- Health Care, Drugs & Insurance
How Can You Find A Good Doctor? Good Luck!
Tips For Finding A Good Doctor
How can you find a good doctor? The answer is not all that easy. But you can do some things that might protect you from the maybe fatal mistake of finding a bad one. It has been said that doctors bury their mistakes. With the secrecy that surrounds quality assurance and peer review, coupled with the refusal of doctors to police each other, know that finding a bad doctor can many times be easier than finding a good doctor. And while finding the bad one may be easier and require less effort, it may just kill you. Not a pleasant thought?
Reuters reports that there are 100,000 patient deaths per year in the U.S. from medical error and 9 million additional patients harmed because of medical mistakes.
Doctors will very rarely tell you about their mistakes, so you cannot depend on their candor. Many doctors do not take kindly to being questioned about any past errors they have made. While referrals from friends may help, your friends do not have the same medical needs or problems that you have, and their knowledge of good vs. bad medical practice may be just as limited as your own. Do your friends say, "I have a good doctor" or do they say, "I have an incredible doctor!" Take into consideration what friends and co-workers tell you, but also consider whether they see their doctor once a year and whether or not they have chronic medical conditions that require some specialized knowledge on the doctor's part. If your friends have chronic health problems, are they improving? If you are searching for a primary care physician, I strongly suggest (my opinion) that you look for a doctor certified in internal medicine, as opposed to a family practitioner. The bias may come from having to listen daily to a dozen or so family practitioners talk non-stop about how much smarter they were than specialists. They weren't. Their patient outcomes were less than optimal and they were always obsessed with how much money the less-deserving specialists were making, and they hated referring "their" patients for specialty care.
Call your hospital network and ask questions. Talk to a nurse or two or three. They know who the good doctors are. They also know the ones who are not. They will not give specific information (that can cost them their jobs) regarding dangerous doctors, but they will usually try to steer you clear of physicians they would never see. If you have a specific doctor in mind, you should be able to garner information from the way they answer your questions, the tone in their voices, etc. Whatever your condition is, stress that when asking questions. Who, in their experience, would they recommend to treat your ailments? Who, in their opinion, has the knowledge required to treat that illness? Press them a little. Who has the best outcomes? Start there. Ask them who they see? Who members of their own families see?
Understand also, that if your hospital is affiliated with a university, you may have higher quality physicians from which to choose. You are lucky! Smaller, local hospitals may not have the care or treatments that you really need. Smaller hospitals do not often draw the cutting-edge physician talent, either. Location does matter!
Pay particular importance to where your physician did his or her residency. While medical school is important, half of all medical school graduates received their degrees with the distinction of being in the bottom half of the class. A doctor's place of residency is where he got his on the job training. Highest on my personal list would be a doctor who did their residency at the Cleveland Clinic, but there are many fine institutions.
With So Much Charm And That Great Bedside Manner, He Can Kill Me, It's Okay!
Do NOT choose a doctor based on his charm, great smile, wit, or God Forbid! wonderful bedside manner. Some physicians with fine bedside manners have buried a great many patients. Take the case of Dr. HODAD, a startling case chronicled by Reuters. Dr. Hodad was sought out by everyone from the famous to the ordinary because of his charm, self-assurance and unmatchable bedside manner. He had an Ivy League background, the best of training and was board certified. Dr. Hodad also had a reputation for screwing up almost every surgery he performed, leaving patients severely compromised, with life-threatening complications. With each and every bad outcome, the hospital's Quality Assurance Committee met. Other doctors, his peers, reviewed his actions and outlined his negligence in their reports, but because Quality Assurance results are kept confidential, the patients never even knew that their brushes with death were the fault of their own charming doctor.
Dr. HODAD worked for a Boston hospital, but his name has been changed. The residents-in-training at the time gave him that acronym. HODAD stands for: Hands of Death and Destruction...
Interview a doctor before you hire him or her and instead of bedside manner, seek a doctor who actually will care about you. How will you know? He will not play God and will not act like he is God. He will not talk above your level of knowledge. He will actually listen to your complaints and symptoms, without making you feel rushed. He will not make you feel as if your complaints are imaginary, overblown, insignificant or stupid. He will show genuine concern and if he is stumped, he will say, "I don't know what is going on here, but I am going to find out." Then he will actually take the steps to find out! If a doctor has no time to meet with you prior to choosing him as your physician, he will have no time to care for you later.
Instead of telling you to learn to live with it, a good doctor will give you all treatment options, not just his or those that are covered by your insurance. If you are in pain, a good doctor will not simply advise you to "take a couple of Tylenol". A good doctor has the obligation to help adequately control your pain.
Get Them Off That Pedestal! The Air Up There Is Thin!
Do not put doctors on a pedestal! Don't rely simply on what the doctor tells you. While your doctor should be your advocate and always be completely honest with you, you bear some responsibility as a patient. You should be an advocate for yourself, as well. You must speak up and communicate effectively. Research your conditions. Find out the things that you can do to help yourself. Then do them! If your doctor tells you to walk, try. If your doctor suggests a healthier diet, try. You must be an active partner in your health care. You have to help yourself, too.
There are plenty of good doctors out there, but it is up to you to find one. It is also your right to terminate a relationship with a doctor who is not meeting your expectations. Do not be afraid of hurting the physician's feelings. Your health and well-being are the most important aspect of any physician-patient relationship.
If you feel that you have been wronged, speak up! File paperwork with your state under consumer grievances.
- Ask friends and co-workers for their referrals, within reason.
- Seek advice from nurses in the area.
- Check credentials and where the doctor did his residency.
- Interview prospective job candidates. Make a list of your questions. At the initial meeting, you should be able to get a feel for whether the two of you will be able to relate to and actually talk to each other.
- Look for a doctor who listens to you and tells you the whole truth. It is your body and your health.
- If you feel rushed during visits, rush right out of that office. Don't go back!
- Check out the office staff. They are a direct reflection and mirror image of their boss's attitudes. If they are rude and/or make mistakes, chances are their boss will do the same.
- Check your state's disciplinary board website, but know that the information is less than transparent. They will NOT disclose any but the most serious violations, in which case they will let you know if your doctor's practicing privileges have been revoked. They will not tell you how many malpractice cases have been filed or how many patient complaints have been logged.
- Check consumer websites that rate doctors and allow consumer input, but understand they are incomplete as well.
- Know that a doctor can lose his license in one state, move to another, and still practice there. Don't believe it? http://www.wptv.com/dpp/news/local_news/investigations/doctors-lose-license-but-still-treating-patients
- As a personal preference, I look for a young doctor and an old lawyer. Think about it. The younger doctor is trained in the latest medical techniques and treatments. The older lawyer has been around the block and seen everything the courts have to offer. I must qualify this statement. Perhaps the finest doctor I ever met was an attorney first. Within 2 years of corporate practice, he went to medical school and became an invasive cardiologist. He was among the first to perform angioplasties and cardiac caths. He always gave me the same advice: "Young doctor---old lawyer."
Transparency In Health Care
There is very little transparency in health care. That includes both physicians and hospitals. Try to find out which hospital has high post-op infection rates or other poor outcomes. The information is not out there. It is not published. Try to find out which hospitals are best OR WORST when it comes to treating cardiac conditions, providing great quality cancer care, etc.---good luck! You will hear each Hospital Public Relations Department advertise their hospital and their doctors as being the BEST! Remember, most of that is PR.
Try to find out which doctors have been accused by other doctors of being drunk in surgery? Impaired by drug abuse? Accused by their peers of being negligent? Those peer reviews take place every day, but never see the light of day. For some reason, patients are not allowed to know.
How can you find a good doctor?