Here on this page we are going to discuss doctors and hospitals. Mostly doctors because they are a critical component and your partner in getting rid of a Pilonidal Abscess. Many people have some very wrong ideas about what doctors are and we would like to dispel some of those ideas.
First: Doctors are not gods. They don't know everything. Just like in any other profession, there are some really good ones and some that shouldn't be allowed to work. You, as a patient, need to take responsibility for knowing when it is time to find another doctor. This is your health we are talking about here, something that is not to be taken lightly. Doctors make mistakes, just like everyone else. Just because it's "what your doctor told you" doesn't mean it's right. Some people take this reality very hard, but you cannot blindly accept anything anyone tells you. Just because someone managed to pass the lowest bar of standards to get a certificate on the wall does not automatically mean that they are any good - it just means they passed the basic licensing test.
Second: Once they put on the white coat, they are all the same. Wrong! Every doctor is different, they each have their own techniques and philosophy about medicine and sometimes it is virtually impossible to get any two of them to agree on any course of treatment. There are as many personality types of doctors as there are patients, and not every one of those personality types works well with every patient. Some doctors are deeply conservative in their treatments and will only cut as a last resort. Others will have you on an operating table before you can blink. Match your personality type to a doctor who's on the same wavelength.
Third: They have such a cushy job, surgery in the morning, a little golf in the afternoon.... Wrong again. The medical system in the US is falling apart at the seams and no doctor can afford the life of leisure they had 30 years ago. There are mounds of insurance paperwork to be done and doctors have to pack their waiting rooms to make up for the reduction in fees paid by insurers. Today's doctors are under siege by lawyers and patients who sue at the drop of a hat. A recent article in the LA Times profiled a doctor who (like many these days) has become embittered with a system and patients who "think they have a god-given right to a good outcome". When you wait 45 minutes for your appointment and your doctor barely spends 15 minutes with you, this is why. However, to play devil's advocate, the medical establishment has also been atrociously lax in revoking licenses from incompetent physicians. The AMA and the various state licensing boards are as bad as the Catholic Church when it comes to protecting members of their constituency that are doing harm out in the world. Give a good doctor who is overworked a break. Report a bad one to your state licensing board.
Your doctor is your partner in treatment, and you need to choose carefully, as you would any other kind of partner. You need to feel comfortable and be able to ask them anything, and they need to be willing to take the time to answer questions. Many doctors are not good communicators to start with and if your doctor seems rushed then it's up to you to ask (politely) for a few minutes of his/her undivided attention to answer your questions or explain procedures. A good doctor will stop and spend the time with you.
In a perfect world, every doctor who treats Pilonidal Cysts would be reading the newest treatments and info hot off the press, but we don't live in that world. We live in the world where the pace of medical knowledge in past 20 years has expanded at a staggering rate. No doctor can keep up on everything; there are hundreds of medical periodicals and no one can read them all. This is why it is important that you, as a patient, make sure that your physician "has done their homework". This is especially true if your doctor is not a Colon & Rectal Surgeon. While we tend to recommend C/R surgeons, a General Surgeon can do just as good a job - providing they've stayed up on the current techniques and theories.
The American Society of Colon & Rectal Surgeons lists doctors all over the world at their web site: www.fascrs.org and the message boards right here at Pilonidal.org also have a "Pilonidal's Surgeon Hall of Fame" section. Sometimes you have to interview several surgeons until you find one that makes you comfortable. Listen to your gut, if you don't feel good about a doctor, don't go back. Never go back to a doctor who makes you feel dirty, demeaned or like a annoyance because you were asking questions. Good doctors are thrilled when their patients take an active part in their treatment.
It has been my experience (and that of others) that you can tell an awful lot about a doctor by his/her staff. A great doctor would never put up with a rude or incompetent staff. The doctor sets the tone at his/her practice and the staff follows where the doctor leads. Careful evaluation of both a doctor and their staff will tell you an enormous amount about what type of care you can expect.
Not every hospital is a good hospital. Most surgeons have privileges at several hospitals or outpatient centers so you should have a couple to choose from. My advice is to ask your surgeon where he/she most prefers to operate. I've had two surgeries (one for my Pilonidal and one on my hand) and the differences in surgical facilities was night and day. Thankfully, I had my first (pilo) surgery at a great facility. The hospital where I had my second surgery was disorganized, not as clean, staff not as helpful, etc.. I later asked the (hand) surgeon about it and his reply was "Yeah, I hate operating there". Now, I chose the hospital since it was close to my home so I couldn't complain but I learned a valuable lesson that all surgical facilities are NOT created equal.
For US patients, the HHS (U.S. Department of Health & Human Services) has compiled listings and patient ratings of hospitals and is searchable by zip code.
In the UK there is a similar website from the Care Quality Commission.
This page last updated: 11/05/2010