by Alan Greene, MD, FAAP
There was a time when the first question one would ask when looking for a doctor was, "Who is the doctor in the nearest town?" For most people who have the ability to access this Web Site, that is no longer the case. Now, unfortunately, the first question most people ask is, "Does the best doctor in town accept my insurance?" If he or she does, you are in luck. After I discuss how to determine who the "best doctor in town" for you is, I'll give you some hints on how to become his or her patient, even if that doctor doesn't take your insurance.
One of the best ways to identify great doctors is to ask nurses in that field whom they would recommend. Nurses see both the professional and the human sides of doctors. They see firsthand how physicians handle medical crises, and how they interact with people. If I were moving to a town where I didn't know which pediatricians were great, I would call or drop by a labor and delivery unit, a newborn nursery, or a pediatric ward at a local hospital and ask several nurses for their opinions.
When considering a doctor, you want to think about four things:
- Is he or she a well-trained physician who stays current with medical trends?
- Does she or he practice medicine in a way that agrees with your philosophy of healthcare?
- Does the Practice he or she is affiliated with fit your practical needs?
- Will you feel comfortable asking this doctor any health-related questions that might arise?
Determining a physician's qualifications is fairly simple and a great place to start. If a doctor does not meet your standards, you can easily eliminate him or her as a candidate and move on. Here are some questions you can ask that will help you determine her or his qualifications:
- Where did he or she complete undergraduate school?
- Did she or he receive honors?
- What medical school did he or she attend?
- Where did she or he complete Residency?
- Did he or she serve as a Chief Resident? (If so, he or she was the top of the class and judged to be good with people.)
- Is she or he Board Certified? (All physicians are licensed, but not all are certified.)
- What is he or she doing to continue training? (The AMA gives a "Physician's Recognition Award" to those in practice who actively pursue continuing education.)
While many excellent doctors didn't complete their educations at top-ranked schools, finding out their stories is worthwhile. You may want to ask each one why he or she chose a particular medical school and a particular field of medicine. Probe about the methods used to stay current with rapidly expanding medical knowledge. How she or he handles these questions will give you a lot of information.
The second major factor in determining the right physician for you is much more subjective. It requires you to determine the kind of physician you are looking for. Do you want a doctor who works with you to determine the best course for your healthcare, or are you more comfortable with a physician who simply tells you what to do? Do you prefer a minimalist approach to medicine, or do you want medical intervention whenever it may be appropriate? Are you excited about alternative medicine, or are you more comfortable with traditional Western medical practices?
After you have answered these questions for yourself, you will be able to tailor the following questions to draw out the information you are looking for:
- Does he or she provide patient education?
- Does she or he give you treatment options?
- What is his or her approach to the use of antibiotics? Does she or he prescribe antibiotics for the common cold?
- Is he or she open to discussing alternative treatments, such as diet?
The practical aspects of a practice may not be important in determining if you want to select a physician, but they are very important in determining if she or he will be able to serve the needs of your family:
- Is his or her office within a reasonable distance from your home?
- What hours is the practice open? Any Saturdays or evenings?
- How long in advance do you need to schedule a physical? (This is tricky -- if you have to schedule too far in advance, you are likely to become frustrated. On the other hand, if there is no waiting, you might want to ask why (perhaps the practice has just added an additional doctor, for instance.)
- Does the practice take same-day appointment for sick patients? Do they accept drop-ins for sick patients? If so, how long is the average wait?
- Does she or he accept phone calls during office hours? (This often saves you a trip to the office.)
- How many doctors share after-hours on-call duties? If you have an after-hours need, will you be able to talk to one of the doctors in the same practice? A doctor from another practice? A nurse? An answering machine?
- How do they handle "after-hours," non-emergency needs? Are they associated with an after-hours clinic, or do they meet you in the emergency room? Or do they tell you to take two aspirins and call in the morning?
- How do they handle billing? Do they require payment at the time of the visit, or do they bill your insurance company first and then bill you after receiving payment from your insurance? (This is not important if you have an HMO.)
Finally, and in many ways most importantly, notice the quality of your interaction with the physician. This can be more significant than the specific information imparted. You need to feel comfortable with this person, confident that she or he is genuinely interested, and encouraged that communication will flow smoothly in both directions.
After looking at this exhaustive list of questions, it is obvious that no doctor will score 100%, so prioritize your concerns and select the best candidate.
If you decide that you have found the physician who is the best fit for your family, but you look him or her up in your insurance company's handbook only to find that he or she is not listed, don't give up! Call the doctor's office and ask to speak to the person who is in charge of insurance billing. Ask him or her if the doctor you want is now accepting patients with your insurance. If the doctor is not, ask if there is any creative solution to your problem. If they can not help you in any way, ask for a list of insurances that they do accept. If you are paying directly for your insurance, you may want to consider changing companies. If you are getting insurance through your employer, take the list to your employer and find out if they currently offer any of these options. If you are looking for a pediatrician for a new baby, in many cases you will have 30 days from the baby's date of birth to make changes in your benefits. During that time you might be able to change to an insurance that the doctor you want to see accepts. If you are not looking for a pediatrician for a newborn, you may have to wait until open enrollment at your place of employment to make a switch.
Now that we have options, selecting a physician for our children or ourselves is not an easy undertaking, but the reward for our efforts can be a more meaningful physician-patient relationship has ever been possible before.
Dr. Alan Greene, author of Raising Baby Green and Feeding Baby Greene, is the founder of Dr.Greene.com and the WhiteOut Movement. He is a frequent guest on such shows as Good Morning America, The Today Show, and the Dr. Oz Show. He is on the Board of Directors of Healthy Child Healthy World and The Lunchbox Project. Dr. Greene is a practicing pediatrician at Stanford University's Packard Children's Hospital.
Copyright © Greene Ink, Inc., all rights reserved. Permission to republish granted to Pregnancy.org. Reviewed by Khanh-Van Le-Bucklin M.D. & Rebecca Hicks M.D. April 7, 2009.