Off-topic general question about doctors consulting each other

[Sarah Tee]

It’s my impression that doctors have a sort of brotherhood (for want of a better word) that means they can contact each other to ask for advice about difficult or unusual cases, even across jurisdictions and borders.

Am I right about this?

[MikeO]

13 hours ago, Sarah Tee said:

It’s my impression that doctors have a sort of brotherhood (for want of a better word) that means they can contact each other to ask for advice about difficult or unusual cases, even across jurisdictions and borders.

Am I right about this?

I have had my medical providers do a phone consult and they are across different medical organizations. if you are talking across the pond, not sure about that.

[Pistol]

@Sarah Tee yes, you are right. However - this can backfire on us, the patients! For example - a few times in the ER I told them I needed IV fluids to stop the syncope and then i could be on my way. They refused. I asked them to call my PCP - they refused ( I assume because THEY are the big ER doc and HE is "only" a PCP ). I begged them to contact my cardiologist and they refused - Stating my symptoms were not serious enough to make a call to the big guy. 

Another example: I had begged my PCP for a long time to order a port for home infusions to avoid the trips to ER. He was uncomfortable because of the risks involved. My cardiologist agreed that a port would be appropriate in my case. I asked him to order one but he said he could not go against my PCP's opinion. But he DID send my PCP a note mentioning why he felt a port would be good in my case. Not long after that, after another refusal of fluids in the ER, my PCP allowed the port and I have been mostly stable since then. 

[Sarah Tee]

@MikeO, @Pistol, thank you for the info.

I am contemplating asking my rheumatologist or autonomic specialist to contact Dr Novak in the US and ask him if he uses any immune treatments on patients with OCHOS, or what he does with patients like me who have trouble tolerating vasodilating meds.

I know he used IVIg on one patient with OCHOS, because he published a case study about it. So I suspect he might use “lower level” immune treatments as well.

Problem is my autonomic specialist is very unconfident and fears going outside his comfort zone. Rheumatologist is more likely to be open to the idea, but as I am a new patient I will hold off for a bit before asking for favours.

[MaineDoug]

@Sarah Tee,

I can speak to this question somewhat. Any provider involved in a patient’s care can discuss a single identifiable patient in the US with any other provider involved in the care. 
Nothing prevents any provider from contacting others to discuss general medical issues, knowledge, procedures or anything else as long as no patient can be identified. I don’t see any barriers to international communication. 
 

However, be aware that most providers in the US do not understand the law and have developed many false beliefs and fears that (they believe) prevent them from communicating. They think that they can only communicate with a written consent from the patient! 
But, as I told my staff many times, the only relevant question is: “do I need to share this info for me, and for the other party to do their job”! If “yes”, in the US that communication is okay. If “no” then they SHOULDN’T EVEN KNOW THE INFO THEMSELVES. 

[Sarah Tee]

@MaineDoug, that is interesting to know. In another couple of months, I will ask my specialists how they feel about sending a general enquiry about medications and auto-immune treatments.

[MaineDoug]

LOL, I just remembered an episode where one of my therapists called out, unexpectedly for the week. No problem, things come up. All week I hear nothing else. On Friday I go into a hospital room to discuss an issue with the patient in B bed. 
Imagine my surprise to see my absent employee in bed A!!! 
All week, his coworkers were treating him, AND NOT EVEN A WHISPER REACHED ME or any other department staff.
I was so proud of my staff! 
THAT’s confidentiality! 😁