Choosing and Working with a Physician

Regular exercise and healthy eating are fundamental to good health - so is choosing the right physician. If you don’t have a physician, don’t wait until a serious health problem prompts you to select one.

Finding a Doctor

The type of doctor you need to see generally depends on your current health and medical history. Doctor’s services fall into two categories - primary care or specialty care.

Primary Care. Primary care physicians usually provide preventive care and care for many illnesses and conditions. A primary care doctor is trained to treat a wide variety of diseases and conditions. He or she will also know when to refer you to a specialist for more specific care. Generally, a primary care doctor is in one of the following categories: family practice, pediatrics, general practice, or general internal medicine (internist). Some primary care doctors also specialize in a particular area of medicine. For example, an internist may have a sub-specialty in cardiology.

If you build and maintain a relationship with a primary care doctor, he or she can coordinate all aspects of your health care. When you have a health problem, your doctor can expedite your care, and help to keep expenses down by making an assessment of your condition, ruling out certain ailments, and determining if specialist care is needed. Your primary care physician can also help you choose a specialist, and coordinate treatment with the specialist you choose. Examples of services primary care physicians usually provide include:

• Routine checkups and physical examinations
• Well-baby care
• Inoculations and immunizations
• Periodic lab tests (e.g., cholesterol checks)
• Diagnosis and treatment of a range of illnesses and diseases

Specialty Care. Most often, a specialist is a physician who has completed four years of medical school, followed by additional training in a specialty field. After completing the required additional training, the doctor is eligible to take a specialty examination and become board-certified by the American Board of Medical Specialties. Board eligible doctors have successfully completed the required training and are eligible to take the exams, but have not done so.

The American Board of Medical Specialties defines the following areas as primary specialties:

• Allergy and Immunology
• Anesthesiology
• Otolaryngology
• Pathology
• Colon/Rectal Surgery
• Dermatology
• Physical Medicine and Rehabilitation
• Plastic Surgery
• Emergency Medicine
• Preventive Medicine
• Neurological Surgery
• Psychiatry and Neurology
• Nuclear Medicine
• Radiology
• Obstetrics/Gynecology
• Thoracic Surgery
• Ophthalmology
• Urology
• Orthopedic Surgery

Narrowing Your Choices

Once you’ve determined the type of doctor that’s right for you, check to see if your choice is restricted in any way by your health plan. Then ask friends, relatives, and coworkers for personal recommendations. Ask them about the doctors they see, and find out if they are satisfied with the quality of care they receive.

Once you’ve narrowed your list to two or three physicians, check the background/credentials of these doctors. Following are some ways to obtain background/credential information:

• You can find out where a doctor has completed a residency in the Directory of Medical Specialists, available at most libraries.
• You can find out if a doctor has been disciplined by contacting your state medical board. For the number of your state medical board, call the Federation of State Medical Boards of the United States at 817-868-4000, or visit their Web site at www.fsmb.org. and select “Public Services.”
• You can verify specialties for which a doctor has been board certified by contacting The American Board of Medical Specialties. Call 866-275-2267 or access the information on their website, www.abms.org.

If you’re satisfied with the doctors’ credentials, call their offices to ask some preliminary questions.

• Does the doctor have any practice limitations? For example, a pediatrician may accept only adolescents or infants.
• Is the doctor accepting new patients?
• Are the office hours convenient for your schedule?
• How far ahead does the doctor schedule appointments?
• Does the doctor accept payment from your insurance plan or Medicare?

Personal Evaluation

To help you finalize your decision, call the office manager and set up a short, get-acquainted visit with the doctor(s), sometimes available at no charge. Your time with the doctor will most likely be limited, so have family medical information and questions prepared in advance. Following are some areas you may want to explore during the consultation.

• Ask what hospital(s) the doctor is affiliated with. Are they local hospitals, and do they have a good reputation? Remember, in choosing a doctor, you are also choosing a hospital for your treatment needs.
• If you have a chronic medical condition, or a family history of a particular illness, does the doctor have expertise in this area?
• Ask about the doctor’s philosophy on referrals. A reluctance to refer may be undesirable. A well-trained primary care physician should know when to refer, and be willing to work closely with a specialist.
• How can you get in touch with the doctor in case of an emergency?
• During normal office hours, under what circumstances will your calls be put through to the doctor? And during what hours and under what circumstances can you speak directly with the doctor?
• When the doctor is out of town, who fills in, and where is that doctor’s office located? While doctors generally have regular office hours, they usually arrange for coverage seven days a week, 24 hours a day.
• Ask the receptionist how office visits are booked. Are multiple people booked in the same time slot?
• What is the average time spent in the waiting room?
• How does the office handle requests for prescription refills? Will the doctor or nurse call the pharmacy?

While you’re there, observe the office. Does the office seem clean, orderly and well managed? Is the staff friendly, knowledgeable, and professional in manner and dress? These issues may seem trivial, but they can be an indication of how the practice is run. Sometime during your visit, speak with the office manager to gather some additional information.

Once you’ve made your selection and scheduled your first visit, be sure to provide the appropriate office staff with your health insurance plan information and ID card.

Benefits of Continuity

Many people, particularly the elderly and those with chronic medical conditions, find it advantageous and comforting to continue seeing the same doctor. By remaining a “loyal” patient, you help your doctor develop a comprehensive picture of your physical condition. Over time, you will most likely establish an amiable rapport that can make visits a more pleasant experience.

Although there is a lot to be said for continuity of care, at some point you may feel uncomfortable or dissatisfied with the quality of health care you are receiving. Or your health may change and warrant treatment from a different doctor. In either case, speak with your doctor about the situation and do not hesitate to seek the services of another doctor. If you’ve made a decision to change doctors, ask your previous doctor - in writing - to send a copy of your medical records to your new doctor. Find a new doctor as soon as you decide to make a change - don’t wait for your next appointment or an emergency.