Check Out Your Doctor, Don’t Be Afraid to Ask Questions

You can’t rely on “bedside manner” alone! Before choosing doctors, give their credentials and record a thorough checkup.

Few decisions are more critical than choosing the physicians who hold your health, sometimes even your life, in their hands. This is a very personal choice, one that warrants research and careful thought. But if you are new in town, or unexpectedly in need of immediate care, it may be tempting to open the Yellow Pages, shut your eyes, and point to a listing for a nearby medical practice. Or, you may be swayed by a doctor’s social standing or reputation for charisma.

Both hard news and popular myths have contributed to negative public perception about doctors. A 2010 Gallup poll shows that, in terms of honesty and ethics, Americans rank nurses, military officers, pharmacists and teachers above medical doctors. Why would nearly a third of the population distrust doctors? For one thing, healthcare is a controversial issue politically and many people have become cynical about the medical community. A more likely reason, however, is that, despite the technological advancements of the information age, it is still harder to check out a doctor than, say, a hairdresser or a used car!

There are ways for assuring that the guardians of your health have the education, experience, and track record to serve you well. The following are guidelines for finding a competent doctor who suits your unique medical needs. And the best time to begin your search is now, before you need one.

Before you embark upon this “treasure hunt,” you should check your health insurance plan:

• If you have a managed care plan, this may limit your choice of doctors. A health maintenance organization (HMO) has a network of providers from which you must select a primary care physician (PCP). If you need a specialist, you must get a referral from your primary care physician. A preferred provider organization (PPO) contracts with a network of physicians from which you may choose in order to get the highest policy benefit. You may use doctors outside the PPO network, but it will cost you more out of your own pocket. If you need a specialist, you do not need a referral.
• If you are on Medicare and have a Medicare Advantage plan or supplemental insurance, your policy may require that you consult physicians from a network directory in order to get full payment for your care. In addition, some physicians have opted out of Medicare and will not accept Medicare patients.
• In considering any medical practice, you should verify that your insurance coverage will be accepted by confirming with your insurer and with the doctor’s billing office.
• Make sure you understand whether a doctor’s office will bill your insurance company directly, or if you have to pay up-front and file insurance claims yourself. You also may want to check whether billing is processed by the practice itself, or is out-sourced to a medical billing company that could tangle you in endless red tape if there is a problem.

Consumer Reports surveys indicate that the most successful patient experiences are with doctors recommended by the patient’s family members, friends or co-workers. Referral by a physician in a different specialty, or even outside the area, is another good way to get started . . . but it is just a start, the beginning of your detective work.

Once you have a short list of possible doctors, whether from your insurance plan directory or trusted recommendations, you should assess your basic needs so you can match them with the qualities and services of doctors you are considering.

If you are searching for a primary care physician, do you want someone who will care for the entire family or just some family members? A primary care physician will handle your routine medical needs, such as regular checkups and routine ailments such as colds or the flu. This doctor could be a family practitioner who will care for everyone, regardless of age; an internist, who specializes in internal medicine; a pediatrician who handles the medical concerns of your children; or a gerontologist trained to handle the needs of older adults.

Make a list of the current medical problems you and family members have as a guide to seeking specialists you may need. Generally, it is advisable to ask your primary care provider to refer you to appropriate specialists – and sometimes your insurance requires a referral. One advantage of a referral is that, if you like and trust your primary care physician, you will have confidence in his or her recommendation. If you choose to find a specialist on your own, you will want to follow the same investigative process you would use for choosing any kind of physician.