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Tomaino Arm Care Network

Dr. Tomaino's Blog

What's Our Mission?

June 20th, 2014
I frequently see patients who ask me to refer them or a family member to another physician for care when I am not able to render it----for a case of hip or knee arthritis, a foot problem etc.

Similarly, I see patients who call our office and request a second opinion or a first time evaluation with a complicated and/or chronic history. I almost never refuse. I may recommend either against surgery, or for addtitonal surgery when outcome has been unsatisfactory, but I almost always add value by either providing reassurance and listening , or by suggesting a different approach in order to renew hope that things might get better.


I have a fairly liberal philosophy when I am asked to see a patient for an assessment because I think that meeting a patient face to face to appreciate their perspective and understand their concerns, is necessary so that I am not guilty of dismissing my fundamental mission---providing service---whether it is through offering my opinion, agreeing with what has been done to date, or advising an alternative treatment strategy.

I guess I would sum it up by saying that I have a really difficult time not agreeing to see someone in need at least once. In situations where I may not want a patient to think that I will be assuming their care, I make it clear that the visit is for a consultation without any guarantee that I can help long term by assuming their care.

In that light, I have noticed an increasing incidence of patients telling me that another physician has refused to see them---sometimes after a record review, sometimes without an explanation. While this may be perfectly understandable if the request is outside the doctor's expertise, if they are not accepting new patients, if they do not accept the patient's insurance, etc---it is a bit more perplexing when there appears to be no explanation.


I regard my job as a mission/vocation---and so the default is to help those in need. I hope that the institutionalization of medicine does not dilute our willingness to help those in need---a committment that characterized my profession for years.

*POST EDITED BY DR. TOMAINO.

*POST EDITED BY DR. TOMAINO.

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