Calling the shots: Finding the right doctor

Calling the Shots: Finding the Right Doctor

The key to being satisfied with your health care is the relationship you have with your doctor, and that begins with choosing a physician who is a good match for you. But a good rapport with your health care practitioner is only one piece of the doctor-patient puzzle. Another is effective communication. Patient surveys reveal that many people are dissatisfied with their doctors; but the doctor's medical expertise usually isn't the reason for the dissatisfaction. More often, it's the doctor's bedside manner that's the problem. In fact, communication obstacles rank high on most patients' list of complaints.

A recent study reported in the Journal of Women's Health & Gender-Based Medicine highlighted the value that women place on open and effective communication with their physicians. The primary goal of this survey, which included 137 women from across the United States, was to determine how women wish to experience their health care. A central theme that cut across geographic regions was that women desire a partnership with their health care provider. They also noted that they expect their providers to be trustworthy and non-judgmental, and to be good listeners. In addition, the women polled stated that they wanted to be respected and to have their input taken seriously.(1)

There's a lot that you, as the patient, can do to facilitate a more meaningful and satisfying relationship with your doctor. Developing a strong bond with your doctor begins by investing the time to seek out a practitioner that meets your needs. Most people spend more time looking for a supermarket with low prices than they do looking for a physician. This is the person to whom you have entrusted your health and your life. Doesn't it make sense to devote some time and thought to the decision?

The following five-step process is designed to help you find the doctor of your choice.

1 Decide what kind of doctor you need

I always advocate having a family physician, regardless of what your insurance or medical plan requires. Health care has become so complex that you need someone to coordinate your care, as well as treat your minor health ailments. If you use a specialist as your primary care physician for example, a gynecologist -- be sure to seek out a board certified specialist for complicated or serious problems.

2 Devise a list of candidates

Your access to health care and your geographic location may influence the length of your list. An extensive list can be whittled down by ruling out doctors according to some easily identifiable criteria; for example, gender, location or, if you are American, the insurance plans accepted. In this information age, it's easy to find the names of medical providers in your area. Many hospitals publish directories of physicians or offer a physician referral service. You can add names to your list by checking the telephone book, searching the Internet and your local library for directories of physicians and medical specialists, and contacting the local medical society and/or university medical schools. Don't forget to ask for recommendations from your other health care providers, friends and relatives. Nurses are a particularly knowledgeable source of information.

3 Narrow your list

Now that you've assembled your list of candidates, you need to streamline your options. Begin by identifying traits that you desire in a physician and her staff. Since no one is perfect, categorize these characteristics and features according to those you consider to be `necessities' and those you consider to be "niceties". Then evaluate each physician according to these criteria. Factors that appear on your list may include education and training, continuing education, specialty area, treatment philosophy, communication skills, hospital privileges and office hours.

You can obtain much of this information before meeting the physician, but it may require some legwork. For example, you can call the doctor's office and speak with the office manager. Ask about hours of operation, and if you are American, whether or not the office accepts your insurance plan and the availability of payment plan and the availability of payment options. If you have limited mobility or require other forms of accommodation, ask about accessibility and how your needs can be met. Also ask about the average lead time needed to schedule a routine visit, how quickly you can be seen for an urgent situation and the number of patients the doctor treats for the medical problem you have. You can also consult physician directories, publications and websites that list physicians certified in a specialty field or those for whom disciplinary action has been taken.

4 Meet the doctors

Once your list is narrowed down to a handful of physicians, it's time to meet the doctors. Although this usually requires a scheduled visit, you can gather information on a doctor's communication skills, areas of interest or specialty, and health philosophy by attending a class that she teaches or listening to her speak at a support group meeting, on the radio or on television. When scheduling an appointment to meet the doctor, be sure to go into the appointment prepared. Since your time will be limited, you need to use it wisely.

Draft a standard list of questions to ask each doctor, and leave room to record her answers. If you're seeking a clinician who's knowledgeable about a particular disorder, bring up the topic for discussion and ask the doctor to briefly educate you on the problem and her treatment approach. Since many patients living with chronic illnesses and disorders are medically savvy about their conditions, they usually can discern if a doctor has kept current on a specific problem in that area. Also, inquire about the scope of the doctor's practice and the volume of patients she treats with similar concerns.

Other topics to consider addressing during this visit include: Other partners in the practice; where lab work and diagnostic tests are sent for interpretation, as well as the reliability of the facility; attitude regarding second opinions and complementary care; receptivity to approaching the doctor-patient dyad as a partnership. Some women may be fearful of certain examinations and may want to ask whether a support person might be present.

5 Choose a doctor

Finally, the time comes to select your doctor. Take a look at your candidates and gauge how they met your criteria. How did they score? Which ones met the most necessities on your list? Did you find anyone who satisfies both the necessities and some niceties?

Once you've ranked the candidates, give them some additional consideration. Only this time, use your intuition. If a doctor looks great on paper, but your gut cautions you against choosing her, then pay attention to your instincts. You may be better off moving to the next person on your ranked list.

Keep in mind that your decision isn't etched in stone. If a physician turns out to be vastly different than she presented herself, or if your preferences drastically change, you can always move on and find someone else.

Whatever you do, don't settle for a doctor with whom you do not feel comfortable, and who does not treat you with compassion and respect. Noted Canadian medical educator Sir William Osier once said, "It is as important to know the person who has the disease as the disease the person has." Not only do I wholeheartedly agree with this philosophy, but I believe this connection begins by choosing a physician who's right for you.

Selecting a physician with whom you will entrust your life is one of the most important and meaningful decisions that you will ever make. Don't make it lightly. Waiting until you're ill to find a doctor probably won't result in a well thought out and satisfying decision.

While it's unlikely your doctor will read you your "patient rights" at every visit, you have rights nonetheless. It's not unreasonable to expect your health care provider to be competent, caring and communicative. There are many physicians out there who fit the bill. You just need to take the time to look for them.

Endnotes

(1) Roger T. Anderson, Ph.D., et al., "A Qualitative Analysis of Women's Satisfaction with Primary Care from a Panel of Focus Groups in the National Centers of Excellence in Women's Health", Journal of Women's Health & Gender-Based Medicine, Vol. 10, No. 7(2001). pp. 637-647.