, you might be able to persuade your health insurance plan to cover that doctor's services.
- Find a doctor you can talk to. It is all right to shop around a bit and visit the two or three doctors on your short list. This part of the decision-making process is very subjective. You are looking for a doctor who will take the time to explain the details of your cancer and cancer care in a way that is easy to understand and who will involve you in your care. Communication is very important.
Remember, you do not have to feel toward this doctor as you would toward a good friend — but it is preferable to have a pleasant working relationship with your oncologist. You might want to take a friend or family member — ideally, the person who could become your leading caregiver — when you visit the doctors on your list. Their opinion will be very helpful.
- Investigate each potential doctor's affiliations:
- Board certification in oncology (although there is no certification for breast cancer specifically)
- American Society of Clinical Oncology
- On staff at quality hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
- Affiliated with any cancer research institution supported by the National Cancer Institute (referred to as NCI-designated cancer centers)
- No complaints on file with state or city board of medical examiners
- Investigate each potential doctor's professional history:
- How many years has he or she been in practice?
- Has he or she received any advanced training in breast cancer care?
- How many patients, on average, does the doctor see with your type of breast cancer?
- Does the doctor recruit patients for or conduct any clinical trials?
- Consider the details of the practice that could affect your care:
- Is the office easy to get to from your home or work?
- Is parking accessible? Are there any reserved spots for patients close to the entrances?
- How far will you have to travel between this doctor's office and the places you will have to go for treatment, labs and care if they are not all at the same location? If you have to travel, how will you get there?
- Will you have access through the doctor's practice to other services and specialists you might need during treatment? Is there a staff member who will help you coordinate all these aspects of your care?
- Can blood work be done there, or will you have to go elsewhere?
- How can you reach the doctor after hours or on weekends?
- What role do nurses play in the care provided at the office? Are any of the nurses certified in oncology?
When you have visited the doctors under consideration on your short list, think about the answers to these questions and your gut feeling about the doctors and their offices. Although you might feel some pressure to make a decision and get started with treatment, this is an important step and it is worth devoting some time to the decision if you have more than one doctor to consider.
FOR MORE INFORMATION: The American Society of Clinical Oncology has an online database that can help locate an oncologist in a specific geographic area. Go to www.cancer.net and search for "oncologist database."
SOURCES: American Society of Clinical Oncology (www.cancer.net)
Written by Madeline Roberts Vann, MPH
Reviewed by Susan L. Luedke, MD
St. Louis Cancer & Breast Institute
St. Louis University Medical Center
Last updated September 2008
