May 31, 2013

Finding the Best Doctor-Patient Fit

This is a topic I have been avoiding and I thought I would not do this. However, with the activities of the last few weeks, I decided I should restudy this blog and see what I could determine for myself. Nancy Finn does make some good points. In talking this over with some of our group members, I have made my own discovery. When talking about doctor-patient fit, this is so individual that some ideas can only be generalized.

Because I live in a fairly rural area, many doctors are over 30 miles one-way to see them. And presently, most of mine are at that distance. This is also a determining factor not covered by most writers. I am patiently waiting to discover one that will use telemedicine, but I doubt I will see this in my lifetime. Too many obstacles standing in the way. This will be limited by the state medical board, other local doctors, and the medical insurance providers. I am not the only one that could benefit, as several in our group would consider this. Many people could benefit if the doctors could provide a list of reliable internet sources, especially in the more rural areas of this country.

If you live in a more doctor dense area or a larger city, then what Nancy Finn has to say may be of great assistance. I will list her points (in bold) and give my comments.

#1. What is the doctor’s specialty and does that match your health issues? We are fortunate that the two cities, about 30 miles distant, do have a large variety of specialists. Some are excellent and others are just specialists. We also have an advantage of being about two and one half hours drive from the Mayo Clinic in Rochester, MN. I have not needed to use their services
#2. What is the doctor’s background i.e., what medical school did he/she attend and where did he/she train after medical school? This is interesting as this is something we look at, but for the most part, we have little choice.

#3. Has this physician passed the required medical boards (that information, as well as information on whether the doctor has ever faced any sort of disciplinary action can be found by contacting your state medical board. Again, this is interesting, but not easy to accomplish, as our state medical board is very secretive and hesitant to disclose information like this. We normally know something is wrong when a doctor just disappears and very little has been said about it. It is easier to discover information in local court proceedings.

#4. Does this doctor accept your medical insurance? (Check with your insurer and they should be able to provide you with a list.) In our state, currently the medical insurance company provides us with a list of doctors that have accepted the terms of the company. Also, most doctors post a list of insurance companies they will not accept. For us this is a good thing. On one occasion, I did ask the insurance company who would be a provider and I was told none, but if I went out of state, there were three available.

#5. Is the doctor conveniently located near your home or work? Does he/she have evening or weekend hours? This is not applicable here and a very few have evening or weekend hours. Most work Monday through Friday with a half day off during the week.

#6. How long has this doctor been practicing this medical specialty? Has he/she published any papers? Is he/she involved with any medical organizations? Again, this is interesting, but seldom practical in this area.

#7. Is the doctor in a solo or group practice? Again, you take what is available.

I dislike saying that in many circumstances that you need to take what is available, but this is often the case and if you do not establish a good doctor-patient relationship, you may be required to travel even farther. Therefore, the patient is generally the one that needs to work the hardest to make the doctor-patient relationship work. I will give the majority of doctors credit because they work at the relationship. A few are known for operating on autopilot and some do use the cookbook style of medicine.

Nancy Finn does list many sources that can help find a good doctor if you are in a doctor dense area and not in a largely rural area. So check out her blog for these sources.

In selecting someone with whom you want to have a long-term relationship, it is permissible to request an introductory phone call. A doctor that refuses to do this might not be the right person for you. Some of the personal questions you need answered before making your choice may include:

#1. Are you choosing a primary care physician or a specialist? The criteria are different, but in our area, you take what is available.

#2. Do gender, language, racial differences matter to you? Seldom do you have a choice. I have some of each gender and really feel better with a woman doctor when available for most things.

#3. Will the doctor communicate with you between office visits and about treatment options and choices? Some will, but with most, it will depend on whether they can send you to an emergency room.

#4. What hospital is the doctor affiliated with and is it a place where you would be comfortable if you had to go there? Many are employed by the hospital in the two larger cities. With many local county hospitals eking out an existence and depending on Medicare handouts, it normally is wise to head for the larger hospitals about 30 miles distant. In many cases where using an ambulance is necessary, they are required to take you to the nearest local hospital if Medicare is involved to make sure you are stable enough to be transported to a larger hospital. In some instances, I have known people that have a spouse or relative drive them to the larger hospital to bypass many of the local hospitals.

Many of the decisions can be yours in a doctor dense area, but in many rural areas, you will not have a large choice unless you are able to travel many miles round trip.

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