Posted by: notdeaddinosaur | August 20, 2015

Finding Doctor Right

Proudly Co-Authored with the NinjaBaker, Cross-posted at his group blog, Science ACEs

FINDING DR. RIGHT

Finding the right primary care physician for you and your family is a lot like dating. You can swipe right at the first doctor who takes your insurance, then find out he’s a complete jerk when you meet him. Maybe you’ve looked at his medical profile in great detail, then you go for your first check-up and just don’t feel that spark. That’s fine. It’s okay to be picky, and to keep looking for the right person who will take you as their patient, to have and to hold, for better or worse, in sickness and in health, as long as you both shall live. Well, you, at any rate.

We’re here to help you with several “dating” tips on finding Dr. Right.

Find someone you can trust

Why do you go to the doctor at all? Same reason you hire a plumber or a mechanic: because they have special training and knowledge about something you don’t.If a doctor tells you things you either know are wrong or that don’t make sense (and that they can’t explain to your satisfaction), steer clear.

Don’t be afraid to put yourself out there

Just because you have a bad experience with one doctor doesn’t mean you’re destined to never have a rewarding relationship. Be careful about insisting on the “best” doctor, endlessly perusing “Best Of” lists in magazines (which are generally compiled by asking other doctors who they like best, not patients.) The best doctor for you may not be best for your BFF, your neighbor, or even your spouse. You may like the idea of a doctor who’s willing to spend time discussing every detail of your condition at length, while someone else wants “just the facts,” enough information to make a decision, but no dilly-dallying with endless small talk.

Google them first

Looking up your doctor online can be a great way to get information. Are they board certified? Where did they go to medical school? Where is the office? What are their hours and what insurances do they accept? Be careful about reading patient reviews, though. As with all online reviews, remember that they are generally submitted by people who are very pleased or very displeased.

Communication is key

As in every good relationship, appropriate communication is important. A good doctor should be able to explain everything at your level of understanding without being patronizing. A pediatrician will tell you that “boo-boo” is perfectly acceptable medical jargon, whereas a neurosurgeon should be able to explain brain surgery to you in a way that isn’t rocket science.

R-E-S-P-E-C-T (find out what it means to me)

Doctors’ schedules can get busy, but if they show up an hour late to your appointment without any apology or explanation, they are not respecting you or your time. While no office can run smoothly 100% of the time, a small gesture like an apology can show the difference between a doctor who respects you and one who is trying to crank out as many appointments in the day as possible. Be patient and respectful of the doctor’s time as well (i.e. don’t show up late yourself, call if you need to cancel, etc.). Respect from both sides will help build a meaningful relationship.

Get along with their friends

It’s important that your “friend with health benefits” has friends who are a good influence on them. Your Primary Care Physician will often refer you to specialists in certain situations. It’s important that these specialists fit you as well. Just because they are a friend of a friend doesn’t mean they need to be your friend. Some doctors are paid by drug companies to prescribe their drugs. You don’t want a doctor who has anything to do with people like that.

Be (a) patient

This whole process is so exasperating! Why do you need a doctor at all? Just use one of the gazillions of symptom checkers online and make your own diagnosis. If only. The problem with the Internet is that there’s too much information. Whatever you plug in, some online resource is going to say that it’s cancer or AIDS. It’s the doctor’s job to know which of that information does NOT apply to you. It’s not as easy as it looks. So hang in there and keep plugging away until you find the perfect doctor for you.

Know when it’s not working

You’ve done everything right: google references were stellar, hanging with all the right specialists, and the office is wonderful about communication. But after a few visits, you’re just not happy. You may not be able to put your finger on it. Was that remark he made meant to be funny when it sounded condescending to you? Was she just a little too brusque? Doesn’t matter. You’re the one who needs to be satisfied, and you’re the one who gets to decide what that means. Like any other relationship, if it’s not working for you then it’s not working. Breaking up doesn’t have to be hard either. When you find a new doctor, send the old one a request to transfer your records. Don’t worry about the request being taken personally. Doctors are professionals and patients transfer in and out all the time, for all kinds of reasons. Your doctor wants you to be happy, and if another doctor is better able to do that, then that’s what they want for you. (More on that here.)

If they try to touch your genitals the first time you meet, run.

Actually, this one doesn’t always apply to doctors, especially urologists and gynecologists. Just make sure they wear protection, but do tell them if you have a latex allergy.

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Responses

  1. This is all great advice, but the process could drag on for years. My insurance allows me one physical a year, and the cost is high enough that I can’t afford to pay out-of-pocket again and again until I find someone who’s just the right fit. I’m kind of stuck with Doctor Wrong for 12 months, during which time I can Google and talk to my friends and then, sigh, try again. Meanwhile, I hope I don’t develop any serious medical crises during that 12-month period because if I do, I’ll be receiving treatment from someone I don’t completely trust. From the patient’s point of view, I suspect that finding a new primary is more difficult than you as a doctor realize.

  2. Finding a primary care doctor is incredibly easy providing you’re not sick. I’m medically considered a “zebra” with all of the diseases I have and frankly, my primary care doctor is a quack. I’m a square peg that doesn’t fit in a round hole, so he has misdiagnosed me every.single.time. because of it. As for finding another one, well I’d be in the same boat. I don’t do well with primary care doctors; I never have, however specialists love me because of what they always tell me, “Oh, I’ve read about this but never seen it on anyone!” If I had a quarter for every doctor that told me that, I’d be retired.

  3. Miss Chevious,
    I too am considered a medical zebra. What the #1 Dinosaur said about becoming friends with your primary care doctors friends can also work in reverse! If you have a specialist you trust who treats you for your zebra diagnoses, talk to him/her about who they would recommend a patient with your condition see for primary care services. I think your best bet is to look for someone trained in Internal Medicine, as they work with a lot more of the complex conditions in adults and geriatrics that are more likely to require hospitalization.
    If you are frequently hospitalized, you could ask the nurses or the social worker what doctors they work with and have good relations with that might be likely to treat someone with your condition. You want to find someone who is available when you need them, and if something happens at night/on the weekend will be able to answer your call promptly, or have another physician on-call who can help you instead. This is EXACTLY how I found my current Internal Medicine doctor.
    I go to a hospital about an hour away from my house that has a clinic for my genetic disorder. When I was in the hospital one time I was having a slight problem with my attending physician who had been assigned to me at admission. I was speaking to the social worker one day and she mentioned another doctor that I could request in the future if I was unsatisfied with my current doctor to the point I wanted to switch. I was eventually transferred to a lower level of care, and my assigned doctor didn’t visit that facility, so I was treated by the doctor she had mentioned instead. I ended up liking him A LOT better. His bedside manner was more to my liking. He took more time to listen to my complaints and concerns, and explained things better than the other doctor did. Having a medical background myself, he was willing to listen to my suggestions and either say that it was a good idea, or not likely to work in my case because of XYZ.
    When I discharged, I decided I liked his care so much that I pulled the string and switched over to his care full time (my then Internist was in another county and did not have admitting privileges at the hospital of my choice, so when I needed to be hospitalized I was assigned a doctor from that hospital). I go to his office for both well visits and for care of illness and referrals when necessary. If I have a problem after hours or on weekends, I am not relegated to going to the ER for care. Their office phone directs you on how to contact the on-call provider (some offices use a call service who will page the MD, others direct you right to the on-call voicemail and the provider will return your call). My doctor usually calls back within about 30 min, and will help direct you over the phone if possible. He will sometimes phone in a Rx, and of course, if it can’t wait until office hours will direct you to urgent care or the ER.

    I guess this got longer than expected, but my point was that there ARE good primary care providers who can treat zebras. Ask around and see who your trusted specialists would send you to.
    Last, if the specialists you are seeing are being taught about your disorder by you, you need to seek out a specialist with more experience treating your condition. Look online for discussion boards on your condition, or a non profit dedicated to your condition, and see who they all see in your area, or who they recommend near you.

    Good luck!

  4. Hi AVE,

    I’m so glad you found a good primary care doctor. As for me, my primary care doctor is both an internist and an idiot. I have spent the past 6 years in and out (mostly in) of the hospital, and did he pick up on my rare disease? Nope. My pulmolologist found it. My internist does literally NOTHING for me. He doesn’t admit patients to the hospital (he makes the hospitalists do that), he has never coordinated care between my specialists (and they are many), he doesn’t take call at night (you get someone who tells you to “go to the emergency room”), and like I said earlier, has never diagnosed me correctly ONCE. As for asking other medical professionals for a good recommendation? More often than not, I hear MY internist’s name. “He’s a really fantastic doctor!” If I’ve heard that once, I’ve heard it a thousand times. Sure, if I had a normal medical history and never needed a specialist or hospitalization, yeah, he’d be GREAT. My rheumatologist knows my internist, and he probably summed it up best: “Yeah, he’s not such a great doctor, but he’s nice, and sometimes you want a nice doctor rather than a smart one.”

  5. Cathy: Many doctors (including me) are willing to sit down with you for a “get acquainted” visit, specifically for you to figure out if you might “click” (or if you definitely won’t.) Sort of the equivalent of “Just coffee.” A caveat though: This is NOT an opportunity for you to go into your entire medical history and ask for an opinion. It’s fine to say, “My history is pretty complicated. How comfortable do you feel managing such-and-such a zebra diagnosis?” but it’s not the same as a physical.

  6. Thank you, Dr. Hornstein. I’ll try this approach and see what happens.

  7. picked a new doc almost a year ago for hubby and I. Episodic care (bronchitis, ear infection) was good. 4 specialist referrals – 2 good ones, and 2 that seemed to be going through the motions – nothing wrong but not any sense of connection, either.
    I had my ‘annual physical’ last week – he never touched my skin. Looked at feet, auscultated chest and palpated/percussed along my back. My feet were bare only because I left my shoes off after being weighed.
    One of my 2 concerns was a sore hip – he did lift my leg and manipulate it through the range of motion, while I was wearing slacks.
    I stuck out my hand to shake his at the end…he hesitated, then briefly took my fingers.
    I don’t have a need to display my skin or be touched by relative strangers. We’d already determined that pelvic/pap were not necessary.
    But this seems weird.
    Is is a quirk? Is this how ‘modern’ medicine works? (I got a 7 page Epic system handout of all the relevant health guidance for my age group/gender. No discussion of what parts are most important in my case, etc.) Is this “California” care vs. New England?
    Hate the idea of starting over, but……

  8. Clairsmum: Sounds like you inadvertently found someone who’s either a closet germaphobe, or perhaps on the spectrum. Definitely sounds more like an individual quirk than anything “modern”, “California” or any other state. You don’t have to “start over”, but unlike in the dating realm, it’s okay to keep seeing other people. Keep an ear out for someone new, and consider a get-acquainted visit to see if there’s a better “click”.


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