Doctor Who Featured

10:04am EDT July 22, 2002
The new managed-care plan is in place, and the time has come to pick a new doctor. While perusing through the hundreds of names in the health plan directory, a question comes to mind: How do you pick the right doctor?

Geographical location is an obvious starting point. You don't want to drive to the other side of the city for a routine appointment, so the list narrows, but many names remain. What should the determining factors be?

Hospital affiliation may be important if you have a preference for a particular health facility. A high level of prestige within the community is important to some, while others, for example, may prefer a female doctor.


Choice guidelines

If you're a member of a health plan, you can be assured it has some sort of credentialing requirements for its physicians. This may include board certification or a verification of license and specialty training.

Most health plans require the use of a primary-care physician. This person handles all routine care, and any trips to a specialist usually have to be on referral from the primary-care physician. In most directories, primary-care doctors are usually designated as "general practice," "family practice" or "internal medicine." General and family practice physicians usually see everyone, while internal medicine doctors tend to focus on adults. In some plans, pediatricians and even obstetricians may also serve as primary-care physicians. The individual may make the selection.

"Probably one of the most important criteria to consider is the physician's ability to communicate and develop a relationship," says Dr. Michael Kobernick, the medical director for Southfield, Mich.-based Great Lakes Health Systems. "When you are ill, you want someone you can relate to and trust. The only real way to assess that is to interview the doctor."

Once you find a doctor who is close to home or affiliated with your choice of hospitals, call the office and set up a meeting with the physician.

"If the office says the doctor doesn't do that, and can't give you 10 minutes of their time to introduce themselves, that gives you a message right there," Kobernick notes.

Once you get an interview time, you need to consider what to ask.

"You have to have some assessment, but the underlying tone of the questioning is 'how do they relate?' Are they friendly and open? Ask them some specific questions about their philosophy of sharing information and explaining an illness to a patient."

You can often gauge whether the physician's personality is what you are looking for by the answers. A free-flowing conversation often indicates an amiable and approachable doctor. But one might say, "I tell my patients everything," without saying anything more. That might not be the right doctor if detailed information and counseling are important to you.

Kobernick recommends asking these questions:

  • Find out the procedures for after-hours calls. Is there an answering machine that tells the patient where to go for help, or is there an answering service that pages the doctor? If a doctor returns calls after hours, how long does it typically take to call back?

  • How hard is it to get an appointment? If you are sick, can you get in the same day, or is there a three-week wait? Routine appointments should be scheduled within two weeks. Another consideration is whether the physician is a sole practitioner or has affiliates in the same office. While it might be easier to get an appointment with someone in a group rather than an individual, you may also be sacrificing a good relationship with one doctor. "The question is, how important is it to you to see the same doctor and to get to know them?" says Kobernick.

  • How do you view preventative care? What are their views on mammograms and other tests? "Ask them if they do anything if you forget your annual checkup," says Kobernick. "One of the things we need to do better as physicians is to be more proactive for the need for certain care. Veterinarians have done this very well. If your dog is due for shots, you get cards and phone calls reminding you.

"Relationships should be what medicine is all about. Physicians have let down the patient by not valuing that relationship."

While managed care has driven such business-first attitudes, there are still many doctors who can meet your needs, even if you prefer a traditional relationship. Just look at your own expectations and be willing to spend the time to find a doctor who will meet them to ensure a healthy relationship and life.