How do you choose your professionals?

[GREENBACK]

My family doctor of the last 20yrs. just retired and I had to search for a new one. I went to my Ins. companies website and went through the incredibly long list of physicians. The only credentials listed was "board certified" which practically all are. I selected a doctor that I personally know but really have no idea of his skills as a physician. We'll see next week. Yes, they are getting me in next week and it could have been tomorrow if I could have fitted it in. This scenario brought to mind something that has bothered me for a while and I doubt that I'm the only one.

My question or curiosity is what method do you use to choose professionals such as doctors, lawyers,accountants or even someone to put on a new roof or fix something else around the house or your car? I've mostly gone by word of mouth or personal connections but that's not always reliable. It would be nice to have a way to check out the credentials and past history of these people before you hire them. Computer searches have made this somewhat easier but hardly a reliable source to find local information.Maybe I'm missing something but I tend to look for people that are going to do the best job and I really don't mind paying more to have it done right the first time whether it be body, car or home. I Just want a reliable and somewhat easy way to find out who is the best and, in descending order, who really sucks!

[disneysteve]

There is a lot of push to have some type of rating for doctors and a number of sites popping up for folks to post reviews and opinions. The problem with those kinds of sites is that who will post the most? People who are unhappy with their experience. There are also sites that list if a doctor has had any malpractice suits brought against him. As much as the average person might think that would be important to know, it is really meaningless in our litigious society when people can and do sue for any reason. Just because a doctor has been sued multiple times doesn't mean a darn thing about his skill as a physician. In fact, doctors who tend to take on more challenging cases are likely to have more suits on their record than those who avoid the harder stuff.

I think for a physician, you need to go by word of mouth and a "get acquainted" visit. Even asking friends, family and co-workers who they see doesn't tell you all you need to know because everyone's likes and dislikes are different. I've known doctors who I heard were unfriendly or hard to talk to and I found just the opposite to be true. Often, it is the personality of the patient that is the problem more than that of the physician. So get recommendations and then call and make an appointment. You can even consider dropping into the office. See what the place looks like. See if the front desk staff are friendly and responsive to your questions (but be respectful of their time and the fact that you are dropping in unannounced). You can tell a lot about a doctor by spending 10 minutes in the waiting room. And it doesn't generally take more than one visit with the doctor to know if he/she is the right one for you.

[GREENBACK]

I think for a physician, you need to go by word of mouth and a "get acquainted" visit. Even asking friends, family and co-workers who they see doesn't tell you all you need to know because everyone's likes and dislikes are different. I've known doctors who I heard were unfriendly or hard to talk to and I found just the opposite to be true. Often, it is the personality of the patient that is the problem more than that of the physician. So get recommendations and then call and make an appointment. You can even consider dropping into the office. See what the place looks like. See if the front desk staff are friendly and responsive to your questions (but be respectful of their time and the fact that you are dropping in unannounced). You can tell a lot about a doctor by spending 10 minutes in the waiting room. And it doesn't generally take more than one visit with the doctor to know if he/she is the right one for you.

This is somewhat what I'm doing for my visit next week, though I actually haven't spoken to any of his patients. I've been to his house and have talked to him a few times and he seems to be a decent guy. That's why I chose to make an appt.. That's hardly a great reason but in comparison to my other choices it struck me as the best option.. I've driven by his office many times and it seems nice but have never been inside.

I don't want to over-analyse things but I would love to know how he and all the other providers in my network "rate" if that's the appropriate word.

[Joan.of.the.Arch]

The only health care person I went to due to a friend's recommendation was a dentist. He did some work which I later read was rarely a necessity but sometimes done as a money-maker. I did not learn of that until a couple years after I no longer went to him due to the long drive. I justified to myself that maybe I really did need that work and was not taken advantage of.

Years later I chose a dentist simply because he was within walking distance of my apartment. He turned out to be great and had a lot of extra qualifications so that I never had to be sent out to some other specialist for work. He even did his own cleaning rather than hire it out to a hygienist. One of the framed documents on his wall indicated that he'd been top of his class as well as having been voted something that amounted to "Most popular" by his classmates. I never would have gone looking for that, but I suppose it did say something about his ability to get along with all kinds of people. So I lucked out on finding this dentist, but now I know more about what to look for in the future.

After I'd been this dentist's patient for some years I mentioned to him what this other dentist had done. I knew the two of them had not only gone to the same dental school, but had been in the same class. He kind of stopped in his tracks at what I said. I was surprised that he was willing to repeat that that kind of work was rarely necessary and that the other dentist had been poorly thought of at their school and in the years since graduation too. ...So my friend's recommendation turned out to have not been very worthwhile.

As for MDs, well I have primarily just looked for one that took my insurance and was, again close to home. I used to be able to ride my bike to appointments (assuming I wasn't sick.) Also important to me is which hospital(s) a doctor is on staff at. Having worked in some, and having friends who do now, I have preferences about which hospitals I might go to.

I also like having a doctor who is part of a larger practice. This way, if for some reason my doctor is unavailable, there is someone who may offer to see me on short notice (same day) for something that feels urgent.

Having a primary care internist I like, I put some trust in his recommendations if I would need a specialist. I would want him to be able to communicate well with anyone I may see and trust that he would not knowingly point me toward someone whose work he suspects less than desirable.

I have never interviewed a doctor before signing on with them; that seems an impossible luxury. As long as the doctor shows a reasonable level of respect and seems competent to me, I can be fine with them. I once had a doctor who just barely met the respect criterium and I think that I would have eventually found someone else. I think if I were ever really in bad shape, I could not have tolerated that doctor's attitude. That might be something I would have found out had I interviewed him beforehand. But anyway, I truly think he was well beyond competent and that was all I needed at the time.

When I was pregnant I found out my ob-gyn's husband was a pediatrician. No -wait- I did interview one doctor, this pediatrician. My ob-gyn was such a remarkable person that I thought probably her husband would be, too, so I wanted to meet him as a possibility for my child's doctor. Sure enough he was great. Sadly, he moved, so we just switched to another person in the same practice. He was fine, too. All three of these people were also close to our home. It is a large practice with offices all over the metro area.

This may sound like a little thing, but I have always found my doctor's staff to be polite and seem to do their job well. These days, neither of those is a given, so someone in that practice is good at hiring. The staff also stays for years and years, so it must be a decent place to work. I like knowing that, for sure. You know how it is said "Garbage in; Garbage out"? Well I also think in the work place it is "Kindness and excellence in; Kindness and excellence out." Again, having worked in hospitals I know that sometimes in healthcare there can be a wicked, just barely below the surface meanness, judgementalism, and harshness. I would hate to have to go to a doctor's office where I sensed any of that.

Another reason I like larger practices---My doctor gets a takes vacation or two every year. I'm not sure that is possible in a small (especially single person) practice. He also seems to have "hours" that are fairly well defined for him, you know so he actually gets to go home and see his family. Really, I do not want a doctor who is a worn out dishrag, unable to think clearly or have patience with me.

For optometry and glasses, I don't know if it is a matter of [bad] luck or just that you get what you pay for, but by far my best exams and best glasses have come from independent shops with one or two doctors, shops that also dispense the glasses. Well, actually the very inexpensive optometry school was also excellent. It was the chain places where I've had terrible exams and goofed up glasses.

[disneysteve]

This may sound like a little thing, but I have always found my doctor's staff to be polite and seem to do their job well. These days, neither of those is a given, so someone in that practice is good at hiring. The staff also stays for years and years, so it must be a decent place to work. I like knowing that, for sure.

I don't think this is a little thing at all. Surveys show that most patients who switch doctors do so because of issues with the staff, not with the doctor himself. It is not the doctor who schedules your appointments. It is not the doctor who handles billing and insurance issues. It is not the doctor who triages your phone calls and decides when you need to be seen. It is the staff. A lousy staff can sink the best of physicians.

For the record, I've been in my current practice for over 9 years. Three of the four staff members have been there for several years longer than me, so I know exactly what you're talking about.

[GREENBACK]

Joan

Your post speaks loudly to the point of my thread. I really don't want to have to "try doctors on for size" until I find one that fits. Your life or the lives of your family could be potentially on the line while you're doctor shopping. Maybe other insurance providers have a way to at least guide you toward better doctors or maybe those that most suit your needs. I live in a fairly small community and I still came up with a list of like 30 different doctors! I can't imagine what that list would look like in N.Y. or L.A..


I just wish there were a way to seperate the wheat from the chaff( and not just with doctors). The process of looking for doctors, lawyers, etc. somewhat reminds me of a person trying to select funds within a 401k except that there are ways to judge the performance in that case.

[graceful]

I guess for us, it has always been referrals and the luck of the draw.

A girlfriend that worked as a nurse at NYU medical center referred me to my first and current OB-GYN back when I was in college. She said the nurses in the maternity ward raved about this doctor. I, in turn, brought my Mom to see her years ago when she was having "problems." She had not seen a "woman doctor" for years - ever since the doctor that delivered me retired. This OB-GYN is wonderful and I wouldn't see any one else. She does have a private practice which has it's disadvantages but it is worth it for my comfort level.

When my DH worked at a major university, he had to chose a primary doctor "out of a hat" that participated in his insurance plan. He asked around and just "picked one" sight unseen. It was a doctor in the university hospital system. He didn't have the best "bedside" manner but he was sharp as a tack and asked the right questions when DH went to see him.

Turns out this doctor specializes in geriatrics. So, when my Dad and then Mom and then I needed a new doctor, we all went to him. And he has taken excellent care of our family, especially my parents. He has a PA we like and we get along with his office staff which is EXTREMELY important in terms of billing and getting an appointment.

When it was time to choose a pediatrician, I choose one that was affiliated with the university hospital also - they have a famed children's hospital - and that practiced near our home.

Things I liked - he was 5 minutes from us, worked out of his home, was available for phone consultations, still taught at the university hospital, could get a same day appointment and NEVER had to wait more than 3 minutes.

Things that I didn't like but was willing to compromise on - he's not a hand holder, appointments are in and out (measure, shot, see you next month), didn't see him crack a smile for the first 3 years (lol), sterile offices out of the 1950's and private practice doctor not available during all Jewish holidays (another doctor near the hospital covers for him during the holidays).

My kids always seem to pick the Jewish holidays to get sick. DD10 had the coup when she was about 10 months old and had to take her to see the doctor on call. Waiting room full of sick kids - would have gotten sick if she wasn't sick already and was just there for a check up. They did fast track us because of the severity of her illness and to clear the waiting room of the sickest kids. But it was still a half hour wait. WONDERFUL pediatrician - was wonderful with the child and the parents - took the time to explain things to us that we didn't even think to ask.

Regardless of this wonderful experience with this doctor, we decided the advantages of our current pediatrician outweighs the disadvantages. After 2 kids and 10 years later, he is like a member of our family. (Well not really but we are on the same page regarding my kids' health)

I have neighbors that ask me for referrals and while I give them his name, I point out all the disadvantages and let them know if you need a doctor to reassure you and hold your hand about everything, he is not the one for you. If you need a doctor for immunization shots, quick and convenient appointments, being able to bring the child in immediately when they are sick, then he is one to consider.

[snafu]

Each time we've moved to a different city, I've called the College of Physicians & Surgeons to ask for their listing of newly certified GPs in my district. They may not have much experience but they know the latest techniques and have new equipment. If their support staff is unpleasant, I can tell the Dr. the individual would be helped by training in customer service. I've always trusted the GP for referrals to specialists.

Our last realtor was recommended by the folks who bought our previous home in another city. I've used the lawyer recommended by that realtor to buy property and used the lawyer at the mall to review our wills which we created from a kit. Our accountant was referred by a friend and is also a member of a service club we belong to. The vet was suggested by the Animal Shelter who sold us our puppy but the location was inconvenient and there is a less pricey clinic nearby. Our excellent dentist recently retired so we will need to get a referral. I wish they had a' meet the guy I sold the practice to' coffee party. We have no information about him and he has all our records.

[disneysteve]

Maybe other insurance providers have a way to at least guide you toward better doctors

You'll save yourself a lot of headaches if you accept the fact that this is an impossible task. Unless you are talking about getting treated for some rare disease managed by only a handful of sub-specialists in the country, there isn't anyone who can tell you which doctor is best suited for you. That would be like there being a list somewhere of women who were best suited to be my wife. There are far too many variables and subjective and personality issues involved in choosing a doctor. It is very much a personal decision.

You should start with the list of doctors who accept your insurance.
Cross out the ones who aren't conveniently located for you.
If you have a preference of male or female, cross out the ones of the non-preferred gender.
Decide if you prefer a big group or a smaller practice and eliminate the ones that don't match your preference.
If you prefer a certain hospital, eliminate docs who don't work out of that hospital.
Then call and ask about office hours and eliminate ones whose schedules don't align with yours.
Once you are down to a smaller number, start asking around. Co-workers who have the same insurance are a good place to start.
As I suggested earlier, do an informal office visit. Stop in, introduce yourself, let the front desk staff know you are looking for a new doctor and just wanted to see the office, ask about hours, hospital affiliation, etc. Ask how long it typically takes to get an appointment for a) a sick visit and b) a routine visit.
Ask about after-hours coverage. Does the doctor do it himself or share coverage with other doctors not in the practice.

Then make your decision from there. Ultimately, you won't know until you've met and spoken with the doctor and decide if you feel comfortable with that person.

[MonkeyMama]

This is where it is good to know people.

I've had some bad recommendations in the past (dentist for one - what a ripoff artist he was). If I think hard about it, the people that referred bad people were kind of flakey or not very price sensitive. I no longer take recommendations just from anyone.

BUT, you still get bad recommendations from good people once in a while...

The more people you know, the easier it is to find good people. Sometimes it is trial and error.

For doctors, I work with a lot of doctors so have asked recommendations for friends, etc. (Another - "it's who you know" answer).

For stuff around the house, I am actually putting some stuff off because don't know who to ask. Will probably ask neighbors; don't know them so well though. Kind of in wait and see mode.

[GREENBACK]

You'll save yourself a lot of headaches if you accept the fact that this is an impossible task.

DS, I completely agree with you about it being impossible. I'm not looking for a way to find the perfect doctor in the perfect place that's ideal for my particular situation. What I want is maybe a short synopsis of the doctor's (or any profession)educational background and his experience as well as comments from patients of his/her. If I owned a buisness and was capable of telling prospective customers about my accomplishments, education along with postive comments from my patients/clients/customers I would post that info all over the place.


It would be nice to be able to access this type of information without having to go to however many doctors or other professionals to find the "right" one. I would think this would be fairly doable in today's high tech communication world.

[disneysteve]

What I want is maybe a short synopsis of the doctor's (or any profession)educational background and his experience as well as comments from patients of his/her.

The first part of that shouldn't be too difficult. You may find that info at the insurance company website, the local medical society website or some independent website. Also, many doctors maintain their own websites where they detail their backgrounds and give info about their practices.

Experience is a very nebulous area. If I told you that I am board certified and have been in practice for 16 years, how would you compare that to a doctor down the road who is not board certified but has been in practice for 22 years and is the president of the medical staff at the community hospital? If doctor A was voted Best in Town by some local magazine, does that mean anything at all?

As for patient comments, those are totally worthless. Why? Who posts comments about customer service? Folks who are unhappy with the service. Folks who are pleased and satisfied don't feel the need to go online and share their satisfaction. Folks who had a bad experience and want revenge post reviews to spread the word.

[Joan.of.the.Arch]

RedThunderBird, there have existed for years now a variety of internet sites for rating doctors and other professionals, too. I do not really recommend those sites, but here is one you might look at. RateMDs.com | Doctor ratings and reviews See if a doctor you know of has a rating there. Mine has been listed there for years, but has no ratings.

[disneysteve]

RateMDs.com | Doctor ratings and reviews See if a doctor you know of has a rating there. Mine has been listed there for years, but has no ratings.

I'm not listed. I wonder how they decide who to list.

[disneysteve]

UCompareHealthCare - Find Information on Doctors, Hospitals and Nursing Homes

I did find myself at this site. It lists my name, office address (with map), my specialty and med school and graduation year.