View Full Version : Should your HT doctor ever contact your PCP?

08-07-2009, 12:44 PM
This controversial issue came up elsewhere and wanted to share my thoughts with you.

IMHO, any reputable clinic whether in this industry or not will take a complete medical history from every patient which includes past and present medical conditions.

They should also be asking about current medications and yes who your family doctor (PCP) is.

And yes, there are certain situations when it is necessary to contact and even get an opinion from the PCP as to whether there would be any reason the patient should not undergo a HT.

Let me give you a few examples I have witnessed myself when I did work inside the clinic. One case involved a patient on blood thinners and beta blockers and being treated for another medical condition he had. His primary doctor insisted the patient not have the surgery until he was off theses two medications. We saw this condition when we reviewed the patient's medical history at the time he enrolled for the HT surgery.

Another patient was an acute diabetic who had extremely high glucose readings the morning of surgery. Again we consulted with this patient's PCP who advised against it until the patient's glucose levels were within acceptable ranges. This patient could have potentially experienced diabetic shock during surgery. In addition, the high sugar levels would have an adverse impact on the healing process. Again, we pulled the surgery and set-up a re-evaluation period.

Another case was a patient who was epileptic and had uncontrollable seizures. We also found this out from his medical history and his doctor informed us that he had just been switched to a new medication and his MD wanted us to wait until they knew how their patient responded to the new meds. This was going to take a minmum of 60 days and again we pulled the surgery. His doctor went on to state that this patient even asked him about undegoing a HT procedure and his MD advised against it for several months. The patient never pointed this out to us so we were glad we called. The patient was also angry that we pulled his surgery but better safe than have a crisis in the OR.

There are plenty of situations that can arise that would prompt any responsible ethical HT doctor to consult with the patient's PCP or specialist. There have been times, although far and few between where we got the PCP's written consent upfront.

There were even some cases whereby we got the PCP's consent to pull the patient off certain meds pre-op and then to resume them after surgery.

We never would have known these particulars in varying medical conditions had we not taken a complete medical history from every patient upfront.

IMHO, the patient's medical history should be taken at the time of the initial consultation and the HT doctor goes over that with every patient he consults prior to setting up a surgery date. It's an integral part of establishing the patient's candidacy for the HT procedure.

Are there conditions that patients can have that would rule them out for the HT procedure? Of course there are. And some of these patients have great donor, and look like good candidates "on the surface" but you always have to get the full picture before the final decision is made.

I highly recommend every patient to ask their prospective HT doctor if or when they may feel it necessary to contact their PCP in their own situation. In most cases, it will not be necessary.