Choosing a Doctor: teamwork makes your body work

Having a doctor that you get along with and respect can make a world of difference. I, like almost everybody else, have had both good and bad experiences with physicians taking care of me. At worst, they make me feel unheard and defensive, and leave me with unanswered questions. At best, they make me feel empowered and confident in my care. While there’s no science to picking a doctor, let’s talk about a few important things to consider.

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Tell me what you want, what you really really want

Now’s the time to be honest with yourself about what you need. If you’re looking for primary care, you’ll be looking for an Internal Medicine or Family Medicine doctor. If you’re a woman, you probably will also want an Ob/Gyn doctor. Do you care what gender they are? Some people are more comfortable with a provider the same gender as them, while others don’t care. Do you care what their age is? Older doctors have more experience, but younger doctors may be more up to date on recent advances. You can check www.health.usnews.com/doctors to filter possible providers.

Every once in a while, you’ll see DO after their name instead of MD. That means they are a doctor of osteopathic medicine, versus MDs who practice allopathic medicine. What in the world does that mean? The big difference for you is that DOs are trained in manipulation (OMT), which involves moving muscles and joints to try and treat/prevent illness. While all DOs learn OMT, not all of them still practice it; and some MDs have done further training to learn OMT. Historically, DOs have been trained in holistic medicine and MDs focus on symptomatic medicine, but their training has gotten more similar. Both are qualified, licensed physicians, and either would be a good choice as a provider.

I know, I hate being practical too

Before you do anything, check to see who is in-network for you (meaning that your insurance will pay for them). It doesn’t matter if they have the brain of Sherlock Holmes and the charisma of McDreamy, if you can’t afford to see them, you won’t. This will depend on your insurance, but you should be able to log on to your online account and check.

If you have another doctor that you like, it’s generally better to see someone in the same system as them if possible. As a provider, I can tell you it’s a lot easier if you can see the other practitioners’ notes and the labs/imaging they may have already ordered.

Dr. Google

Now it’s time to take to the internet- but where to look?

If you Google the doctor you’re looking at, they may have a profile they or their institution made for them. This can help you see what their interests are, and what they think is important for you to know, Look on YouTube, maybe they’ve made a video with their institution or local news, and you can see what their philosophies are like. If you’re feeling very motivated, you can try searching them on pubmed.gov, to see if they are involved in research in a disease important to you.

On some sites like HealthGrades, you can see how many malpractice cases or disciplinary actions they have. Do not be afraid of someone who has had 1 or 2 malpractice cases- unfortunately, it’s very common (especially in Ob/Gyn). But if there’s a pattern of legal issues, that may be something to keep in mind.

Overall, I would beware of “top doctor” lists. The most reputable is Castle Connolly, which bases rankings on peer nominations- essentially who other doctors say they would go to if they were sick. While it’s most likely a good sign if your doctor is listed, it doesn’t really help if they aren’t listed. Castle Connolly has been accused of being a little bit of a popularity contest. There are some online sites, like Angie’s List, that are forums for patients to post their review of their doctor. While this can provide good insight into their practice style, it’s usually more of a place where people air their grievances. Think of getting on Yelp to look for dinner- 3.5 out of 5 stars is pretty good, as most people don’t get on the internet to rave about tacos. Fewer people than that write online about how great their doctors are. Some sites like TopDocs allow for doctors to buy their way in, meaning it has nothing to do with their actual clinical practice.

There’s a lot of information about physicians on the internet, some less important than others. Where they went to school is probably not that important- medical school is still medical school. It’s hard to qualify intelligence, and where somebody got into medical school doesn’t always correlate with how good of a clinician they end up being.

Now you finally get to call

Next step- call the office. But wait, there are some steps before making an appointment. Ask if there’s an online messaging system, like MyChart. This can be an easy way to reach your provider without waiting for an appointment. What are their hours? Are there any opportunities for early or late appointments? This can be convenient if you work. Do they offer same-day appointments if you get sick? Double check that they take your insurance.

After you’ve had all of those questions answered, see how long it takes to get in for an appointment. If it’s going to be 4 months before you can even meet them, you may want to look at other offices as well.

The big day

It’s finally here- your appointment. When you meet your physician, they’re going to have plenty of questions about you. But ask them some about themselves- do they tend to rely on research or experience when they make decisions? Any medications they won’t prescribe, like birth control? What is their policy on drug reps? Also, if you have several health questions write them down so you’ll stay on track and not forget to talk about during the appointment.

Let’s say you found everything you could ever want in a doctor- they take your insurance, they specialize in a disease you have, their office policies are super convenient… but you leave your appointment feeling unsatisfied. That’s okay! Unless they said or did something that was a red flag for you, try and go to that second appointment to see if it gets better- we all have our off days, maybe you caught them on one of theirs. But don’t stay if you don’t feel a good connection with them. There is something non-quantifiable about a great patient-doctor relationship that you’ll only develop through mutual trust.

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Is your doctor running late to your appointment? I once had an appointment that they were running three hours late for… I mean, I wouldn’t be late to a first date or an interview, so why should they be late?? This is where I ask that you be a little forgiving. Appointments are usually every 20-30 minutes; that includes the time to be put in a room, take vitals, talk to the nurse, talk to the doctor, get orders, and leave. Most of the time, if the office is running late, it’s because a patient was late or had more to talk about than usual, and it’s really hard to catch up without shorting a patient a comprehensive visit. If timing is a really big issue for you, I recommend an early morning appointment or right after lunch (around 1 pm). If your provider is habitually over an hour behind, that is something to consider, but please excuse a one-time infraction.

It takes two to tango

A good doctor always hears your concerns; a good doctor doesn’t always agree with you. You don’t need a yes man- you need someone who combines your clinical picture, priorities, and their medical knowledge to create the best advice. While many of us (myself included) go in with a specific idea of what we expect to happen, have an open mind.

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Your viral cold doesn’t need antibiotics, your sprained ankle doesn’t need a MRI, your stomach pain isn’t best treated by opioids. And a good doctor will tell you that. But they also shouldn’t dismiss your concerns in a way that you feel disregarded or unheard. If they say no, feel free to ask “Why?” Respect their expertise, and if they respect your experience and concerns, you’ll have a great relationship.

Now go out there, and find yourself Dr. Perfect!

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