FINDING A NEW DOCTOR: QUITE A CHALLENGE

Fortunately, finding a new family doctor is a task you don’t have to do very often. When the situation arises, however, it can be very problematic. A lot of questions come to mind and uncertainty occupies your thoughts. Do I want a man or woman doctor? An internist or a family physician? Old and experienced or young with fresh ideas and current knowledge? Am I ready for a physician in the concierge model or do I stay with the old standard fee-for-service practice? How do I know this doctor knows his/her stuff? Is he/she board certified? When I’m sick will I see the doctor or a nurse practitioner/physician assistant? How many stars does this doctor get on the HealthGrades scale? What do other patients say about him/her? Is he/she taking new patients? There are a lot of things to consider. 

These are just some of the items you have to think about when looking for a doctor. Will his/her bedside manner (ie. personality) mesh with yours? You never know how you will relate until you meet the person one-on-one, face-to-face. First impressions mean a lot, but until you spend some time together, and get a better understanding of their level of compassion, their dedication, and their opinions, you really don’t know. Some doctors are extremely paternalistic—it’s my way or no way; I’m right so do what I say. Some work with the patient as a partner and practice shared decision-making. Others have a laissez-fair, hands off approach. I think patients like some direction. How is the patient to know if he needs tetracycline or cephalexin. They like some decisions to be made for them. After all, the physician is the expert and should provide guidance and advice. The patient has no idea about the physician’s practice philosophy before visiting him/her the first time.

We just recently had to find a new family doctor. Our doctor for the last 7 years left his practice suddenly and unexpectedly for reasons we have yet to find out. We weren’t exactly left in the lurch, but I felt we needed to find a new doctor sooner rather than later. I began by looking for a board certified general internist who practices within the same umbrella organization as our previous doctor. I began the search on the group website to find a general internist, and with each doctor I looked at several criteria. Those criteria are:

           1. The medical school they graduated from

           2. Honors they earned during their education—eg, Phi Beta Kappa, Alpha Omega Alpha

           3. The residency program they completed

           4. Recognitions received during training—eg, Chief Resident, outstanding resident

           5. Board Certification—eg, Internal Medicine, American Board of Family Practice

           6. Years at the same location—have they moved around often

           7. HealthGrades ratings—1-5 Stars

           8. Patient Testimonials

Of course, I’m at an advantage knowing details about medical schools and residency programs  that the average person would not know, but most people know if the doctor is a graduate of Harvard, Yale, or Johns Hopkins medical school he/she is of above average intellect. The same is true for residency programs. Those affiliated with major institutions are going to accept and graduate above average residents. Choosing an internist who did a residency at Rush-Presbyterian St. Luke’s, Michigan, Case Western Reserve, or Texas Southwestern at Parkland Hospital will not be a mistake. Intelligence will not be an issue, but personality and communication skills may be. Those characteristics will be the deciding factors. 

In my search I found an internist who had graduated from the University of Texas Medical Branch in Galveston, was AOA, did a residency UT at Galveston, was boarded in internal medicine, and had practiced in Phoenix for many years. I made an appointment to see her but it wasn’t until five weeks later. Two days before my February 21st appointment, the office called to tell me the doctor was retiring in May! What? How could that be? Why did they give me a new patient appointment? I told the caller I would keep the appointment because I needed a new prescription for simvastatin. I kept the appointment, got my prescription, and received the names of four doctors she would recommend I call instead. I would have been pleased with this doctor, but it was not to be.

I then began looking into the four doctors who had been recommended. Unfortunately, they were employed by a different organization than all of my other doctors, and the two groups used a different electronic health record system. My previous health records would not be available to my new doctor. Not a good situation, so I went back to square one—another search. 

At Desert Ridge there was a family medicine group with eleven physicians. Surely someone in that group would be taking new patients. Lo and behold there were four doctors who were….

and each of them could see both of us (my wife and me) TOMORROW! What? Tomorrow? Not six weeks from now? No, tomorrow! I said “ok, why not? Which doctor are we seeing?” She told me, and I looked him up, as I had done several times for other physicians.

What I found was both reassuring and worrisome at the same time. His bachelors degree was from Harvard, he went to medical school at the University of California at SanDiego Medical School, and did a residency at Banner Health Good Samaritan in Phoenix. For the next few years, he was on the faculty of the residency program and then joined the Desert Ridge group. All of this was very reassuring, so I then looked at his HealthGrades score and became concerned. His rating was 2.5 stars out of five. OOPS! Patient testimonials were not complimentary. Patients didn’t seem to like him. I decided to keep our next day appointments, but I have to admit I was filled with skepticism.

At our appointment, his medical assistant saw us first and spent a lot of time going over our medications and organizing our health records. She was very attentive, very personable, very patient, and very interested in us and getting our medical record updated. A few minutes after his assistant left, the doctor entered, introduced himself, shook hands with both of us, and began reviewing my wife’s medical history. He asked about every diagnosis, every medicine, and made suggestions for changes he thought would be beneficial. Having practiced the same profession as he for 40 years, I found him knowledgeable and competent. He explained his recommendations using scientific data to justify the changes. Being retired for 10 years, recommendations and guidelines change and new information is learned about older treatments. He presented these new ideas well and proved his point. 

He went through the same process for me, also, reviewing my medical history item by item and making similar changes which I felt were reasonable. One thing that gets omitted in many new patient visits is a physical exam—he examined both of us. It was a cursory exam, but it was hands-on. Many doctors don’t bother.

After our appointments, in spite of the low HealthGrades score, I felt we had made the right choice in physicians. I can see how people might misunderstand his intentions or demeanor. He was straightforward, confident, and convincing and might be interpreted as arrogant or pushy. I did not feel that way. Maybe he toned it down a bit knowing I was a physician, but I don’t think so. He was certain of his position on the issues he addressed, but did not say we were foolish for doing what we had been doing. He wanted us to understand there was a better way to achieve the same, or better, outcome. I did not find any inaccuracies in his comments, and he didn’t make us feel inferior or stupid. The folks who gave him only one star may have felt that way, but we did not.

The process of finding a doctor is very important. Being able to communicate effectively with the doctor is the most important factor of all. Plus you want the doctor to care about your problems just as much as you do. When they don’t or when they minimize your complaints, it’s time to start looking for a doctor who does care. After our first appointment, I don’t think I will need to look for a doctor a third time.