You and Your Doctor
The doctors that you choose to work with can have an enormous impact on your physical and mental health. It is important to have a positive, trusting, ongoing relationship with your medical care providers. A doctor can help you and your family members stay healthy and receive rapid, appropriate treatment when illness strikes. However, it’s critical that you be an active member of your health care team. Ask questions, press for answers, continually stay informed and engaged for your, and your family’s sake.
If you have health insurance, depending on your plan you will probably be given a list of participating healthcare providers (doctors and specialists) which you can choose to see. That means that those medical professionals accept your healthcare insurance for payment. If you don’t have insurance you should call a doctor’s office first to make sure that they accept clients without insurance. Most will, but you will be responsible for paying 100% of your bills and usually you are required to pay at the time of service (i.e. when you come in for a visit, get your lab work done, etc.) Some doctor’s offices will take patients without insurance and will allow you to set up a payment plan if you are not able to pay all of your bills in full each time you visit.
There are two main categories of doctors that you will most likely choose – primary care physicians and specialists. Let’s look at both:
Primary care physicians are the doctors that you will see for common medical problems. He or she will be your main healthcare provider in non-emergency situations. There are several general types of primary care physicians (PCPs):
- General practitioners – doctor who have completed an internship but not a residency
- Family practitioners – doctors who have completed a family practice residency and are board certified or board eligible for a specialty. Their scope of practice includes children, adults and possibly services including obstetrics and minor outpatient surgery.
- Pediatricians – doctors who have completed a pediatric residency and are board certified or board eligible in this specialty area. Their scope of practice includes caring for newborns, infants, children and teens.
- Internists – doctors who have completed a residency in internal medicine and are board certified or board eligible in this specialty area. Their scope of practice includes caring for adults with a wide range of medical concerns and problems.
- Obstetricians/gynecologists - doctors who have completed a residency and are board certified or board eligible in this specialty area. They also often serve as primary care providers for women of childbearing age.
- Nurse practitioners (NPs) and Physician assistants (PAs) – clinical practitioners who undertake separate, different training than doctors or nurses. They may be your key contact in a doctor’s office and can undertake basic assessments and some treatment protocols. All PAs and NPs consult with physicians in this practice.
Specialists are doctors that specialize in a certain medical area whom you will see for a specific condition or illness (i.e. oncologist, gastroenterologist, endocrinologist, etc.) They are able to provide more specialized care for specific illnesses or chronic medical conditions than a primary care provider. Most often you will be referred to a specialist by your primary care provider. Frequently health insurance companies require policyholders to obtain a referral before they will authorize payment for a specialist’s services. Verify with your insurance plan if you are able to self-refer or if you need authorization from your physician.
When you are choosing a primary care physician, begin by:
- reviewing the list of providers that your insurance company approves
- asking friends, family members, neighbors and co-workers for recommendations
- checking online for physician information on websites like Healthgrades.com or even your health plan or insurance company’s website or calling their customer service number
- asking other healthcare providers you use such as your dentist, optometrist, pharmacist, etc.
In addition to getting recommendations it’s important to find out if the doctor you’re considering is covered by your health plan and if his or her office is in a convenient location to your home, office and children’s schools.
After you narrow down your list of potential primary care physicians you should then consider making an appointment with him or her to “interview” them to serve as your healthcare provider. Tell the receptionist why you would like to meet with the doctor. It will, by necessity of a doctor’s busy schedule, be a short meeting (15 minutes or so) and should be free, or you should be charged a very nominal amount that your insurance company may even pay.
Consider asking a potential doctor the following questions:
- What is your education?
- What did you study as an undergraduate?
- Where did you attend medical school?
- When and where did you do your residency? Any training beyond that? (You can also look up a doctor in the Directory of Medical Specialists at the library for certification and training information.)
- What is your primary hospital affiliation?
- How many partners are there in your practice (if any)? If you are unavailable, will they be able to see me?
- Do you respond to calls at night or on the weekend?
- What are your office hours, and are extended hours available?
- What is your primary patient mix? Typical age range of patients? Do you see more women or men?
- What hospital emergency department do you recommend?
- What health insurance plans do you accept, and are you familiar with my health insurance plan?
- Will you treat other people in my family as well?
- If I get really sick and end up hospitalized, will you be able to treat me there?
- Do you make hospital rounds personally, or does someone else in your practice handle it?
- In your opinion, what makes you and your practice different or better in any way?
Gathering the information from your conversations, research and in-person meeting, consider the following before making your choice:
- Was the office staff friendly and helpful?
- Was it easy to make an appointment when you called?
- Was there a long wait when you went for your meeting?
- Is the office good about returning calls?
- How easy is it to reach the provider? Does the provider use email?
- Do you prefer a provider whose communication style is friendly and warm, or more formal?
- Do you prefer a provider focused on disease treatment, or wellness and prevention?
- Does the provider have a conservative or aggressive approach to treatment?
- Does the provider have a reputation for ordering a lot of tests?
- Does the provider refer to other specialists frequently or infrequently?
- What do colleagues and patients say about the provider?
- Does the provider invite you to be involved in your care? Does the provider view your patient-doctor relationship as a true partnership?