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Archive for Saturday, January 10, 2009

How to choose a doctor

There are thousands; which one is right for you?

Dr. Sherri Vaughn, check the ears of 8-month-old Madison Culbertson at Vaughn's office at Mount Oread Family Practice, 3510 Clinton Parkway, Thursday, Jan. 8, 2009. In choosing a family doctor Vaughn recommends asking co-workers, neighbors and friends.

Dr. Sherri Vaughn, check the ears of 8-month-old Madison Culbertson at Vaughn's office at Mount Oread Family Practice, 3510 Clinton Parkway, Thursday, Jan. 8, 2009. In choosing a family doctor Vaughn recommends asking co-workers, neighbors and friends.

January 10, 2009

Editor’s Note: This is the first in a two-part series on doctors. Next week: How to communicate.

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Quick checklist for picking a physician

According to the Agency for Healthcare Research and Quality, consumers should look for a doctor who:

• Is rated to give quality care.

• Has the training and background to meet your needs.

• Takes steps to prevent illness — for example, talks to you about quitting smoking.

• Has privileges at the hospital of your choice.

• Is part of your health plan unless you can afford to pay extra.

• Encourages you to ask questions.

• Listens.

• Explains things clearly.

• Treats you with respect.

To verify that the doctor has a Kansas license, visit docboard.org/ks/df/kssearch.htm.

Kansas Health Online — kansashealthonline.org — offers information, tools and links on various health topics. The site pulls information from reliable resources and is a collaboration of the Kansas Health Policy Authority, the State Library of Kansas and the Dykes Library at Kansas University Medical Center.

With 10,350 licensed doctors in Kansas, picking one can be a daunting task.

There are 2,618 doctors in the Douglas County area alone.

Even doctors struggle with choosing their personal doctor.

“It’s hard,” said Dr. Tom Marcellino, of Mount Oread Family Practice in Lawrence. He recently had to go through the process himself.

“We are in the same boat as everybody else,” he said. “There’s no real special treatment there.”

While there’s a lot of information on the Internet, Marcellino suggests finding a doctor the old-fashioned way: word of mouth.

Dr. Sherri Vaughn, vice president of medical affairs at Lawrence Memorial Hospital and one of Marcellino’s partners, agrees.

“I think that is one of the best ways because then somebody has had personal experience with that physician,” Vaughn said. She said many of her new patients come from referrals.

Corrie Edwards, executive director of the Kansas Health Consumer Coalition and a breast cancer survivor, said she also picks doctors and dentists by asking around. But she takes it a step further — something she suggests others do as well.

“People need to use, as with anything in life, a combination of things,” she said.

For example, she said, when buying a car, you might ask for a friend’s opinion, but you don’t go buy the car without some research on Consumer Reports or the car maker’s Web site. And, of course, you take it on a test drive.

What to look for

Kristi Pankratz, spokeswoman for the Kansas State Board of Healing Arts, which regulates physician licenses, said people need to shop around.

“It is important that you take a little time to do your own research and consider a number of factors such as whether or not they accept your health care. That’s a big one for a lot of people,” she said.

Pankratz cited a number of other things to consider, such as:

• Education and training. Is the doctor board-certified? Board certification is not required but indicates the doctor has gone through extra testing and evaluation with the American Board of Medical Specialties and the American Medical Association.

• Qualifications. What kind of doctor are you searching for? For example, parents may see a general practitioner but take their children to a pediatrician.

• Insurance. Before making an appointment, find out how much the doctor charges for office visits and whether he or she accepts your health insurance plan. Also, be sure to ask whether the doctor’s office will process your claims.

• Convenience. Getting to appointments on time is usually easier if the doctor is closer to home or work.

• Hospitals. Some health issues may require hospitalization. Find out at which hospital your doctor may have practicing privileges.

• Lab work. Does the doctor do his or her own tests? Is there a lab in the same complex, or do you have to go to another location?

• Coverage. Ask whom you will see if your doctor is unavailable.

• Office hours. When does the doctor see patients, and how can you contact the doctor in an after-hours emergency?

• Disciplinary action. Has the doctor faced any disciplinary action by licensing boards? You can verify Kansas licenses at docboard.org/ks/df/kssearch.htm or visit the Board of Healing Arts’ Web site at ksbha.org and select “Board Actions.” People also can contact the Board of Healing Arts at (785) 296-7413.

Web site dilemma

While they consider the Kansas State Board of Healing Arts’ Web site to be reliable, doctors warn that some sites are not.

Vaughn looked herself up on the Internet, and one Web site reported she was located in Baldwin City, but she’s never practiced there.

“Some of that information is inaccurate, and there’s no way to tell which is reliable and which is not,” she said.

Marcellino said he wasn’t even listed on some health professional Web sites. He also warns consumers to be cautious when reading information on Web sites such as HealthGrades because it can be misleading.

“They may be the best doctor, but because they are seeing the most complicated patients they have worse outcomes,” he said. “You have to take those health grades with a grain of salt and realize they may not be fairly accurate.”

To help Kansans navigate the Web, the Kansas Health Policy Authority, the State Library of Kansas and the Dykes Library at Kansas University Medical Center have teamed up to provide a new Web site: kansashealthonline.org. The site offers information, tools and links on topics such as finding doctors and comparing hospitals. Karen Cole, director of Dykes Library, said medical librarians are involved in the content selection and development to ensure reliability and relevance to Kansans.

The site was launched one year ago, but will be updated with better searching and display capabilities on Jan. 29.

Cole said the goal is to provide “reliable and accurate health information” for all Kansans.

To enhance the Web site, Kansas Health Online and the Kansas Health Consumer Coalition met with focus groups, with about 350 people, across the state from July to December to see how they picked their health care providers and what information they needed.

Among the things they found: Urban and rural populations mostly use word of mouth and the Internet to find doctors, and Kansans are receptive to doctors who pursue continuing education and who are open to cutting-edge medicine or alternative treatment.

Kansans also said they look for numerous characteristics when seeking a doctor, including a good temperament and bedside manner. Those two are biggies and play an important role in getting appropriate care.

Personality match

Marcellino said patients should look for a doctor who is good at communicating and listening.

“I think a lot of doctors just say, ‘Here’s this medicine. Take this,’ ” he said.

If that’s what a patient wants, that’s OK, he said. But a patient might want a better explanation. The doctor should take time to explain the disease, what caused the disease, what to expect from the disease and how to treat it.

He suggested that patients come with a list of questions for their doctor, especially during the first visit.

“It’s important for patients to tell the doctor what they are looking for and what they want,” he said. “A lot of times patients go there and they are expecting that they are going to get this or that and then go to several visits and find out the doctor can’t help them. So, if a patient wants something in particular, then I think it’s important for them to ask up front.”

Marcellino also suggested giving the doctor at least two visits.

“During the first visit, if you don’t think you like a doctor, I would say give them a second visit because everyone has a bad day, and I think they deserve another chance,” he said.

And if you don’t like a specialist to whom the primary doctor has provided a referral, speak up and get another referral.

Edwards said consumers shouldn’t hesitate to change doctors if they are not satisfied.

“Use your instincts and your gut feeling,” she said. “You are your best judge for what you need to have done. If you are not feeling like this is working, you jump ship, because you are the only one who knows. You are your own advocate.”

Comments

ridinthefence 5 years, 10 months ago

Yes it is a problem. In Lawrence be prepared to wait for an hour, then when you get in the room another half hour, then when the doctor finally comes in they are forever in a hurry because, you know, they are behind because they had to squeeze in the kid with the fever, so he/she wont look at you just your chart because we need to get through this and fast because they are already thinking about the next patient who has waited an hour and a half. Ya I love going to doctors. Oh and always loved the pediatrician visits where they have toys there for your kids to play with so they can pick up whatever virus they dont have so you can make another visit next week.

Ryan Neuhofel 5 years, 10 months ago

In traditional (insurance-driven) practices, primary care doctors are required to see in increasing number of patients just to maintain the same salary - now 40+ patients per day with a patient census of 3000+. As long as third-parties (insurance entities: public or private) dictate every aspect of health care, quality will suffer while prices escalate. Direct-medical practice (insurance free) is the only way to return to a patient-centered approach to medicine; costs would be dramatically reduced and quality vastly improved. This is a viable model for all of outpatient primary care and many specialties. Patients and doctors must take the power back!

Tandava 5 years, 10 months ago

In choosing a doctor, one should definitely find out what it takes to finally get in to see him or her. Most doctors obviously think their time is far more valuable than yours.At the Reed Medical Group, the docs are all surrounded by many administrative layers, and you have to go through all of them before you finally get in to see the doc. It's ridiculous.At The Internal Medicine Group, 4525 West 6th, you will wait in the waiting room for an hour or more. You have to sign in with the same pen that everyone else has signed in with, including all the sick people. Bring your own pen! Meanwhile, you are stuck in the waiting room with people coughing and sneezing, exposing you to all their germs. Plus, the doctors there are no better than doctors anywhere else. The wait at Mount Oread family Practice is short. They usually get you in in 15 minutes or less. Sometimes it is only 5 minutes.

1wetwilly 5 years, 10 months ago

How about turning the question around.Q.) How do doctors choose patients?A.) First, immediately eliminate patients that don't have insurance. Let those worthless rogues die. Second, prioritize patients based on the highest possible insurance reimbursement. Third, select those patients that you can issue a presciption drug from a pharmeucitical company that gives you free gifts, club memberships, trips and vacations for pushing their products. Finally, don't see patients with anything too serious as they may delay your tee time.

BuffyloGal 5 years, 10 months ago

Log onto the BCBS website. Find doctor closest to you. Call and make appointment. This illusion of choice is charming! But using this method, I found a good enough doctor and I never have to wait more than ten minutes when I go in.

brookcreeker 5 years, 10 months ago

I've always had great (and timely) service and Internal Medicine Group and I like that they can do lab and x-rays in house. Sigler Pharmacy shares the same bldg so it's one-stop shopping.

Ryan Neuhofel 5 years, 10 months ago

Starlight, that textbook chapter brings up some important aspects of health care economics, but the larger problem is that we (health care professionals and patients) pretend that economics do not (or should not) determine health care delivery. The text mentions that doctors are the true "spenders" (and determine cost) of medical care, which I would challenge is not true in our third-party ran system - most physicians could not tell you the "true cost" of almost any service they provide or medicine they prescribe. And with a system that doctors or patients are clueless about the true costs, it is no wonder that inefficiencies abound and costs are sky-high.

mom_of_three 5 years, 10 months ago

There are a couple of offices in Lawrence where your wait is short. The wait in the Mt. Oread Family practice is very short, as in Lawrence Family Practice. After years of waiting hours in a pediatrician's office, it was very refreshing to spend less time waiting than the length of the actual doctor's visit.

tangential_reasoners_anonymous 5 years, 10 months ago

For me,it's pretty much how many feathers can be tethered to the end of a stick.

Sigmund 5 years, 10 months ago

Do what I do, ask a couple of local medical malpractice attorneys. A good malpractice attorney will steer you away from bad practitioners and a bad attorney will steer you towards the same people. Either way you have a list of docs to avoid.

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