DISCLAIMER: I am guilty of having chosen bad doctors. I am also guilty of staying in an unhealthy doctor-patient relationship because the physician was nice or I did not know how to “break up” with him or her.
Not having the best doctor to meets your need may result in poor management of a health condition, avoidance of routine checkups, or waiting until your illness gets so bad that you are forced to go to the urgent care or emergency room. The irony is that we would not allow this in other aspects of our lives, so why do we tolerate it when it comes to our health? This is a complicated matter, but I believe that it is partially the result of the respect that doctors have in society and as a profession. However, patients are ultimately in charge of their healthcare providers and can exercise this right.
Doctors can be categorized as primary care physicians (PCPs) or specialists. PCPs have been referred to as “gatekeepers” and are usually the first point of care for diagnosis and management of disease, as well as preventative care and screening exams. They coordinate care with hospitals, rehabilitation clinics, and specialists, as needed. PCPs include family medicine and internal medicine doctors as well as pediatricians.
Medical specialists focus on specific organs or disease states.
Examples include cardiologists (heart), neurologists (brain and nerves), pulmonologists (lungs), and oncologists (cancer). These doctors may be “consulted” on a one-time basis and make recommendations to your PCP, or may provide ongoing treatment and management of a specific condition.
Surgeons are specialists that operate on specific body parts. Some examples of this include orthopedic (bones, joints, ligaments), urologic (kidneys, bladder), or ophthalmologic (eye) surgeons. PCPs often refer patients to a certain specialist that they are familiar with, but as a patient you have the right to also perform due diligence and choose the best physician for your needs.
Identifying qualities that are important to you. I conducted a survey that asked people to identify the five most important qualities they want in their doctor. I found that there was great variability, and even opposite preferences, but included them so you can determine what is important to you.
—Ability to make an appropriate diagnosis and treat the condition effectively.
—Ability to explain what and why in an understandable manner. However, a few people responded that they wanted a doctor who took charge and made decisions for them.
—Listens. Patients know their body better than anyone else.
—Knows what they do not know. When things were not getting better, or getting worse, the respondents stated that they wanted their doctor to address this and be willing to get a second opinion or refer them to a
—Appears concerned and interested. No patient wants to see their doctor looking at their watch, answering private phone calls, or looking bored.
—Flexible hours. For some, it may be difficult to take off from work. It may be helpful to have a doctor with early morning, late afternoon, or weekend hours.
—Promptness with returning phone calls, making referrals, or refilling prescriptions.
—Ease of getting an appointment. In particular, when you are sick, you want to be able to get in so you do not have to go to an urgent care or emergency room.
—Accepts your insurance.
—Admits to or is affiliated with a hospital that you are comfortable with.
—Cost-conscious. Only orders tests that are necessary and will help guide decision-making.
—Research in their field. It is impressive when your doctor is an expert in a certain area or has written the book chapter that others read and learn from.
—Other: Location, easy parking, clean office, courteous staff. Now that you know what you want, how do you get it? I have to admit that this is no easy feat. However, this is not marriage and you do not need a divorce decree to change physicians.
Here are some suggestions to collect information to help with your decision:
1. Word of mouth. Family, friends, co-workers, neighbors, or groups you are affiliated with may suggest (or caution you against) a particular doctor. Ask them what they like about them and how they feel on other matters that are personally important to you.
2. Internet ratings. Numerous websites exist where patients can rate their doctors. However, be aware that reviews are often written by patients that hate or love their doctor. As a result, they can be biased or omit important details. Additionally, it is possible that doctors can “rally” for positive reviews from friends, relatives, or even patients.
3. Pubmed (www.pubmed.com) is the government’s online resource for research articles and reviews that are published in medical journals.
The search engine is very sophisticated and you enter the last name followed by the initial of the doctor’s first name (e.g. for Dr. John Doe, you would enter Doe J). You may be surprised with your doctor’s accomplishments and achievements.
4. Practice webpage. This is obviously biased because a doctor will not put negative information about him- or herself. However, it can provide some basic information about their locations, hospitals they are affiliated with, services they provide, areas of expertise, or awards/recognition.
5. Board of Medical Examiners. Each state has a Board to ensure that physicians meet certain standards. You can Google “Board of Medical Examiners” along with the state you reside in. Once you have identified the doctor, you should be able to see details about their education and board certification, office address, legal actions (e.g. malpractice settlements, criminal violations), and professional activities. Malpractice lawsuits do not mean that your physician is unacceptable or dangerous. In fact, most physicians have had a lawsuit
filed against them at some point during their career (general surgeons and obstetricians have the highest rate due to the intrinsic liability of their specialty). However, criminal actions are probably a red flag.
—Insurance companies have been rating physician performance for years; however, they may have a financial interest and rate doctors higher because they have lower costs. They are useful in that they usually
list how many procedures a surgeon has done. Your insurance plan may also limit your choices to “plan-approved” physicians or provide financial incentives to use “plan-affiliated” doctors. If your doctor does not participate in your health plan, it may be possible to still see him or her, but may require out-of-pocket expenses.
Most people do not marry the first person that they date (though in some cases this happens). So if you do not feel that your physician is a good fit for you, determine what you are looking for and if it is realistic. You may yet find your Physician Prince or Princess Charming.
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This article is for general information only and should not be used for the diagnosis or treatment of medical conditions and cannot substitute for the advice from your medical professional. Dr. Nina has used all reasonable care in compiling the current information but it may not apply to you and your symptoms. Always consult a doctor or other health care professional for diagnosis and treatment of medical conditions.