Monday, January 15, 2007

doctor patient relationships, ending information limbo, Your Doctor and You - Third in a Series

Ending Information Limbo

Here are your options for ending information limbo.

• Simply seek out a doctor with credentials on the wall with whom you feel comfortable and trust.

• Find your doctor through word of mouth, referrals from other doctors, asking your friends and relatives, calling your local hospital or medical society, or by leafing through the yellow pages.

• Go to healthgrades.com to find if doctors have been disciplined.

• Visit www.hospitalscompare.gov to see how the federal government rates hospitals for their treatments and outcomes of certain common diseases.

• Call your local hospital to see how many nurses they have on staff, and what the nurse/patient ratio is (the ideal NPR ratio varies from 1:1 in trauma units and operating rooms to 1:5 on general medical or surgical wards)

• Go right to the top by consulting America’s Top Doctors book or a referral service like America’s Best Doctors (www.bestdoctor.com).

• Proceed directly to a nearby well-known clinic or hospital with a good reputation. Hospital systems and academic medical centers pride themselves on having the best doctors and providing the best care.

• Look at your health plan’s website. It will have information on doctors and hospitals in its network, the website may compare costs of brand name and generic drugs, and it may even list the prices charged by its participating physicians.

• Gravitate to doctors who have practice websites. Most businesses across America now have websites. Why not doctors, too? Ideally practice websites will tell you how to get to the doctor’s office, the hours of operation, the credentials of the doctors, and will help you refill prescriptions, schedule appointments, educate you about disease, and allow you to consult with your doctor by email for minor non-emergency illnesses.

• Study your disease over the Internet, download relevant references, compile your questions, and then go to the doctor with your concerns. Doctors vary in how they react to Internet-savvy patients. Some doctors welcome well-informed patients; others regard them as misinformed. You may want to call ahead to see how the doctor might react.

• Tell your doctor you want to create an equal partnership with equal sharing of information, guidance to the best evidence, open-ended access, and economic mentoring about best values in health care.

Another Possibility

Another possibility is slowly evolving – patronizing doctors whose offices have electronic health record systems. Government, corporations, health plans, and consumers are pressuring doctors to install computer systems to generate electronic medical and health records. These electronic records, it is said, will make you safer, separate good doctors from mediocre doctors, and coordinate your care as you go from doctors’ offices to another, to hospitals, to rehab units, to your home.

Another Tack - Interviewing the Doctor

You may want to interview doctors before considering their services. That way, you can judge the personal chemistry and see if you can work with this person. You can ask them about their results, how many procedures they have done, and how their quality ranks among their peers.

This approach may work best if you are considering undergoing a major operative procedure. It may require confidence and an assertive personality.
I have a friend, the former CEO of a major company. He knew he had to have both knees replaced. He did not go to the Internet to find the best doctor.

Instead he personally visited four orthopedic surgeons, assessed the compatibility of their personalities, and asked how many bilateral knees that had done and what their results had been. The operation succeeded, and he is now walking without pain.

My friend says if had he had it to do over again, he would still go the interview route. Nothing, he says, can replace talking to a doctor in person before what needs to be done is done.

1 comment:

Dr. Val said...

How many doctors have time to be interviewed? Does it cost the patient an "office visit" to do the interviewing? How does this really work?