An Insider’s Guide
By Paul Konowitz, M.D., Medical Director of HealthAngle
Finding the right doctor doesn’t just mean finding a physician with excellent medical credentials. It also means finding a doctor you are comfortable talking to and is comfortable talking to you, and where there is the right mutual chemistry. You are not doing you or your doctor any favors by maintaining a relationship that doesn’t seem to work well.
Here are some tips to help find the doctor who is right for you.
Call the Office
When you call the office to make an appointment, evaluate the phone system, as it is often a reflection of the doctor’s practice and style. Is there a pleasant, clearly stated recorded voice offering helpful options or a poor quality recorded message with few options? Is there an option to talk with a live person? How long does it take to speak with a live person? Are the phone directions clear or are they frustrating?
How are emergencies handled over the phone? Is there an emergency option – if so, does this lead you to a live person? Is the emergency option offered for you to “hang up and call 911”? This may be an immediate sign of a physician’s inability or disinterest in taking care of emergencies.
Is it easy scheduling the appointment or a tremendous hassle? Is there a sense of courtesy and accommodation by the person making the appointment? If your doctor is in a group practice, is an offer made for you to see another physician in the group if your physician is not available?
Survey the Waiting Room
The waiting room is where you will likely make your initial impressions of your physician’s practice. After all, we know that a significant amount of time may be spent in this area. Is the waiting room comfortable, clean, and well lit? Are other patients waiting to be seen — generally a good sign — or are you the only patient in the office? Is there educational material available for reading? Are there current magazines or newspaper? Is there privacy when speaking with the receptionist, test scheduler, or other office personnel? Are you presented with a list of privacy rules (“HIPAA” rules)? Does the atmosphere in the waiting room add to your stress, or do you find it calming and reassuring?
Read Any Posted “Rules”
Many physician offices will have posted “rules” on display in the waiting room with items such as referrals, communication of test results, cancellation of appointments, etc. Make sure that the tone and philosophy contained in these rules matches your own expectations from you physician.
As an example, I was recently sitting in my primary care physician’s waiting room and his rules stated that test results would be available “within two weeks from the time they are obtained. Please do not call unless you do not hear from us after three weeks.” This particular philosophy could lead to significant anxiety for the patient and potentially could lead to a delay in treatment. So beware of the rules.
Evaluate the Visit
Both the initial visit to your physician and subsequent appointments should consistently leave you feeling confident in the care you are receiving and in the professional relationship. Does the physician clearly introduce him or herself to you? Does the physician shake your hand and make consistent eye contact? This is particularly important in the new age of the computerized medical record as the physician may be typing while you are talking. Does the physician listen to your history with interest or does he constantly interrupt and try to cut you off? Does your physician ask appropriate questions of you? Do you get a feeling of concern from your physician? Are there multiple interruptions during your visit? Does your physician seem to be seeing multiple patients all at the same time resulting in a sense of disruption or disinterest? Does the physician seem to have interest in you as a person?
Many physicians are, by necessity, multi-tasking – but to you, as the patient, this should be invisible. You should feel that the physician’s attention is on you and you alone – that your problem is the most important issue that your physician will deal with. You should leave the office with this feeling as well.
It is also important to leave your visit at the physician’s office with a plan. Are there tests to be done and how and when will they be scheduled? Is there a follow-up appointment made? Have all your questions been answered?
Quantity vs. Quality of Time
Although quantity of time seems paramount when seeing your physician, it is really the quality of time that is crucial. As much can be accomplished to deal with your problem thoroughly in a short efficient visit as in a longer, disorganized visit. There should always be enough time for you, even if this means extending past your allotted time. You should never feel rushed!
Communication: How, When, Why?
Being able to communicate with your physician is the key to a successful doctor-patient relationship and most importantly, to obtaining excellent care. Communication with your physician is certainly important during your visit, but it is equally important once you are out of the office. How does your physician communicate with you? Will your doctor call you back directly when needed or is there always a surrogate answering your call? Does your doctor have email for direct communication? How are test results communicated – i.e., should you expect a letter or a phone call or do you have to track the doctor down to obtain results? Are messages answered in a timely fashion?
I once had a physician who took two weeks to communicate a test result to me by telephone, and never communicated with me directly, instead having his secretary tell me the results. One time, when I had a copy of the test result faxed to me, I noticed that the date of the report was two days after the test was completed. But the physician had this result for over a week but never contacted me with the results until I called to follow up!
I provide my email address to my patients as a direct way for them to contact me with questions or concerns. Conversely, I use email (through a secure system) to provide test results in a timely fashion. A physician who offers email is a physician who doesn’t mind communicating with you.
After the Visit
Does the quality of follow-up meet the original expectation from your office visit?
Many of us leave our physician’s office feeling confident in our physician and satisfied with the visit. But does that feeling continue in the days and weeks following the office visit? Are promises made kept – e.g., promises to make appointments with consultants, schedule tests, call you after a surgical procedure to check on your well being (if your physician is a surgeon), provide a test result as soon as it is available? Short-term satisfaction should be no different from long-term satisfaction.
How Available is Your Physician?
Does your physician have qualified coverage (in the same specialty) that is readily available? Are there periods of time that your physician is uncovered and where you have to use the emergency room if there is an urgent issue?
It is important for you to determine if your physician is available and what arrangements are present when they themselves are not available, so ask him or her. It is generally not acceptable for a physician to use the emergency room at a local hospital as their coverage. Make sure that your physician has a bona fide coverage plan that you can understand and is acceptable to you. Your physician will not always be around when you need them, so it is crucial to have one who cares how you will receive care when they are inaccessible.
Is Your Doctor In Tune with You?
It is important for you to feel like your physician treats you like a human being and not just another patient. This means that your physician shows interest in you as a person. Does your physician show interest in your beliefs and opinions? Does your physician make an effort to know you as a person?
The psychological issues that each of us face are an important part of one’s health. Your doctor should be delving into the psychological issues in your life and correlating them with your physical illness. Does your physician ask about stress in your life? Are stress reduction techniques discussed and made readily available? Does your physician have as much respect and interest in your mental health issues as he does in your physical ailment(s)?
Openness to Integrative Approaches
The use of non-traditional techniques in the treatment of illness is an ever-increasing area of interest to today’s patients. You should feel comfortable discussing alternative medicine treatments and holistic care with your physician, as these may be appropriate for you. Even if your physician is not knowledgeable about these possibilities, they should at least have an open mind to your desire to learn and potentially pursue an alternative pathway for your health, and be interested in continuing to have you as a patient even if you decide to include holistic medical remedies to your treatment plan.