Doctors - How to Find & Keep a Good One

Nov 12, 2008 | The HWN Team | Insider
Doctors - How to Find & Keep a Good One

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Getting married is easy, finding a good doctor isn't. Learn the strategies on how to find and keep one. No guarantees, but your life will probably be healthier!

A study completed in 2005 confirms what you probably already instinctively know: having a strong and effective relationship with your doctor makes you much more likely to be healthy, frequent the ER less, take fewer medications and spend less money on healthcare. Furthermore, there is no need to rely on specialists for day to day issues. Primary care doctors, specifically family doctors or general internists, are all you need.1,2

In the past, families often stayed in one community and maintained longstanding physician relationships. Today, the combination of a mobile society and the tendency to change health insurance coverage more frequently presents many families with the need to choose a new physician more often. Unfortunately, it can be difficult to know which doctor to choose from the list your new health insurer provided, especially if you are also new to the community. While the selection process will always be more art than science and may require some trial and error, information gathering to help you choose a primary care doctor or specialist can be daunting.

So, here's some ways to lessen the confusion and find that good doctor.

Word of mouth is probably the most important.

Get a recommendation from someone you trust. Friends and relatives who know the physician can give you excellent insight about style, chemistry and so on but you must remember that each person’s point of view is affected by their personal circumstances so you will have to decide what kind of filtering you need to do when taking other people’s opinions. It’s often a real advantage to get an opinion or recommendation from another healthcare provider who may have had peer interaction with the physician you are considering. Of course, many providers are uncomfortable making recommendations either because they are uncomfortable dispensing information that might be construed as medical guidance or they would prefer not to show favoritism within their field of work.

Even ask your local pharmacist if the doctor you are considering is average, above average or below average in responding to calls from the pharmacy, changing prescriptions when there’s a less costly and effective alternative and fighting for the right medication when the insurer is unconvinced. The pharmacist can answer without making a recommendation and that answer can tell you a lot about that doctor. You want a doctor who is at least average and preferably above average in these areas. Or, ask your chiropractor or physical therapist to rate your doctor’s office on access for consultation and timely communication. Again, these practitioners can answer the question factually without making a recommendation if they prefer.

Be sure that your doctor participates in your health plan.

If you have not received a list of possible physician choices, you should request that list. If your health plan is not restrictive about physician participation and consequently cannot offer you a specifically compiled list, you’ll need to check this issue yourself.

If you favor a specific hospital, be sure the physician you are considering holds privileges to practice at that hospital.

Even if your physician hands off patients to a hospitalist, i.e. a physician who only takes care of people in the hospital, he or she must have hospital privileges of some sort. And if you have any special medical problems that may require referral to a specialist, you may be need your primary care doctor’s recommendation or approval before you can have specialist services covered by your insurance. Be sure that you feel comfortable with the physicians or groups that your doctor typically uses.

Be sure the physician you choose is either board-certified or, if not, there’s a reasonable explanation.

You can find state medical boards, certification and physician locators under FindaDoctor. It makes sense to check your state’s physician disciplinary database to see if your physician candidate has had involvement in this process. Involvement should not necessarily eliminate a candidate but you should certainly ask about any disciplinary process so you can judge your comfort level with the situation. 3

Some groups and some states offer consumers additional information for evaluating physicians. For example, the National Committee for Quality Assurance offers a list of physicians who have been recognized for their competence in specific areas. Some states and independent groups provide access to lists of physicians who face disciplinary action.4

Each type of physician specialty, including the primary care specialties of internal medicine, family practice and pediatrics, is represented by a society or organization that sets standards for care and accredits physicians within the discipline. Some physicians are not board-certified yet or there may be some other extenuating circumstances. Any physician who doesn’t believe board certification is necessary is raising a red flag that you should carefully review.

Call the doctor’s office to ask questions.

However, you may not be able to get the full attention of office staff who are typically also very busy handling patient issues. It might make more sense to call and ask if you can email questions that can be answered at a later time or ask that the office send you any brochures about the practice that are available. The tenor and content of published material can tell you a lot about how a practice operates.

Many physician offices and all health insurance plans have websites. Visit your doctor’s website or see if your health plan has a webpage dedicated to your doctor or his/her practice. You can find out about office hours, after hours coverage, training and board certifications, hospital affiliations. Often times, the doctors are pictured there along with personal information such as their philosophy of practice or special interests. These can be wonderful insights into your practitioner’s point of view.

Since Murphy’s Law works so well, your acute need for your doctor’s services may not come during normal office hours. Instead you’ll have to rely on that doctor’s after-hours service arrangement. These arrangements vary considerably. You need to know what the practice offers and if you can live with that approach, e.g., first after-hours call goes to a triage nurse or several practices share after-hours care so you may be treated by someone you don’t know in a hospital that is not your choice.

Make a visit to the doctor to get acquainted.

Why? It can be very difficult to figure out whether or not a physician is a good communicator and whether or not he/she will be a good advocate for you without seeing how the office operates, have a chance to ask questions and assess the chemistry and communication. That visit is unlikely to be covered by health insurance so you’ll have to pay out of pocket but it’s worth it.

A final word about choosing a doctor. You owe it to yourself to have a doctor who meets your needs. If you are now in a relationship with a physician and you are not satisfied, speak up. Give your physician a chance to work with you towards a resolution. And if that doesn’t work it’s time to choose another physician.

Now here's some tips on how to keep a good one.

Before Your Visit

Know the names of all the medications you take, their dosage strength and your schedule for taking them. It’s best to write all the information down in a chart. Even if you’re an expert at your own medications and schedule, it’s not unusual to confuse directions when you’re trying to give information quickly or feel anxious during your doctor’s visit. In addition, you can simply hand the doctor your list and he can quickly extract the information he needs.

Think about topics that you and your doctor will discuss at this visit. For example, if you are diagnosed with diabetes, your doctor may have prescribed glucose monitoring, an insulin schedule and diet modifications. He or she will want to know what your progress has been. Bring in your chart of readings and insulin so he can see how it’s working. Make a list of times that you felt light headed and be honest if you are having trouble following the diet in the evenings. Write down the questions you want answered as well. It’s much easier to think in the comfort of your home than while you’re sitting on crumply paper wearing a threadbare gown.

The U.S. Preventive Services task force is an independent panel of experts in primary care and prevention that develops recommendations for clinical preventive services based on systematic reviews of clinical evidence of effectiveness. This group publishes a list of screenings that are recommended at every stage of life. Don’t rely on your doctor to notice that you just turned 50 and should be scheduled fro a screening colonoscopy. Some offices have automated systems that reminder doctor and patient of important screening information but these systems are not foolproof. Learn which tests you should be having and at what intervals. Remind your doctor that you are due for a screening or call the office and ask that your doctor schedule a screening for you.5,6

During Your Visit

If you are like most people, when you visit your doctor’s office, you become slightly anxious. Some people even experience “white coat hypertension,” their blood pressure goes up at the doctor’s office. Since it’s normal and quite reasonable to feel some anxiety, you should take steps to make that doctor’s visit as useful as possible by working around the this and inevitable barriers such as the office’s hectic schedule, confusing medical terminology and so on.

Be on time for your appointment. If you’re flustered because you’re late and the doctor is annoyed because his schedule has been delayed, no one is going to communicate well. If your doctor’s schedule is unpredictable, be a realist and plan for it. This waiting time can be a great opportunity to write a letter you’ve been putting off, balance your checkbook or fit in some recreational reading. Also, consider scheduling your appointment early in the morning. You may find that your always-late doctor generally starts his schedule on time but gets bogged down as the day wears on.

At the start of your face-to-face time with the doctor, let him or her know that you have questions. In fact, it’s useful to show your list. Your doctor will know that you are taking responsibility for your care and that will encourage him or her to pay attention to your issues. Bring a balanced perspective to the visit. Your doctor is neither a god whose opinion is always right, nor the enemy, deliberately ignoring your needs. He or she is a highly trained professional who is trying to maintain your health in partnership with you. You may feel that he or she sometimes forgets the point of the job; that’s why you have to be prepared to help your doctor stay on course.

If you disagree with the approach your doctor is taking, you need to say so. You may not be a physician yourself, but you know your own body and you certainly have a valid opinion about whether a particular type of intervention is going to work in your life. If you are facing major medical decisions, you may want to seek a second opinion before consenting to a major procedure or course of treatment or agreeing to forego treatment.

Don’t be offended if the doctor refers you to the nurse for more information. Office nurses are also well-trained in the disorders the doctor treats and are very good at explaining difficult information. Write down the answers to your questions as well as any new instructions you receive. It’s hard to remember everything that goes on during a medical visit, particularly if you are given new or surprising information.

After the Visit

Call the office if you later realize that you are confused about instructions or don’t remember everything you are told. It is much better to get the information straight right away than to make mistakes in your care and medication routine. If you have received information about a new diagnosis or are scheduled for an unfamiliar test, take the time to do some research.

Go online and find additional information so that you will have the best information available about your situation. You may learn about side effects of a drug you’ve been prescribed, alternative treatments that you might want to consider or additional warnings that your doctor may not have mentioned or you didn’t hear correctly. Use the information you have discovered to help yourself and your doctor manage your situation.

Pay your co-pay or bill, if there is one. A doctor’s office is a business. If you fail to keep up the business end of the relationship, your medical relationship can suffer. Most doctors work very hard to be sure that they are not thinking about money when dealing with their patients and are generally successful in separating business from medicine. But, doctors are only human and if your name keeps coming up on the delinquent pay list, it may have a negative effect.

The Bottom Line

Congratulations, you did your homework and found a good doctor. Just don't forget to be a responsible partner in your medical care. Carefully choosing your physician is merely the start. No guarantees, but your life will probably be healthier!

Published November 12, 2008, updated April 14, 2014


References

  1. Starfield B et al, Contribution of primary care to health systems and health, Milbank Q. 2005;83(3):457-502
  2. Starfield B et al, Commentary: Primary Care and Health Outcomes: A Health Services Research Challenge, Health Serv Res. 2007 December; 42(6 Pt 1): 2252–2256
  3. FindaDoctor, HealthWorldNet.com
  4. Clinician Directory and Search, National Committee for Quality Assurance
  5. Men: Stay Healthy at Any Age, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, September 2010
  6. Women: Stay Healthy at Any Age, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, September 2010

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