How To Find a Doctor or Treatment Facility If You Have Cancer
Key Points
If you have been diagnosed with cancer, finding a doctor and treatment facility
for your cancer care is an important step to getting the best treatment possible.
Although the health care system is complex, resources are available to guide
you in finding a doctor, getting a second opinion, and choosing a treatment
facility. Below are suggestions and information resources to help you with these
important decisions.
Physician Training and Credentials
When choosing a doctor for your cancer care, you may find it helpful to know
some of the terms used to describe a doctor’s training and credentials.
Most physicians who treat people with cancer are medical doctors (they have
an M.D. degree) or osteopathic doctors (they have a D.O. degree). The basic
training for both types of physicians includes 4 years of premedical education
at a college or university, 4 years of medical school to earn an M.D. or D.O.
degree, and postgraduate medical education through internships and residences.
This training usually lasts 3 to 7 years. Physicians must pass an exam to become
licensed (legally permitted) to practice medicine in their state. Each state
or territory has its own procedures and general standards for licensing physicians.
Specialists are physicians who have completed their residency training in a
specific area, such as internal medicine. Independent specialty boards certify
physicians after they have fulfilled certain requirements. These requirements
include meeting specific education and training criteria, being licensed to
practice medicine, and passing an examination given by the specialty board.
Doctors who have met all of the requirements are given the status of “Diplomate”
and are board-certified as specialists. Doctors who are board-eligible have
obtained the required education and training, but have not completed the specialty
board examination.
After being trained and certified as a specialist, a physician may choose to
become a subspecialist. A subspecialist has at least 1 additional year of full-time
education in a particular area of a specialty. This training is designed to
increase the physician’s expertise in a specific field. Specialists can
be board-certified in their subspecialty as well.
The following are some specialties and subspecialties that pertain to cancer
treatment:
-
Medical Oncology
is a subspecialty of internal medicine. Doctors who specialize
in internal medicine treat a wide range of medical problems. Medical oncologists
treat cancer and manage the patient’s course of treatment. A medical
oncologist may also consult with other physicians about the patient’s
care or refer the patient to other specialists.
-
Hematology is a subspecialty of internal medicine. Hematologists
focus on diseases of the blood
and related tissues,
including the bone
marrow, spleen,
and lymph
nodes.
-
Radiation
Oncology is a subspecialty of radiology.
Radiology is the use of x-rays
and other forms of radiation to diagnose and treat disease. Radiation oncologists
specialize in the use of radiation to treat cancer.
- Surgery
is a specialty that pertains to the treatment of disease by surgical
operation. General surgeons
perform operations on almost any area of the body. Physicians can also choose
to specialize in a certain type of surgery; for example, thoracic
surgeons are specialists who perform operations specifically in the chest
area, including the lungs
and the esophagus.
The American Board of Medical Specialties® (ABMS) is a not-for-profit
organization that assists medical specialty boards with the development and
use of standards for evaluation and certification of physicians. Information
about other specialties that treat cancer is available from the ABMS Web site,
which can be accessed at http://www.abms.org/
on the Internet.
Almost all board-certified specialists are members of their medical specialty
society. Physicians can attain Fellowship status in a specialty society, such
as the American College of Surgeons (ACS), if they demonstrate outstanding achievement
in their profession. Criteria for Fellowship status may include the number of
years of membership in the specialty society, years practicing in the specialty,
and professional recognition by peers.
Finding a Doctor
One way to find a doctor who specializes in cancer care is to ask for a referral
from your primary care physician. You may know a specialist yourself, or through
the experience of a family member, coworker, or friend.
The following resources may also be able to provide you with names of doctors
who specialize in treating specific diseases or conditions. However, these resources
may not have information about the quality of care that the doctors provide.
- Your local hospital or its patient referral service may be able to provide
you with a list of specialists who practice at that hospital.
- Your nearest National
Cancer Institute (NCI)-designated
cancer center can provide information about doctors who practice at that center.
The NCI is a component of the National
Institutes of Health (NIH).
The NCI-Designated Cancer Centers database provides contact information for
NCI-designated cancer centers located throughout the United States. It is
available at http://www.cancer.gov/cancertopics/factsheet/NCI/cancer-centers
on the Internet. Users can select all cancer centers or search by location,
type of cancer center, or cancer center name.
- The ABMS has a list of doctors who have met certain education and training
requirements and have passed specialty examinations. Is Your Doctor Certified?
lists doctors’ names along with their specialty and their educational
background. The directory is available in most libraries and online at https://www.abms.org/WC/login.aspx
on the Internet. Users must register to use this online self-serve resource,
which allows users to conduct searches by a physician's name or area of certification
and a state name.
- The American Medical Association (AMA) DoctorFinder database at http://webapps.ama-assn.org/doctorfinder/home.jsp
provides basic information on licensed physicians in the United States. Users
can search for physicians by name or by medical specialty.
- The American Society of Clinical
Oncology (ASCO) provides an online list of doctors who are members of ASCO.
The member database has the names and affiliations of over 27,000 oncologists
worldwide. It can be searched by doctor’s name, institution, location,
oncology specialty, and/or type of board certification. This service is available
at http://www.cancer.net/portal/site/patient
(click on "Find an Oncologist").
- The American College of Surgeons (ACS) membership database is an online
list of surgeons who are members of the ACS. The list can be searched by doctor’s
name, geographic location, or medical specialty. This service is located at
http://web3.facs.org/acsdir/default_public.cfm
on the Internet. The ACS can be contacted by telephone at 1–800–621–4111.
- The American Osteopathic Association (AOA) Find a D.O. database provides
an online list of practicing osteopathic physicians who are AOA members. The
information can be searched by doctor’s name, geographic location, or
medical specialty. The database is available at http://www.osteopathic.org/directory.cfm
on the Internet. The AOA can be contacted by telephone at 1–800–621–1773.
- Local medical societies may maintain lists of doctors in each specialty.
- Public and medical libraries may have print directories of doctors’
names listed geographically by specialty.
- Your local Yellow Pages or Yellow Book may have doctors listed by specialty
under “Physicians.”
The Agency for Healthcare Research and Quality (AHRQ) offers Your Guide
to Choosing Quality Health Care, which has information for consumers on
choosing a health plan, a doctor, a hospital, or a long-term care provider.
The Guide includes suggestions and checklists that you can use to determine
which doctor or hospital is best for you. This resource is available at http://www.ahrq.gov/consumer/qntool.htm
on the Internet. You can also order the Guide by calling the AHRQ Publications
Clearinghouse at 1–800–358–9295 or 703–437–2078
if outside the United States.
If you are a member of a health insurance plan, your choice may be limited
to doctors who participate in your plan. Your insurance company can provide
you with a list of participating primary care doctors and specialists. It is
important to ask your insurance company if the doctor you choose is accepting
new patients through your health plan. You also have the option of seeing a
doctor outside your health plan and paying the costs yourself. If you have a
choice of health insurance plans, you may first wish to consider which doctor
or doctors you would like to use, and then choose a plan that includes your
chosen physician(s).
If you are using a Federal or state health insurance program such as Medicare
or Medicaid, you may want to ask the doctor about accepting patients who use
these programs.
You will have many factors to consider when choosing a doctor. To make an informed
decision, you may wish to speak with several doctors before choosing one. When
you meet with each doctor, you might want to consider the following:
- Does the doctor have the education and training to meet my needs?
- Does the doctor use the hospital that I have chosen?
- Does the doctor listen to me and treat me with respect?
- Does the doctor explain things clearly and encourage me to ask questions?
- What are the doctor's office hours?
- Who covers for the doctor when he or she is unavailable? Will that person
have access to my medical records?
- How long does it take to get an appointment with the doctor?
If you are choosing a surgeon, you may wish to ask additional questions about
the surgeon’s background and experience with specific procedures. These
questions may include:
- Is the surgeon board-certified?
- Has the surgeon been evaluated by a national professional association of surgeons, such as the American College of Surgeons (ACS)?
- At which treatment facility or facilities does the surgeon practice?
- How often does the surgeon perform the type of surgery I need?
- How many of these procedures has the surgeon performed? What was the success rate?
It is important for you to feel comfortable with the specialist that you choose
because you will be working closely with that person to make decisions about
your cancer treatment. Trust your own observations and feelings when deciding
on a doctor for your medical care.
Getting a Second Opinion
Once you receive your doctor’s opinion about the diagnosis and treatment
plan, you may want to get another doctor’s advice before you begin treatment.
This is known as getting a second opinion. You can do this by asking another
specialist to review all of the materials related to your case. A second opinion
can confirm or suggest modifications to your doctor’s proposed treatment
plan, provide reassurance that you have explored all of your options, and answer
any questions you may have.
Getting a second opinion is done frequently, and most physicians welcome another
doctor’s views. In fact, your doctor may be able to recommend a specialist
for this consultation. However, some people find it uncomfortable to request
a second opinion. When discussing this issue with your doctor, it may be helpful
to express satisfaction with your doctor’s decision and care and to mention
that you want your decision about treatment to be as thoroughly informed as
possible. You may also wish to bring a family member along for support when
asking for a second opinion. It is best to involve your doctor in the process
of getting a second opinion, because your doctor will need to make your medical
records (such as your test results and x-rays) available to the specialist.
Some health care plans require a second opinion, particularly if a doctor recommends
surgery. Other health care plans will pay for a second opinion if the patient
requests it. If your plan does not cover a second opinion, you can still obtain
one if you are willing to cover the cost.
If your doctor is unable to recommend a specialist for a second opinion, or
if you prefer to choose one on your own, the following resources can help:
Finding a Treatment Facility for Patients Living in the United States
Choosing a treatment facility is another important consideration for getting the best medical care possible. Although you may not be able to choose which hospital treats you in an emergency, you can choose a facility for scheduled and ongoing care. If you have already found a doctor for your cancer treatment, you may need to choose a facility based on where your doctor practices. Your doctor may be able to recommend a facility that provides quality care to meet your needs. You may wish to ask the following questions when considering a treatment facility:
- Has the facility had experience and success in treating my condition?
- Has the facility been rated by state, consumer, or other groups for its quality of care?
- How does the facility check on and work to improve its quality of care?
- Has the facility been approved by a nationally recognized accrediting body,
such as the American College of Surgeons (ACS) Commission on Cancer and/or The Joint Commission?
- Does the facility explain patients' rights and responsibilities? Are copies of this information available to patients?
- Does the treatment facility offer support services, such as social workers and resources, to help me find financial assistance if I need it?
- Is the facility conveniently located?
If you are a member of a health insurance plan, your choice of treatment facilities may be limited to those that participate in your plan. Your insurance company can provide you with a list of approved facilities. Although the costs of cancer treatment can be very high, you have the option of paying out-of-pocket if you want to use a treatment facility that is not covered by your insurance plan. If you are considering paying for treatment yourself, you may wish to discuss the possible costs with your doctor beforehand. You may also want to speak with the person who does the billing for the treatment facility. In some instances, nurses and social workers can provide you with more information about coverage, eligibility, and insurance issues.
The following resources may help you find a hospital or treatment facility for your care:
Finding a Treatment Facility for Patients Living Outside the United States
If you live outside the United States, facilities that offer cancer treatment
may be located in or near your country. Cancer information services are available
in many countries to provide information and answer questions about cancer;
they may also be able to help you find a cancer treatment facility close to
where you live. A list of these cancer information services is available on
the International Cancer Information Service Group’s (ICISG) Web site
at http://www.icisg.org/meet_memberslist.htm on the Internet. A list may also
be requested by writing to the NCI Public Inquiries Office at:
Address: |
Cancer Information Service Room 3036A, MSC 8322 6116 Executive Boulevard Bethesda, MD 20892-8322 USA |
The ICISG is an independent international organization composed of cancer information
services. Their mission is to provide high-quality cancer information services
and resources to those concerned about, or affected by, cancer throughout the
world.
The International Union Against Cancer (UICC) is another resource for people living outside the United States who want to find a cancer treatment facility. The UICC consists of international cancer-related organizations devoted to the worldwide fight against cancer. UICC membership includes research facilities and treatment centers and, in some countries, ministries of health. Other members include volunteer cancer leagues, associations, and societies. These organizations serve as resources for the public and may have helpful information about cancer and treatment facilities. To find a resource in or near your country, contact the UICC at:
Address: |
International Union Against Cancer (UICC) 62 route de Frontenex 1207 Geneva Switzerland |
Telephone: |
+ 41 22 809 1811 |
Web site: |
http://www.uicc.org |
Some people living outside the United States may wish to obtain a second opinion
or have their cancer treatment in this country. Many facilities in the United
States offer these services to international cancer patients. These facilities
may also provide support services, such as language interpretation, assistance
with travel, and guidance in finding accommodations near the treatment facility
for patients and their families.
If you live outside the United States and would like to obtain cancer treatment
in this country, you should contact cancer treatment facilities directly to
find out whether they have an international patient office. The NCI-Designated
Cancer Centers database (described above in the section “Finding a Doctor”)
offers contact information for NCI-designated cancer centers throughout the
United States. This database is located at http://www.cancer.gov/cancertopics/factsheet/NCI/cancer-centers
on the Internet.
Citizens of other countries who are planning to travel to the United States
for cancer treatment generally must first obtain a nonimmigrant visa for medical
treatment from the U.S. Embassy or Consulate in their home country. Visa applicants
must demonstrate that the purpose of their trip is to enter the United States
for medical treatment; that they plan to remain for a specific, limited period;
that they have funds to cover expenses in the United States; that they have
a residence and social and economic ties outside the United States; and that
they intend to return to their home country.
To determine the specific fees and documentation required for the nonimmigrant
visa and to learn more about the application process, contact the U.S. Embassy
or Consulate in your home country. A list of links to the Web sites of U.S.
Embassies and Consulates worldwide can be found at http://usembassy.gov
on the Internet.
More information about nonimmigrant visa services is available on the U.S.
Department of State’s Web site at http://travel.state.gov/visa/temp/temp_1305.html
on the Internet.
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