Choosing a Doctor
Contents
> Decide What You Want and Need in a Doctor
> Make a List of Doctors
> Check on Quality
> Contact the Doctors' Offices
> Talking with Your Doctor
> Your Personal Health History
> Urgent or Emergency Care Centers
> Sources of Additional Information
It is important to choose your doctor with care, because quality
varies. For example, the Pacific Business Group on Health asked
patients of California doctors' groups how they rated their care. The
results? More than 80 percent of the patients said they were satisfied
with their care. But fewer than two-thirds were happy with the ease of
getting that care.
This chapter can help you choose a primary care doctor who will meet
your needs and give you quality care. The information also may be
useful in choosing any specialists you might need. Primary care
doctors are specially trained to serve as your main doctor over the
long term. They provide your medical and health care, help you stay
healthy, and help to manage your care. Your primary care doctor can
refer you to specialists (doctors who treat only certain parts of the
body, conditions, or age groups) if you need them.
Quick Check for Quality
Look for a doctor who:
[x] Is rated to give quality care.
[x] Has the training and background that meet your needs.
[x] Takes steps to prevent illness-for example, talks to you about
quitting smoking.
[x] Has privileges at the hospital of your choice.
[x] Is part of your health plan, unless you can you afford to pay
extra.
[x] Encourages you to ask questions.
[x] Listens to you.
[x] Explains things clearly.
[x] Treats you with respect.
Internists and family physicians are the two largest groups of primary
care doctors for adults. Many women see obstetricians/gynecologists
for some or all of their primary care needs. Pediatricians and family
practitioners are primary care doctors for many children.
Physician assistants, nurse practitioners, and certified nurse
midwives are trained to deliver many aspects of primary care.
Physician assistants must practice in partnership with doctors. Nurse
practitioners and certified nurse midwives can work independently in
some States, but not others.
Doctors and Health Plans
If you already are in a health plan, your choices may be limited to
doctors who participate in the plan. But if you have a choice of
plans, you may want to first think about which doctor(s) you would
like to use. Then, you may be able to choose a plan that has your
choice of doctor(s).
Decide What You Want and Need in a Doctor
What is most important to you in a doctor? A few ideas are listed
below. Add your own to create a list that will help you choose a
doctor who is right for you.
My doctor must be highly rated by a consumer or other group. You will
want to find out who did the ratings. Is the information reliable? Who
collected it? Does the group have something to gain from the ratings?
Notes:
My doctor needs to have experience with my condition(s). Research
shows that doctors who have a lot of experience with a condition tend
to have better success with it.
Notes:
I want a doctor who has privileges (is permitted to practice) at the
hospital of my choice.
Notes:
My doctor must be part of my health plan.
Notes:
Additional items:
Make a List of Doctors
* If you are in a managed care plan, check the plan's list of
doctors first.
* Ask doctors or other health professionals who work with doctors,
such as hospital nurses.
* Check the "Physician Select" service of the Web site of the
American Medical Association. This can give you lists of doctors,
by specialty, who practice near you. You can also check on
training and board certification: http://www.ama-assn.org/aps/amahg.htm.
* Call a doctor referral service at a hospital. But keep in mind
that these services usually refer you to any of the doctors on the
staff of that hospital. The services do not have information on
the quality of care these doctors provide.
* Some local medical societies offer lists of doctors who are
members. Again, these lists do not have information on the quality
of care these doctors provide.
* Ask family, friends, neighbors, and co-workers.
Write your list here.
Name: _________________________________
Telephone: ____________________________
Name: _________________________________
Telephone: ____________________________
Name: _________________________________
Telephone: ____________________________
Check on Quality
Once you have a list of doctors, there are several ways to check on
their skills and knowledge, and the quality of care they provide:
* Find out if a consumer or other group has rated doctors in the
area where you live. Again you will want to find out how reliable
the ratings are.
* Information on doctors in some States is available on the Internet
at http://www.docboard.org. This Web site is run by Administrators
in Medicine-a group of State medical board directors.
* The American Board of Medical Specialties (1-800-733-2267) can tell
you if the doctor is board certified. "Certified" means that the
doctor has completed a training program in a specialty and has
passed an exam (board) to assess his or her knowledge, skills, and
experience to provide quality patient care in that specialty.
Primary care doctors also may be certified as specialists. You can
also check the Web site at http://www.certifacts.org. (While
board certification is a good measure of a doctor's knowledge, it
is possible to receive quality care from doctors who are not board
certified.)
* Call the American Medical Association (AMA) at (312) 464-5000 for
information on training, specialties, and board certification
about many licensed doctors in the United States. This information
also can be found in "Physician Select" at AMA's Web site:
http://www.ama-assn.org/aps/amahg.htm.
Contact the Doctors' Offices
When you have found a few names of doctors you might want to try, call
their offices. The first thing to find out is whether the doctor is
covered by your health plan and is taking new patients. If the doctor
is not covered by your plan, are you prepared to pay the extra costs?
Below are some questions you might want to ask the office manager or
other staff. You may have some additional questions. Note that some of
these items might have more to do with the health plan than with the
doctor's office.
Things to find out from office staff:
Which hospitals does the doctor use?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
What are the office hours
(when is the doctor available and when can I speak to office staff)?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
Does the doctor or someone else in the office speak the language that
I am most comfortable speaking?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
How many other doctors "cover" for the doctor when he or she is not
available? Who are they?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
How long does it usually take to get a routine appointment?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
How long might I need to wait in the office before seeing the doctor?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
What happens if I need to cancel an appointment? Will I have to pay
for it anyway?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
Does the office send reminders about prevention tests-for example, Pap
smears?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
What do I do if I need urgent care or have an emergency?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
Does the doctor (or a nurse or physician assistant) give advice over
the phone for common medical problems?
Doctor A: ____________________________________________________
Doctor B: ____________________________________________________
Doctor C: ____________________________________________________
You may also want to talk briefly with the doctor by phone or in
person. Ask if you are able to do this and if there is a charge.
The next step is to schedule a visit with your top choice. During that
first visit you will learn a lot about just how easy it is to talk
with the doctor. You will also find out how well the doctor might meet
your medical needs. Ask yourself: Did the doctor...
1. Give me a chance to ask questions? YES NO
2. Really listen to my questions? YES NO
3. Answer in terms I understood? YES NO
4. Show respect for me? YES NO
5. Ask me questions? YES NO
6. Make me feel comfortable? YES NO
7. Address the health problem(s) I came with? YES NO
8. Ask me my preferences about different kinds of
treatments? YES NO
9. Spend enough time with me? YES NO
Trust your own reactions when deciding whether this doctor is the
right one for you. But you also may want to give the relationship some
time to develop. It takes more than one visit for you and your doctor
to get to know each other.
Talking with Your Doctor
Research has shown that patients who have a good relationship with
their doctors tend to be more satisfied with their care-and to have
better results. Here are some tips to help you and your doctor become
partners.
Give information. Don't wait to be asked!
* You know important things about your symptoms and your health
history. Tell your doctor what you think he or she needs to know.
* It is important to tell your doctor personal information-even if
it makes you feel embarrassed or uncomfortable.
* Bring a "health history" list with you (and keep it up to date).
You can use the form provided in this guide. You might want to
make a copy of the form for each member of your family.
* Always bring any medicines you are taking, or a list of those
medicines (include when and how often you take them). Talk about
any allergies or reactions you have had to your medicines.
* Tell your doctor about any natural or alternative medicines or
treatments.
* Bring other medical information, such as x-ray films, test
results, and medical records.
Get information.
* Ask questions. If you don't, your doctor may think you understand
everything that was said.
* Write down your questions before your visit. List the most
important ones first to make sure they get asked and answered.
* You might want to bring someone along to help you ask questions.
This person can also help you understand and/or remember the
answers.
* Ask your doctor to draw pictures if that might help to explain
something.
* Take notes.
* Some doctors do not mind if you bring a tape recorder to help you
remember things. But always ask first.
* Let your doctor know if you need more time. If there is not time
that day, perhaps you can speak to a nurse or physician assistant
on staff. Or, ask if you can call later to speak with someone.
Take information home.
* Ask for written instructions.
* Your doctor also may have brochures and audio and videotapes that
can help you. If not, ask how you can get such materials.
Once you leave the doctor's office, follow up.
* If you have questions, call.
* If your symptoms get worse, or if you have problems with your
medicine, call.
* If you had tests and do not hear from your doctor, call for your
test results.
* If your doctor said you need to have certain tests, make
appointments at the lab or other offices to get them done.
* If your doctor said you should see a specialist, make an
appointment.
Your Personal Health History
Use this form to keep track of your health history. Print out a copy
and take it with you to your doctor appointments to help keep your
doctor up-to-date.
1. I was in the hospital for (list conditions): Date
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
2. I have had these surgeries: Date
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
3. I have had these injuries/conditions/illnesses: Date
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
_______________________________________________________ ____________
4. I have these allergies
(list type of allergy--food, medicine, etc.--and reaction):
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
5. I have had these immunizations (shots):
(Note: In the list below, the names of the shots follow the names of the
diseases they prevent.)
For children: Suggested age Date(s) received
--------------------- ------------------------------- ----------------
Hepatitis B (HBV) Dose 1: Birth to 2 months ______________
Dose 2: 2 months to 4 months ______________
Dose 3: 6 months to 18 months ______________
Dose 1 or 3: 11 years to 12 years ______________
Polio (IPV) Dose 1: 2 months ______________
Dose 2: 4 months ______________
Dose 3: 6 months to 18 months ______________
Dose 4: 4 years to 6 years ______________
Haemophilus Influenzae
type B (Hib) Dose 1: 2 months ______________
Dose 2: 4 months ______________
Dose 3: 6 months ______________
Dose 4: 12 months to 15 months ______________
Diphtheria, Tetanus, &
Pertussis (DTaP, Td) Dose 1: 2 months ______________
Dose 2: 4 months ______________
Dose 3: 6 months ______________
Dose 4: 15 months to 18 months ______________
Dose 5: 4 years to 6 years ______________
Td Once: 11 years to 16 years ______________
Measles, Mumps,
Rubella (MMR) Dose 1: 12 months to 15 months ______________
Dose 2: 4 years to 6 years
or Dose 2: 11 years to 12 years ______________
Chickenpox
(Varicella) (VZV) Once: 12 months to 18 months ______________
or once: 11 years to 12 years ______________
Pneumococcal Disease Dose 1: 2 months ______________
(Prevnar™) Dose 2: 4 months ______________
Dose 3: 6 months ______________
Dose 4: 12 months to 15 months ______________
Hepatitis A Once: 2 years to 12 years ______________
in selected areas
For adults: Suggested age Date(s) received
--------------------- ------------------------------- ----------------
Influenza Every year starting at age 65 ______________
Pneumococcal Once at age 65 ______________
Tetanus (Td) Every 10 years ______________
6. I take these medicines/supplements (bring with you, if possible):
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
7. My family members (parents, brothers, sisters, grandparents)
have/had these major conditions:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
8. I see these other health care providers:
Name Why I see them
______________________________ _____________________________________
______________________________ _____________________________________
______________________________ _____________________________________
Urgent or Emergency Care Centers
What if you get sick at night, on a holiday, or over the weekend?-You
can't get to your doctor, but you are not sick enough to go to the
emergency room. There may be an "urgent" or "emergency" care center
near you. These centers are open long hours every day to handle
problems that are not life threatening. But they are no substitute for
a regular primary care doctor.
To make sure an urgent or emergency care center provides quality care,
call your health plan or visit the center to find out:
* If your health plan will cover your care there.
* If it is licensed. Then check to see if it is accredited by a
group such as the Joint Commission on Accreditation of Healthcare
Organizations (telephone 630-792-5800; Web site
http://www.jcaho.org) or the Accreditation Association for
Ambulatory Healthcare (telephone 847-676-9610, Web site
http://www.aaahc.org). The accreditation certificate should be
posted in the facility.
* How well trained and experienced the center's health care
professionals are.
* If the center is affiliated with a hospital. If it is not, find
out how the center will handle any emergency that could happen
during your visit.
_________________________________________________________________
Sources of Additional Information
Talking With Your Doctor: A Guide for Older People
Suggests ways to discuss health concerns, medicines, and issues
important to older people. 29 pages. Free.
National Institute on Aging Information Center
Building 31, Room 5C27
31 Center Drive MSC 2292
Bethesda, MD 20892-2292
(301) 496-1752; TTY 1-800-222-4225
Web site: http://www.nih.gov/nia
Talking With Your Doctor
Focuses on a healthy doctor-patient relationship and suggests
questions for patients to ask their doctor. Written for cancer
patients but also helpful to others. 6 pages. Free.
American Cancer Society
1-800-ACS-2345
Web site: http://www.cancer.org
Health Care's Front Line: Primary Care Physicians
Discusses choosing a primary care doctor and making the most of the
first visit. Part of a series published by the Health Pages' on-line
magazine.
Web site: http://www.thehealthpages.com/
Personal Health Guide and Child Health Guide
Put Prevention Into Practice (PPIP) encourages Americans to get the
preventive care they need. Two patient booklets help you keep track of
preventive services: Free.
Agency for Healthcare Research and Quality
Publications Clearinghouse
P.O. Box 8547
Silver Spring, MD 20907
1-800-358-9295
E-mail: AHRQPubs@ahrq.hhs.gov
Web sites: http://www.ahrq.gov/clinic/ppipix.htm
http://www.ahrq.gov/ppip/adguide/
(Pocket Guide to Good Health for Adults)
http://www.ahrq.gov/ppip/childguide/
(Pocket Guide to Good Health for Children)
Personal Health History
A confidential form that you can fill out and use to track your health
and medicine history is on the American Medical Association Web site.
Web site: http://www.ama-assn.org
(Select Search, and enter "personal health history.")
healthfinder®
Provides a gateway to reliable consumer health information from the
Federal Government and other organizations.
Web site: http://www.healthfinder.gov
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_________________________________________________________________
Current as of July 2001
Send Questions & Comments to: info@ahrq.gov
_______________________________________________________________
Internet Citation:
Choosing a Doctor. Your Guide to Choosing Quality Health Care. AHCPR
Publication No. 99-0012, July 2001. Agency for Healthcare Research
and Quality, Rockville, MD. http://www.ahrq.gov/consumer/qntascii/
qntdr.htm
_______________________________________________________________
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