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How do you choose a physician?

Having the type of practice that we do, often representing patients who wish to sue physicians and at the same time representing physicians for a wide variety of situations a question that is often asked is as above: How do you choose a physician?

The glib answer is a smartly, wisely and as poorly as do you. However, there are some elements that go into the thought process.

IF IT IS AN EMERGENCY

The primary decision is to get care and the closest physician/facility that can provide that care should be utilized. If you in a rural area there are no options but what exists. If you are on a cruise ship then the first step is the physician on board. There are no choices and no options. Once at the facility and the problem defined then, after the patient is stabilized choices can be considered as to the next step. For example: If the problem is a stroke and stroke medications can only be given within 4 hours then treatment has to be instituted where you are. If there is a fracture then transport to another facility may be an option.

Become an educated consumer. There will always be five minutes to go on the web and visit a site such as the Mayo Clinic and see what they say about the recommendations.

Listen to the recommendations of the treating physicians. Just because you are in a rural area or on a cruise ship does not mean that you are not getting excellent advice and information. Physicians doing this work often do it for life style reasons and that is not a reflection on their capabilities.

IF IT IS NOT AN EMERGENCY

Selecting your Primary Care Physician; This is usually done as you move into an area and get recommendations from friends and neighbors. However, finding out about the physician is always advisable.

A.) Go onto the Web site for your state and find out about the physician's credentials, whether or not he has ever been disciplined or had any malpractice suits filed against the physician. If any suit exists, I would ask the physician about it on the first visit and evaluate the response.

B.) Get a sense of the individual. Does the physician listen to you? Does the physician hear what you have to say and give it due consideration? Is the physician willing to spend the time that you feel is needed to answer your concerns and evaluate your problems? Many medical practices are now run on a volume basis leaving the individual physician little time to spend with the individual patient. Do not allow your physician to get away with this if you feel your questions are relevant and important and should be answered.

C.) Does the physician and his practice accept your insurance? There are times when this is acceptable and times when it is not. You should expect your primary care physician to accept your insurance. You will be making most of your visits to this physician and if insurance is not accepted, visits could become very expensive and you might decide not to visit because of the cost, which is not a good idea.

D.) When diagnoses are made and recommendations given go on the web and review the materials to be found. Physicians are sometimes not able to keep up with everything and good input can be appreciated. One patient was put on a drug which many of her friends were taking for hormonal replacement. She was having a problem with the drug and went on-line and got in touch with the manufacturer. She learned that the drug prescribed had a color coating and she was having with the color and dye. Her physician was unaware that the drug had that problem and that the same drug could be obtained without the color coating. Problem resolved.

SELECTING A SPECIALIST FOR A PARTICULAR PURPOSE

RADIOLOGISTS

Other than laboratory tests radiological examinations are probably the most frequently ordered. With all tests ordered by your Primary Care Physician, make sure that you get the test promptly and make sure that the PCP gets the results, reads the results and discusses them with you. Do not allow them to slip through the cracks. (If the personal assistant calls and tells you the results are fine, that is acceptable).

Radiology is another issue. This is a very blind item. All radiology equipment is to be certified by the American College of Radiology. Radiologists have sub specialties and while a radiologist is qualified to read every study, studies of the spine and brain are best read by sub-speciality trained radiologists. Here going to a regional center for a special studies may be most advantageous.

SURGICAL SPECIALISTS

Go on line and check their credentials. If the surgeon only wants to do the procedure in a surgicenter and has no hospital affiliations I consider this as a red flag. Why not? Did the physician have hospital affiliations and they were given up and if so why?

If the surgeon does not accept insurance, hesitate. Everyone wants to make more money and insurance reimbursement is considered low by many. However, the bills charged can be excessive and individuals with the same abilities can be found, who will accept insurance. There are exceptions to this but we are seeing a tendency to unnecessary surgery and excessive surgery, where there is no insurance accepted; especially when there is no oversight in a surgery center.

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