MFM Quandary

[kerisue]

I'm in a real quandary over my MFM and whether I should go with him or find someone new. Hoping you have some advice!

Doctor A would be my primary doc in a subsequent pregnancy. He knows everything about my previous pregnancy and was even there on my delivery day. He is walking distance from the hospital where I would deliver. He was recently in listed in a local magazine as one of the "top docs" for MFM.

Doctor B is a 3 hour drive away. I have met with him twice and he's run some tests on me. I heart this doctor. I think he's well respected in the preeclampsia community. He strikes me as someone who is very knowledgeable about preeclampsia specifically (of all the "high risk" pregnancy issues) and who cares about each individual woman and each pregnancy. He even gave me his email address and told me to email him anytime with questions.

I saw Doctor B for a consultation and was thrilled to find out that I could continue to see him periodically during my subsequent pregnancy (though I haven't started ttc, I'm trying to get all my ducks in a row). I really want to do this- see both of them (apparently I'm not doctor monogamous ). Doctor A would still be my doctor of record because he's local. BUT Doctor A told me today that he will NOT SEE ME if I continue to see Doctor B during a pregnancy. He thinks Doctor B is a little "out there" on some things and he doesn't want to put me in a situation where they disagree on things. In fact, they already disagree. Doctor A wants me to stop a medication once I get a + preg test that Doctor B put me on and told me to continue using during pregnancy.

Now I don't know what to do! Just forget about seeing Doctor B and be happy with the consult only? Find a different MFM down here who wouldn't mind working with Doctor B too? Would any MFM want to have their patient seeing another MFM simultaneously, or is this some kind of alpha male pi**ing match?

[miamibunnie]

Hi Millie, sounds positive with both doctors. But honestly you have to ask yourself who did you feel comfortable with. Have you discussed this with your hubby? When I got prego this time around I needed a dr that I can reach out to, that I can communicate with and could understand my fear.

One was to rule it out is which hospital has a better NICU....have they discussed future plans if baby was to arrive early? I do know that many MFMs do not like to have pts seeing two drs at the same time.

Thats what I did last year and my care was a mess because one dr said one thing the other said something else...
I would go with my heart and make sure the NICU is prepared for early babies. Keep me posted....

[flori]

Kerisue, it's awesome that you have found two docs that you would be happy to work with. It's unfortunate that Doc A won't work with Doc B though, especially if he is well-regarded in the community. I wonder if Doc A has had a bad experience with B? For them to be so far apart (3hrs) it seems that there may be some history between the two, or maybe Doc A just isn't comfortable with Doc B's way of thinking. Out of box thinking may not be a bad thing though, with this disease.

My personal experience is as follows: I originally started seeing a peri around 17-18 weeks because of my bp medication. The first one I saw was very nice and personable and I enjoyed working with him, however he is the same one that did an ultrasound of Gracie and didn't notice that the amniotic fluid was low. He also didn't notice any indications of IUGR, he just said "she's going to be small like you". It was only after I saw the second peri, the one that dx'd IUGR and placental issues and preeclampsia symptoms that I realized that I was much more comfortable with him than with my previous doctor- even if he was less "friendly". My second doc offered to refer me back to the original peri because he knew of the relationship we had, but I declined, saying I'd rather work with him. He continued with weekly ultrasounds after the diagnosis and even had my postpartum scheduled with him instead of the OB that did my c-section. I heart him too. I saw my original peri in passing at my pp appointment, but he kinda blew me off. I was hurt at first, but I let it go because I know that I did the right thing.

Anyway, the gist of that is to say that you should feel comfortable with whoever you decide on and trust your gut and heart. I understand you wanting to stay with doc A because of your history but I do also understand you wanting to see someone else at the same time. I disagree with doc A's refusal to see you if you see B, could you continue to see B on the side without telling A? Or utilize B as a resource via e-mail? Also, like pp said- NICU location would be very important in my decision making.

Good luck in whatever you decide and keep us posted!

[sam10]

This is not an easy decision. One thing to think about is to organize everything/everybody around you in the most convenient way possible (a three hour drive seems a long trek to me). For me it is important that I can reach the doctor/hospital where my doctor is as quickly as possible; just in case I need to bee seen quickly. Apart from that go with the one whom you trust completely. If you can't make up your mind, you could always go for a third opinion.

[kerisue]

Thank you for the input! There is no way the doc 3 hours away can be my "main" doctor. I know I need someone local. The problem is I want to see both of them and my local doc (A) won't see me if I also go see doc B. So I'm just trying to decide whether I give up on seeing doc B (don't want to) or try and find a different doc A who might not mind me seeing doc B on the side (don't want to do that either!)

[sam10]

Perhaps the question to ask is what Dr. B brings to the table that Dr. A can't or won't? Or., why is Dr. A not enough? If you lived where Dr. B is, would you go with him without pairing him with anybody else? ....

[kerisue]

Yes, Julija, I probably would.

[riehlism]

Hi Kerisue. Since I know who Doctor B is, I can understand why Doctor A may be uneasy. In reading some of Dr. B's work he does seem to go against the grain in the community. But that can either be seen as genius, or "out there" as Doctor A puts it.

Here's another question, would you be able to email Dr. B and ask him if there is someone closer to you that shares his philosophy that you could possibly see? Or, of the local magazine's list of top MFMs, can you contact them to see if they would be willing with Dr. B? I'm sure MFM promiscuity isn't unheard of.

[riehlism]

Oh, and another thing. You can ask both doctors (or other MFMs) what their success rate is with severe, early onset PE in a subsequent pregnancy. When people get plastic surgery (I should know, I live in Los Angeles), they ask their doctors their success rate/complication rate with various procedures. Why shouldn't we ask them?

[sam10]

kerisue- if thatt is the case, you might want to consider shopping around for an MFM in your area who is willing to work with Dr. B.