Backup Doctors

[Lost Sheep]

How difficult is it to get a local urological surgeon to provide pre-op and post-op care for an implant done by another surgeon?

I am trying to work with my local V.A. and Maryland V.A. to get my implant surgery from Dr. Kramer but I need to have a local urologist who knows about implants to do any pre-op arrangements and all followup treatments (activation, etc).

I saw a local surgeon and he was willing to go ahead with the surgery, but I decided Dr. Kramer was a better choice (although 13 hours away by airplane). The local surgeon has not responded to my request. (I don't know if his staff is short-circuiting my message or if he just does not want to answer).

Without prearranging for a local urologist to back up Dr. Kramer the V.A. won't go for it and I am running out of time.

Any advice?

Lost Sheep

[TANGERINE]

I think that most local urologists (especially if you have been seeing them) will be willing to work with you. Usually, if you politely say that you "understand that 80% of all implants are placed by eight doctors in the US", then it is likely that they will go ahead and work with you.

By the way, I do think that the "private pay option" of 28,000 is worth it if your insurance (Or VA benefit) will not cover this. I know that it is a lot of money, but there are few things that I are more deserving than a well functioning 100% reliable robo-dick. If you drive around in a 30,000 car, then I think you can afford the surgery --- just my opinion that penis function is one place that being a spendthrift is probably the justified thing to do.

[Lost Sheep]

Tangerine, you have a point there about the $30,000 car. I observed once that to deal with the typical male "mid-life crisis" one could get a hot sports car or an implant. About the same price and about the same service life.

I do drive a $25,000 car, but it is 14 years old.

One reason I want to go through the V.A. is that they have been providing most of my health care since I got out of the military. So I figure if they do the implant, the are likely to not question any future care or revision. If I have someone outside the V.A. "network" do the implant, they might not care for it later.

I did speak to my local Uro's assistant briefly and she said no, but I have never heard from the Doctor himself. I sent an email to the Doctor's office a week ago. NO answer.. So, I wondered if the surgeon might be feeling slighted. Who would think a doctor would be that insecure?

Who would think that I am that insecure?

Everyone says go to a highly experienced surgeon who has good working relationships with the suppliers. But I live where the the available surgeons' experience numbers in the dozens, not thousands. They do not have the luxury of choosing which manufacturer's implant to use on the day of surgery. They have to schedule the manufacturer's representative to fly in with an inventory of the implants in the different sizes and specialized surgical tools on the day of surgery. And the Coloplast rep never comes on the same day as the AMS rep. All red flags.

But I am seriously considering "rolling the dice" with my local surgeon anyway. Because it may come down to a choice between having an implant done locally or not having one at all.

I really like sports cars, but I would much rather have a working erection and so would my girlfriend.

[mouseco]

Hi Lost Sheep
I believe that Dr Kramer can make all the post op arrangements. He does it as a matter of routine for all out of town patients.I would guess that the large majority of his patients are outside the Baltimore metropolitan area.
I don't understand why your local VA facilities would not be able to handle any pre-op requirements.
Connie, Dr Kramer's medical secretary can also make pre-op arrangements at University of Maryland hospital, which is just across the street from the VA hospital in Baltimore. Most of the specialists that the Baltimore VA use are consults from U of M just across the street.

[GiRn56]

I used my local family practice doc for the prepop requirements, the local va clinic / internal med physician should be able to do the same. Post op care is different other than getting your sutures out which anybody can do. You are considered a fresh surgical case, due to liability and malpractice issues unless it's an emergency you are not going to get anyone other than the physician that cut you to take care of you, That's why your urologist hasn't responded and his assistant said no. I've been a an rn for 33 yrs and that's the way it's been practiced. Now you may have Kramer call and have someone take a look for them out of professional courtesy, but no one is going to touch you unfortunately, I would check with the va uro clinic and see what they say, and since it was done with Kramer, they might say you will have to go back and see him for issues... I would also clarify "Backup" they want, infection, resurgery etc, Eid and I had this discussion over the phone about my incision, if I couldn't get it fixed I was going to fly back out to see him, just the reality of having it done by them...

Ps Almost sounds to me like they're trying to get out of paying for it with all these added requirements, I have gone to my Senators twice "Grassley" for issues, needless to say issues were fixed immediately, and that might be an option if hassles continue....

[TANGERINE]

.........due to liability and malpractice issues unless it's an emergency you are not going to get anyone other than the physician that cut you to take care of you, That's why your urologist hasn't responded and his assistant said no. ........ Eid and I had this discussion over the phone about my incision, if I couldn't get it fixed I was going to fly back out to see him, just the reality of having it done by them...
...

Awesome advice from GiRn56. The VA does have lots of red tape. Perhaps you can get Kramer to issue some sort of letter/consultation on VA letterhead (he has VA privileges I presume), then that might help ?

[ThePlumber1964]

.........due to liability and malpractice issues unless it's an emergency you are not going to get anyone other than the physician that cut you to take care of you, That's why your urologist hasn't responded and his assistant said no. ........ Eid and I had this discussion over the phone about my incision, if I couldn't get it fixed I was going to fly back out to see him, just the reality of having it done by them...
...

Hitting the nail on the head!!!

[GiRn56]

I would personally get a hold of the Va local Patient Representative and get help and explain whats going on and what you need to happen to be successful. In person would be the best. Also make an appoint for "surgical clearance " With your Va clinic Doc..The system is frustrating even for myself being a medical professional,let alone a lay person.. I truly hope you can resolve your issues to get your surgery....