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Do you really know how to choose a good doctor?

Gregory A. Buford, MD
Physician
January 10, 2012
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So you need a new doctor.  You go online and the list is seemingly endless.  You browse your insurance provider’s list and the information all looks the same.  With so many options, how can you really choose the best doctor for you?

Although this topic has been written about before, many people still find it difficult to determine a good fit.  And when they do, this fit often comes simply by chance.  To assure that you are choosing the right physician for whatever ails you, there are a few steps you need to take proactively to find that perfect fit.

Let’s begin with the basics.  First of all, make sure you know your doctor’s education and background.  In today’s world, these lines are blurring and many physicians are practicing in areas in which they may have received very little to no actual training purely in response to economic pressures.    Ask your potential physician what their residency training was in and any additional training programs they may have participated in since.  Next, be comfortable with their degree of experience.  Let’s face it.   We all have to start somewhere.  But if you’re looking for someone to treat an incredibly rare cancer (for example), my confidence would be on the practitioner who has treated enough patients to know which pitfalls to avoid and basics about this illness which can be gained from experience alone.  On the other hand, you also want someone young enough to be current with the latest cutting edge advancements.

Next, ask to speak with their patients.  In Plastic Surgery this is commonplace and generally encouraged.  In other fields (such as oncology), it may not be.  If this is an option available to you, I would wholeheartedly recommend you exercise it.  Getting a firsthand account before actually moving forward may save you the heartache of a bad outcome in the long run.

Ask your physician about their success rate but understand that this area may be difficult to gauge since some of the more talented physicians may take on the more challenging cases.

If you have access to local nurses or other medical professions, ask their opinion.  Ask them who they would go to and you’ll generally get a very honest reply.

Okay, so those are the standard recommendations that everyone would suggest in looking for a good physician.  But in today’s world are they really as relevant?  Not really.  Times have changed and so has medicine and how it is practiced.  Keep in mind that the medicine is increasingly more enhanced (or encumbered depending upon who you talk to) by technology and what worked 20 years ago may not be cutting edge today.  That being said, for the most basic of workups, you don’t always need cutting edge.  So what should you look for?

As a relatively young physician, I see the benefits of experience but I also recognize the value of youth.  For those of us who entered the world of private practice, our everyday lives can often be isolating (as compared to the comradery of residency) and less in contact with the day to day changes around us.  And so we rely on meetings and other educational events to keep us up to date.  But are these really that effective?  Not always.  So many physicians find themselves practicing medicine in a new age armed with old age tools and information.  In this case, younger physicians have a huge advantage since their information was gleaned from a more current source and, what they lack in experience, they potentially make up for in innovation.

As a patient, it is critical to know just how up to date your physician is with current advances and how they are getting this information.  If they are simply attending industry-funded dinners, then they may not be getting a well-rounded viewpoint.  And if they rely solely on the traditional yearly society meetings, they also may not be getting the latest and greatest if the speakers are still using the same slide decks over and over and over.  So how do you know how to gauge their level of medical fitness?  Ask them.  Find out not only how they have maintained their level of competency but also if they themselves have participated in Focus Groups or if they are considered to be Key Opinion Leader in any specific area.  If you are looking for someone well versed in a certain area, why not go to the person who is actually considered to be an Expert in this area.

And what about online reviews?  Are they really valid and how much weight should you really be placing in them?  In my opinion:  none!  Think about the last time you visited a restaurant.  If you were happy, did you really go online and rave about your soup?  Probably not.  But if the waiter was rude, the wait was long, or the food was cold you better believe that you let ‘em know!  And that’s often what happens with medical reviews.  I find it incredibly hard to get my happy patients to write anything online.  Why?  Because they are happy!  They had their surgery, they had a good outcome, and now they have simply moved on.  And so it is with many online reviews.  Keep in mind that there are people who simply are not happy people.  They are not happy now and they never will be and they certainly will never be satisfied with their care no matter how good it is.  And, unfortunately, many of these people know how to post online and they do so.  And physicians have absolutely no recourse when they do.  For the most part, we cannot even respond because of privacy laws.  And so these unhappy people describe their horrible experience (and often do so in painstaking detail), and the doctor has little to no options for giving their side of the story.  As such, when looking at reviews keep the following in mind:

  • Be wary of physicians with all positive reviews.  In a real world, you simply cannot please everyone.  And even though we all love positive feedback, we also expect that some patients will have one or two comments that are less than positive.  But these comments, if directed appropriately, can actually help us improve the overall care we provide to patients and grow out practices over time in a very positive way.
  • If there is a negative review, pay close attention to why the review was negative.  Was the patient upset because of an apparent lack of bedside manner or were they upset because the care was expensive or it took too long to get an appointment.  All reviews, negative or positive, are not equal and should each be judged on their own merits.
  • And if all else fails, ask to speak with former patients.  I always offer this option and never coach my patients on what to say and what not to say.  I feel that this is an excellent way for a potential client to identify the strengths and potential weaknesses of me and my practice prior to them even booking an appointment.

Going forward, I encourage you to keep these suggestions in mind when looking for a physician of any specialty.  After all, this is your health and there is no reason to leave the outcome to the results of a Yellow Page search or some other search that is equally as random.  Optimal outcomes are no accident and are the results of several factors.  And if you can control one of the most important variables—who it is that is actually delivering your care—then you are simply taking charge of one of the most decisions in your life.

Gregory A. Buford is a plastic surgeon and blogs at be for living.

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Do you really know how to choose a good doctor?
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