The first step to becoming your own health advocate: 8 questions for finding a good doctor
The old proverb says, “An ounce of prevention is worth a pound of cure.” As patient advocates, we are here to help you when you face challenging situations in the medical industry, but we prefer that you avoid difficulty in the first place. That’s why patient advocacy begins before you step foot in your doctor’s office. By finding a good doctor in your area, you can avoid some of the common issues that we handle as patient advocates. But how do you know which health care provider to choose?
There are many factors you need to consider when finding a doctor. You want a doctor that provides quality care, but is also affordable and in your insurer’s network. You want a doctor that is an expert in their field, but is also close to home. You want a doctor that is knowledgeable, but also one with whom you connect well.
How do you balance all of these factors? Here are a few questions to help you make your decision.
1. Have you asked your primary care physician for recommendations?
In an effort to save money, more and more insurance plans are requiring patients to see a primary care physician before making an appointment with a specialist. While this can be annoying, it can be to your benefit. Once you have established a good relationship with a primary care physician, you can ask them for referrals to physicians that they like and trust. Additionally, good communication and trust with one doctor means that you are more likely to receive the test and treatments that you need. As a result, you may be less likely to require care from numerous (and more expensive) specialists.
2. Have you searched your health insurance provider’s network?
You want a doctor that is affordable. Most of the time, that means finding a practice that is in your insurance provider’s network. Use your insurance provider’s searchable directory to find a list of doctors in the field you require. Many insurers also provide their own rating system for doctors in their network.
3. Does the doctor have privileges at your local hospital?
Not all specialists can practice at all hospitals. Hospitals often require affiliations or admitting privileges. If your local hospital has good ratings, check to see if your doctor can practice there. If he or she does not, when you need hospitalization, you may find yourself under the care of a doctor assigned by the hospital.
4. What medical degrees or certificates does the doctor have?
When you find a practitioner online, look at their biography information. Do they list their degrees and certifications? Do a little research to see what is involved in that education. For instance, an American Board of Medical Specialties certifications indicates that a doctor received his or her medical degree from an accredited school, completed 3-7 years of residency training, is licensed by a state medical board, and has passed one or more ABMS exams. If you see this certification listed among the doctor’s qualifications, you can likely assume that he or she is well-educated and knowledgeable in their field.
5. Has the doctor ever been sued for malpractice or received disciplinary action?
Sometimes, you will find review sites that mention red flags like malpractice claims and disciplinary actions taken against a particular doctor. However, this information is not always accurate. Instead, check your state’s medical licensing board. You can find information on whether or not their license is (or has been) suspended, and whether they have received disciplinary action in the past. You may also be able to find further information by running a Google search for the doctor’s name with words like “malpractice,” “lawsuit,” and “sanction.”
6. Do you connect with and trust the doctor?
While it may not seem like it should be a deciding factor when compared to things like a doctor’s knowledge and expertise, it is important that you and your health care provider can communicate and interact well. Not only are you more likely to go to your doctor when you have an issue and follow their care plan, but your doctor is also more likely to understand your issue and know how to care for your needs. Does your doctor explain your diagnosis and treatment so that you understand? Do they actually listen to your questions, or just brush aside your concerns? How is their bedside manner? Do they take the time to connect with you, or do they try to quickly rush through the appointment?
7. Does the medical practice meet regularly with drug reps?
While meeting pharmaceutical companies is not strictly inappropriate, it can pose an issue when practices let such meetings happen too frequently. Sales reps can persuade doctors to needlessly prescribe medications they may have previously refused. Additionally, the reps can lead doctors to start patients on brand name drugs that are more expensive and may not be covered by insurance, instead of generics that are more affordable.
8. Do you have a positive experience at the doctor’s office?
A good health care experience is about more than what happens in the examination room. The office staff, waiting room, record management, and billing department all contribute to the quality of care you receive.
- Was the staff friendly and organized? A disorganized office staff means that your procedures can be mis-coded, your files mixed up, and your appointments mis-scheduled. Look for a staff that is both friendly and efficient.
- Did you have to wait a long time to be seen? You should not have to wait longer than a week to be seen for a routine appointment. If you arrive punctually to your appointment, you should also not have a lengthy wait to see your doctor. Lengthy waits indicate a practice that is understaffed and has too many patients. The busier the doctors are, the less time they will have to personally care your health and the more likely that patient information will get disorganized. Additionally, the more time you feel like you are wasting at your doctor’s office, the less likely you are to keep crucial follow-up appointments.
- Do they use electronic records? While electronic records reduce the likelihood of important documents and test results being lost over time, you will want to ensure the staff upholds HIPPA protocol. Documents containing medical information should be protected with passwords, encryption, and other safeguards, and not contained in an email.
Finding a doctor can be intimidating. If you are still unsure after going through these steps, send us an email or give us a call! As patient advocates, part of our role is to help you research your options and make recommendations for the best care providers!