What questions do I ask when I am deciding on a CM/SM physician?
by Barbara Kane
Choosing a neurologist or a neurosurgeon is one of the most important aspects of managing the care of CM/SM. Callers often report they have a difficult time evaluating what a physician is telling them. Doctors often describe their expertise dealing with CM/SM with phrases such as familiar, experienced, a lot of cases, which are difficult to quantify.
Given that ASAP, its employees and support volunteers are not licensed to practice medicine, we have to resist the temptation to say, Just go see Dr. X or Dr. Y. What we can do is direct the callers toward information which can help them make a more informed decision on their own.
The list below is one tool that may prove helpful for patients or caregivers to pre-screen potential physicians. This list has been circulated among ASAPs Medical Advisory Board for review.
Suggested Information to Obtain While Selecting a Physician:
Diagnostic Facilities:
1) Does the physician have access to a state-of-the-art Cine MRI facility?
2) Does the facility have a demonstrated ability to do complete CSF flow studies of the brain and spinal cord?
Experience:
1) Number of cases of CM and/or SM per year? As a point of reference, there may be approximately 3,500 decompression surgeries for CM in the US annually.
2) Number of cases dealing with the patients individual issue (example: tethered cord)?
3) Is the practice geared to children and/or adults?
4) Is the physician board-certified in his/her specialty?
Continuing Medical Education Pertaining to CM and SM:
1) Does the physician regularly dedicate a portion of his/her required Continuing Medical Education (CME) to CM/SM topics?
2) What medical articles does the physician suggest you read if you would like to gain a better understanding of the disorders and treatment options?
Treatment Philosophies:
1) Does the physician monitor non-surgical patients?
2) Does the physician perform surgery, and if not, to whom does he/she refer?
3) Does the physician monitor the patient after recovery from a surgical procedure?
4) Does the physician manage pain for patients who have recovered from surgery or are non-surgical patients?
5) Is there any published work that the physician would recommend which explains the treatment he/she is recommending for the patient?
Team:
1) Is the physician a member of a multi-specialty team which has extensive experience with SM/CM and related disorders?
2) Does the physician have peers in his/her specialty available for consultation and review of cases?
There is no substitute for a full evaluation and a chance to have direct dialogue with a physician after he or she has had a chance to carefully review the patients diagnostic tests. At that point, patients and caregivers can evaluate the more subtle aspects of the physician/patient relationship and determine if they have found the right doctor for them.
http://www.asap.org/resources/deciding-physician.html
The Kanes & friends are the founders of Column of Hope.
www.columnofhope.org/
AZ Syringo Chiari Support Group 