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Doctors responsibility and care

Question: I am having difficulty obtaining the type of doctor I need to monitor my care and progress almost 3 years post stroke. What area of care handles years after a stroke? I have been discarded especially if I refuse Botox. Physiatrist, Neurologist, I don't know where else to look. Therapists such as Occupational, Physical, and a Nurse Practitioner, are mostly all I'm allowed to see. Can you help me? I have a few major problems that aren't being addressed. Thanks.


Answer: Typically, I would recommend these type of doctors for follow up, but once you are stabilized, they often will refer you to your primary care physician (PCP). The care you receive may depend more on the experience and personality of a physician rather than the type of physician they are.

A PCP may be your best bet because they can help manage all aspects of your care or refer you to other physicians if they feel there is something they cannot handle. The problem with a specialized physician is that sometimes they will only manage one aspect of care but not want to deal with other aspects. Sometimes physicians will push treatments or techniques that they are most familiar with and aren't really interested in a patient's opinion about the treatment (e.g. your experience with botox).

Family medicine doctors, internists, general practice doctors and geriatricians are all examples of primary care physicians. The best way to find out if someone would meet your needs may be to call their offices and question their office staff. If they truly listen to your concerns and give feedback as to the services they can offer you, then that is a good starting sign. If they dismiss you and can't answer questions over the phone or say they'll call you back and don't, then don't bother. Basically, you interview the doctor's office before even setting up an appointment. I would also look online for reviews which can be helpful in letting you know about a doctor's rapport with patients and the type of services they offer. You could also search online for doctors that deal with long term follow up after stroke and see what is offered in your area.

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