You call the shots.

This will be long. Hope it's helpful I've said this in other places on this site but not recently.
I'm age 72 and have been treating ET from Cal-R mutation for four years. For the first three years I saw a hematologist who was recommended by, and a longtime friend of, the internist I've seen for decades. I trusted both of those M.D's but had horrible gastro problems from HU when it was increased to a second capsule, some days of the week. The hematologist didn't like my reading things on this Internet group and insisted there was no other option for me other than increasing the amount of HU, due to my age. The internist wanted me to do whatever the hematologist said. On my own, from what I read on this site, without telling either of those MD's, I found an MPN specialist, Dr. Drazin, in my area, which is Westside Los Angeles. I went to him last December for a second opinion.
Meeting Dr. Drazin felt like the sun came out of the clouds. I immediately switched to him. He started me on daily Anagrelide while gradually reducing HU. The gradual transition was the right approach. I have seen him once a month over the last six months. I appreciate his willingness to schedule me that way as he isn't reimbursed much by my insurance. At this point, the worst gastro problems are history and Anagrelide is doing a good job of reducing platelets. Dr. Drazin said he is not familiar with heart issues from Anagrelide. He told me that because he is open to talking with me, and I had concerns about a woman named Genette on this site who had taken HU for many years and believes she had a heart attack when she switched to Anagrelide. Of course, each of us is different, and I hadn't been on HU for very long. I am medicated for slightly high blood pressure. Family history tends towards cancer and not heart issues. Who knows. What I know is that my blood pressure is fine and with Anagrelide instead of HU, I'm feeling better all around than I have in a long time.
Dr. Drazin told me HU is prescribed first, and Anagrelide is the choice for people who have side effect issues with HU. Also, some meds aren't open to me because my ET comes from Cal-R rather than Jak-2 mutation.
Enough. Hope I've been helpful. Happy Fourth of July!

Sure does, doesn't it? I will find someone with the help of the MPN specialist or my Primary care provider. There are surely other oncologists who would welcome the help of a specialist consultant.

My oncologist was offended also when I was going to go for a second consult at Mayo Clinic. My MPN there agreed to work with my internist locally handling my care. I connect with Mayo Clinic MPN every 3 months with Zoom calls and face to face visits twice a year. All tests done either locally or at Mayo Clinic are posted on My Chart for both to have access. It’s a little inconvenient flying out just for an appointment, but worth it mentally knowing I’m getting treated by a specialist in the disease.

I don't like it when my doctor is only concerned with my platelet number but doesn't listen to me about other things, says this medicine, hydroxyurea, doesn't cause these symptoms. Well, something is ......and no I don't need pain management.