Goose Chase

Mayo has a few quirks. One is that they assign a doctor to you – you don’t necessarily get to choose who will do your surgery. They had initially assigned Dr. Michelle J. Clarke, who Grand Rounds said was very good. When I called back to find out about their procedures, though, the fellow who answered the phone said that Dr. Clarke wasn’t the right person for this sort of surgery and re-assigned my case to another doctor. According to Grand Rounds, this new doctor isn’t as highly ranked as the two doctors they recommended in this area.

Furthermore, Mayo’s first appointment to speak with any doctor is April 30th, and according to the impatient guy on the phone, the doctors won’t call and discuss your case with you beforehand. Basically, if they decide surgery is the solution, they’ll schedule it on April 30th, and there’s no telling how far out the scheduling is or who would participate in the surgery because they don’t cross that bridge before that first appointment. I explained some of my challenges with travel and scheduling, and he basically didn’t care and sounded irritated when he conceded that he’d leave a message for the doctor, but he didn’t think anyone would call me back, because they usually don’t.

So, I’d need to cancel my current surgery, change all my plans, and pay for tickets to Mayo without ever having discussed my case with the surgeon we’re going to meet.

Why?  According to the unsympathetic phone guy, because “Those are our procedures. People come from all over the world to have their surgeries at the Mayo Clinic, and this is what they do. You come here for your first appointment, and that’s when you can discuss your case.”

Somehow I doubt that a president or king would be assigned a physician without input and made to wait a month for an appointment regardless of their plans or needs without having the chance to review their case in advance with that physician. There can be no doubt, however, that I am neither president nor king, and I suppose proletarians should feel privileged that Mayo makes room for them at all.

Later, the doctor actually did call. He left a brief message for me that basically said he understood I had a chondrosarcoma, he needed us to send over the images because he didn’t have those yet, and that we’d discuss the case when I came to see him on April 30th. It was a very short message. His speech was clipped and he didn’t leave a number for me to respond or ask additional questions.

I don’t like how their procedures and our interactions made me feel like one in a line of cattle – it all seems really impersonal and paternalistic, like I’m not a real person and my concerns and needs don’t matter.

On one hand, maybe this is like buying a house with good bones – maybe the things that bother me about the Mayo Clinic are window dressing and I’m just letting what amounts to bad bedside manner get in the way of my decision-making. On the other hand, something I fear is being sucked into a medical machine and not being able to participate in the decision-making related to my treatment. The Mayo Clinic may be the best, but do I really want people operating on me who don’t especially care about me?

More to the point, is it better to have a mid-ranked Mayo Clinic physician digging around in my cranium, or to have a top-ranked Harborview chief of neurosurgery?  My gut says Mayo is off the list. To change my mind at this point, they’d have to:

• Call me back
• Tell me another top-ranked surgeon who specializes in skull base tumors wants to do the surgery
• Give me a chance to meet with that person over the phone first so she could explain everything, answer my questions, and tell me what they believe should be the treatment plan
• Schedule the pre-surgery appointments and the surgery within a reasonable amount of time

I know they are busy and have procedures to worry about, but I don’t think any of those things are unreasonable no matter who you’re dealing with.