While you've probably thought about and discussed what your perfect husband or wife would be like, you probably haven't given as much thought to your perfect doctor. That's a shame, because when you think about it, your relationship with your (potential) spouse is pretty similar to the relationship you have with your doctor. Both are potentially long term partnerships where trust and open honest communication are absolutely necessary for the relationship to work. Both parties must be willing to really listen to the other. With chronic diseases such as carcinoid and related neuroendocrine tumors, the doctor-patient relationship becomes even more important than usual. As opposed to two brief visits a year, most such patients will come to see their doctor with increasing frequency, and also begin to rely on them for referrals to specialists and other services.
Much in the same way everyone's idea of their perfect spouse is different, people will likely disagree on what they want from their physician. This is convenient, because doctors come in a huge variety, and I don't simply mean their specialties. 'Bedside manner' is often the term used to describe the way doctors interact with their patients. The term itself seems a bit dated considering the drastic reduction in inpatient care, but that aside, people sometimes use bedside manner to mean anything the doctor does that doesn't have to do with actual medical care. I believe this is misleading because it seems to imply that there is a broad category of attributes that pertain strictly to the practice of medicine, and another broad category termed 'bedside manner' that deals solely with somewhat vague ideas like 'friendliness' or 'easy-going nature'. If you think back to the sections on Informed Consent, however, this notion makes less sense. The manner and effectiveness with which your doctor communicates with you is an essential part of medical care because it strongly influences how you make decisions regarding your own care. To illustrate this, I will use a very simplified example.
Think of an individual who is diagnosed with a rare cancer. There are two popular treatment options, the first giving a 15% chance of a total cure, 60% chance of no effect, and a 25% chance of exacerbating the condition. The second treatment option gives you no chance of full recovery, but will almost certainly manage your symptoms so you may live comfortably for many more years. Your doctor, fully aware of both of these options, prefers the possibility of a cure to the absence of one, and therefore recommends only the first option. Or maybe s/he mentions the second option briefly, and gives you a lot of cues that discourages you from considering it seriously. Whether or not you prefer option 1 or option 2 in this scenario shouldn't stop you from thinking that what the doctor did was wrong. Again, the decisions regarding your body should ultimately be seen as yours.
If you compound this hypothetical with the actual complexities of diagnoses and treatment options, it is easy to get a sense of how important the doctor-patient relationship is. I am not trying to portray the physician as a malicious practitioner bent on imposing his or her will on unsuspecting patients. However, it is important for your doctor to know what your values are beforehand, and equally important for you to trust that those values will mean something to your doctor. Often times, going through every single step is an impossibility. The better your doctor knows you, the easier it will be for him to give you information that will be truly relevant to you in making an informed decision.
Of course, non-medical attributes of doctors are important as well, the point I am attempting to make is that the medical and non-medical parts aren't always easy to distinguish. Most of us would like a doctor that is caring and empathetic, but all of us should insist that our doctors be informative and helpful. Whatever it is you want from your doctor, be honest and upfront about it (though certainly not rude), because as mentioned before, communication is key.
Some links for your consideration:
Caring for Carcinoid Foundation's very own Doctor Database. A comprehensive listing of doctors across specialties with a listing of patient references to help you make your own informed decision
US News article citing the Doctor-Patient relationship as the possible key to quality
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