This section contains an abridged version of the article, "Patient Rights and Your Physician", written by the late Catherine Bontke, M.D.; a woman with a disability who was the medical director of the Rehabilitation Hospital of Connecticut in Hartford. The article appeared in the Fall 1994 issue of the journal ABLED, and was condensed and reprinted with permission from ABLED.
How Do You Find a Good Physician?
None of us would ever consider giving total control of our life savings over to a complete stranger. Yet this is how most of us choose our physicians and entrust them with the future well being of our bodies. We permit doctors to make decisions about the most important aspect of our life, our health, and more often than not, we do not know a thing about their medical acumen. In no other profession is authority and the power of decision-making given to one individual so completely and without question. So how do you choose the right doctor?
When consumers begin to look for a doctor, they desire someone who is nice to them and will have readily available appointment space, but they know virtually nothing about how he or she practices medicine. Affability and availability are qualities that are important in choosing a doctor; however, they should not come at the expense of good medical skills. Other factors to take into account in determining who is a good doctor are accreditation, credentials, and affiliation.
Age should not be a primary motivating factor in your decision-making process. People often mistakenly believe that the physician who has been in practice for many, many years is the best qualified by the very fact he or she has been in the business for so long. Nothing could be further from the truth. You do not want to eliminate a physician solely based upon his or her age; however, after 50 years of age, most doctors have a tendency to be less medically current. Everyone has a point of "letting things slide" a bit more. If you have a major health problem, the physicians that you want to see are usually between the ages of 30 and 45. Those physicians are more likely to be well read on the current medical literature.
Accreditation is very important! "Board-certified physician" means that the physician has passed a special set of rigorous tests from his or her peers that proves he or she has at least a fundamental knowledge of the subject. There are a number of certifying organizations nationwide that require physicians to take their boards every ten years. Consequently, the boards are recognizing the need for physicians to be recertified every ten years. There are also certain states, like California for example, which require physicians to take a specified amount of continuing medical education courses. "Board-eligible" are very young doctors who have to wait a certain amount of time in order to take their oral examinations. They are usually just as qualified as "board-certified"; however, the consumer should be aware of their status.
You want to know where doctors go when they say they have privileges at every hospital in the city. You need to find out which hospitals he or she specifically goes to. More often than not, each physician will go to one primary hospital. You, in turn, can judge the quality of that hospital by its affiliations as well. Affiliation with a medical school usually means that the hospital is used as a primary teaching facility. It can be annoying being at such a facility, however, because you have to deal with residents, interns, and medical students, but you will most likely get the best possible care. Another factor that should be investigated is whether the facility is staffed by physicians 24 hours a day. In other words, if you need your physician, but he or she is unavailable, there should be physicians or resident physicians on duty all day and night.
If you have difficulty getting onto the exam table, you may want to find a doctor who has an accessible exam table in his or her clinic. There are more than 200 accessible elevating exam tables with handrails in this country.
One of the suggestions made in the book Finding the Best Doctor is to call the teaching hospital and ask to speak to the chief resident of medicine and ask, "Who is the best internist in town?" He or she will know. Or you could call the operating room (OR) nurses and ask who's the best surgeon in town. They will know. Never be afraid to ask. Most physicians and other health care professionals love to talk about their field and themselves. It's merely a matter of asking.
You need to like and be comfortable with your doctor. Everyone needs a primary care provider who oversees all aspects of his/her health care. Your rehabilitation doctor, physicist, or neurologist will be able to manage a portion of your health care, but not the complete picture. Specialization is not the decisive factor. That is, internists and family practitioners are probably your best choice if they are board-certified. This means they are comprehensive doctors who will direct things for you and make referrals for you to specialists when necessary.
You should not see your physician for the first time when you are feeling sick. The worst time in the world to see a new doctor is when you are ill. Your ability to think clearly and rationally is definitely impaired. Therefore, if you are ill, you may find it helpful to have a health advocate (i.e., loved one, friend, neighbor) with you during the visit.