guthealthcare.com - Managing your doctor

Does your doctor know what she's doing?

Sometimes it's hard to know for sure how knowledgeable your doctor is. But at a minimum you should check to see if your doctor is board-certified in her specialty. (Note: there are board certification exams in the primary care fields of general internal medicine, family medicine, and geriatrics.) Two sources can help. The Directory of Physicians in the United States and the Official American Board of Medical Specialties Directory of Board Certified Medical Specialists list doctors who are board-certified. These books are available in most public libraries, and your doctor should appear in them.

Perhaps more importantly, does your doctor seem smart to you? When you ask a question about a health problem, are the answers quick, logical, and cogent? Do the answers match with what you know to be true? Are his answers given confidently, or is he dissembling? Keep in mind that it's often fine for a doctor to answer, "I don't know," as long as he promises to find out the answer, and then follows through on that promise. And pay attention to whether your doctor's "smarts" are merely of the book-learning variety, or whether his academic knowledge seems tempered by experience and common sense.

For specialists you will be seeing only once or twice, or who you are going to for some complex or esoteric medical procedure, their experience, knowledge and ability are often much more important than how well they communicate. If I'm having a heart valve surgery, I care much less about how warm and fuzzy the surgeon makes me feel during the pre-op interview, and much more about how many similar procedures she's performed, and what have been her surgical results.

The third most important factor

Is your doctor respected by his peers?

Doctors watch each other perform in the trenches, and in general, are pretty good at sizing each other up. If you can get a recommendation on a PCP from a doctor you know you can trust, that's likely to be a good starting point.

If you know some doctors, ask them what they think. Would they send their own patients to your doctor? Or, better yet, do they send their own family members to him? Do they use him as their own doctor?

If your doctor is invited to participate in the training of medical students or medical residents at the local university, that's a reasonably good sign that he's held in high regard by his peers.

Other factors to consider

Where is your prospective doctor located? Is her office convenient to you?

Which hospitals does she have admitting privileges to? Are these hospitals convenient to you, and do the specialists there (since the specialists in those hospitals are the ones she will be referring you to) have a good reputation?

What are her practice arrangements? Who covers for her when she is away?

Is her age, gender or race important to you?

What is her office staff like? Are they reasonably competent, friendly, and helpful, or is their main job to keep you out?

What are her office hours and office policies?

What insurance plans does she participate in? This may be especially important if you are likely to be changing jobs (and thus changing insurance carriers.)

Where to look

Make yourself a list of potential PCPs.

Start with your family and friends - people whose opinions you trust. Find out who their PCPs are, and whether they are happy with them. Find out why they like them. Also, talk to medical specialists, and especially to nurses and (if you know any), physicians' assistants. See which doctors they respect and admire, and why.

There are several sources on the Internet that can help you in your search for a good doctor. A good compilation of these resources can be found at diagKNOWsis.com. Here's the link.

Once you have made your list of doctors, check for them in the Directory of Physicians in the United States or the Official American Board of Medical Specialties Directory of Board Certified Medical Specialists in your public library. Make sure they are board certified, which is good evidence of at least a minimal level of competence.

Finally, call the office of one or two of the doctors still remaining on your list. See what you have to do to get an appointment. See whether the office personnel seem friendly and efficient, or whether they're obstreperous and obstructive. Remember that you need to deal with these people fairly often, and that before you ever get in to see the doctor, you've got to get past them. And remember that the doctor's front office is a reflection of his own personality. If his receptionists and nurses are difficult to deal with, you've got to assume that the doctor likes it that way.

The remaining step is to pick one of the "finalists" on your list, and make yourself an appointment. If after meeting with the doctor you decide this isn't going to work out, remember Rule # 1.