Selecting a Physician

Do you have any suggestions about what qualities I should look for in a doctor? Our family doctor just moved out of town. She referred me to another physician, but I think I'd like to check around for other options.

In a best case scenario, you would look for a primary care provider who is supremely competent, compassionate, a great listener, intuitive, flexible, available whenever you need help, always on time but never rushed, aligned with your moral and spiritual convictions, affordable and able to leap tall buildings with a single bound. In reality, you may have trouble finding a Superdoctor in your community (or on our planet) who fulfills all of the items on this wish list. This being the case, you’ll want to begin by giving careful thought to the qualities that are the most important to you. For example:

Competence. This is critical in a health care provider. This doesn’t mean that you need a person who’s a walking encyclopedia. Instead, what you should be looking for is a doctor who applies training, experience and ongoing education intelligently – including knowing when (and whom) to ask for help. Great interpersonal skills are no substitute for knowing which end of the stethoscope is which. Most, if not all, physicians groups will verify that their providers have received a degree from an accredited school, completed a residency program in their specialty, passed certifying exams, and are duly licensed to practice medicine. You can locate this information by contacting state medical licensing boards or hospitals with whom the provider is affiliated. You can also learn if a physician is certified by calling 1-866-ASK-ABMS or accessing the website of the American Board of Medical Specialties (a non-profit organization comprised of 24 medical specialty boards).

Compassion and communication skills. These components of the proverbial “bedside manner” rank just below competence as important traits to seek in a primary care provider. If the doctor won’t listen to you, doesn’t seem interested in or concerned about your symptoms, won’t answer questions, and generally treats you disrespectfully, you shouldn’t plan on continuing a long-term relationship. There may be occasions when you require care from someone with unique technical skills – for example, a subspecialist trained to perform an unusual procedure that you need – who has the personality of a brick or the social skills of a porcupine. You can probably put up with their behavior (as long as it isn’t overtly disrespectful or inappropriate) for a short time. But with a primary care provider your intent is to be in a long-term relationship, and that may prove difficult with someone you find irritating.

Worldview compatibility. It is extremely helpful if your primary care provider shares your moral and spiritual outlook, since this can impact many healthcare decisions. This is particularly important if this individual is going to provide input to your children or teenagers, especially in matters regarding sexuality. (It is indeed frustrating to teach standards of conduct in this arena to your adolescent, only to have them undermined behind closed doors in the office or clinic.) Even if you and your healthcare provider are not on the same spiritual page, it is crucial that he or she respects your commitments. Remember also that, as with bedside manner, there are a number of situations where you may need the technical expertise of a physician who does not share your (or anyone else’s) faith. This does not necessarily mean that you will receive substandard care. Conversely, the fact that a physician happens to be a committed member of your church does not automatically mean that he or she is the most competent caregiver in town.

Accessibility and availability. Your primary care provider or medical group is the place you call when you need help. Ideally, making an appointment, refilling a prescription or asking a question shouldn’t feel like running a gauntlet. Some questions to ponder: When you call the office, do you have to wade through a ten-step menu to talk with someone, or routinely wait on hold for fifteen minutes? Is there anyone available to talk to after hours or on weekends, or do you get a recording that says “If you’re having a problem, go to the emergency room”? Do you have to wait for several weeks to get an appointment? In some busy practices, a physical exam may have to be scheduled months in advance, and the next non-emergency opening may be a few weeks in the future. But is there a provision for seeing you or your child for an illness today? Often the person who is designated to see patients for acute problems will be a physician assistant or nurse practitioner – don’t be resistant to that option. Also, there are certain situations – for example, crushing chest pain that started a few minutes ago – that do not belong in the doctor’s office, but rather in an emergency department. If your primary care provider directs you to go directly to the ER (or call 9-1-1), don’t ignore that advice.

On a related note, you may wish to ask whether your primary care physician takes care of his patients if they are in the hospital. There is a trend for some primary care physicians not to go to the hospital. Those physicians would have a specialist (known as a hospitalist) see you when you are in the hospital as an inpatient. Whether your primary care doctor will care for you in the hospital may not matter to you, but if it does it’s good information for you to have.

On time vs. giving you time. There are many reasons why a provider may be behind schedule on any given day, and most of them arise from the unpredictability of the problems that arise during any day in a medical practice. For example, it only takes one patient with an acute, complicated problem to disrupt the schedule for the rest of the day. One other reason may be that the caregiver takes enough time to evaluate each patient’s problem(s) carefully, explain the treatment options and answer whatever questions arise. Very often a person with a 15-minute appointment brings 45 minutes worth of symptoms into the exam room. If the provider feels that these cannot be reasonably postponed to another time, delays will be inevitable. When a few of these show up on the same day, the person at the end of the schedule may have a long wait. If your primary care provider resists rushing with patients, he or she may be frequently behind schedule. Hopefully the office staff will inform those arriving in the waiting room when there is a major delay, and offer the option of coming back later in the day or making an appointment on a different day. On the other hand, you may want to seek a different provider if your routine experience is that of having long waits and being rushed through your visit.


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