Doctor, doctor...how do I choose?

July 27, 2007 10:26 PM

How do I choose a primary care physician?

For the first time in a decade, I have good health insurance (I'm in the US), and at age 41 it's time to take advantage of it and have all that unpleasant probing done that I've been putting off for far too long. I've googled extensively, I've contacted my insurance carrier for a list of approved providers, and I live in a city with a world-class medical center. So I should be set, right? But just picking a name at random from the list doesn't seem like the best way to go about it. I know there are sites that purport to give doctor ratings, for a fee. Has anyone used them, and are they worth it? I want a doc for more than a check-up: I want to find a genuine health-care provider who'll be my doctor for the next thirty years. Is that even possible these days? How'd you pick your doctor, what questions did you ask them, and what were your criteria? (If it matters, I'm a lifelong heavy smoker who'd like to quit, a moderate drinker, and I've never been seriously ill or even hospitalized, except for breaking my jaw in a bicycle wreck as a teenager.)

posted by BitterOldPunk to health & fitness (12 answers total)

First AskMe of the day! W00t!

I should add that I've asked for recommendations from my friends, and they either go to a doc-in-the-box for severed fingers and such or are as white-coat-averse as I have been, so they're no help.
posted by BitterOldPunk at 10:32 PM on July 27, 2007

I asked people I knew well at work who they went to. I also asked them why they liked them, what they didn't like, what was the staff like, etc., so that I could figure out if the things they liked were things that I would like or value. I also asked about the hours, how long a wait, etc. Then I just chose one of them. As it turned out, I couldn't get the first two choices, so I went to someone else in the same practice. She doesn't have the bedside manner that the others do (and which I value) but she's a good doctor.
posted by la petite marie at 10:39 PM on July 27, 2007

Also, I think I've seen people on here ask for recommendations for doctors in a certain area.

There's also www.ratemds.com, where people have put in ratings and reviews of certain doctors. I also found www.vimo.com (you click on the right to research doctors). Good luck!
posted by la petite marie at 10:47 PM on July 27, 2007

Read this interview of 5 physicians. There's a wealth of great information in there.

Realize that at the fuzzy end of things, doctors like any other professional fall along a bell curve. The vast majority are technically competent, some are exceptionally great, and some exceptionally bad. The latter are usually scammers so I wouldn't worry too much about that end of the spectrum. Since you have access to physicians at a world class medical center, you should only worry about finding a physician that you have a good rapport with. You should feel comfortable enough to share any medical and non-medical concerns and you want them to take an interest in your well-being. Think about if you came to this physician with an uneasy stomach if s/he would simply ask if you ate shellfish the night before or also ask if there were any changes in your life in the last few weeks.

Feel free to set up appointments with a few physicians based on recommendations from friends and your gut feeling. Towards the end, ask them what they think about the other physicians on your list. You should be able to separate the honest thumbs-up from the "yeah, he's a good doc" and "i've heard about him." Get a doctor around your age range and stay away from the ones engaged in major research - they're smart but unfortunately they don't make for good listeners.

Good luck!
posted by junesix at 11:58 PM on July 27, 2007 [1 favorite]

I picked my doctor somewhat randomly. I got the best doctor in the world. I mainly picked on close to my house, affiliation with the hospital near my house (this is important, because not all doctors work with all hospitals.) I basically gave him a first chance to make a good impression, and he did ... so I filed him as my PCP. Otherwise, I might've searched out another doctor.
posted by SpecialK at 12:01 AM on July 28, 2007

I picked a doctor that was nearby in a small health center. I also picked because I thought that Terry was a girl but I was surprised to learn that was not the case! The good news is that my particular health insurance means that even though I had to pick a PCP, I can see any of the docs in the small health center and it's covered which has actually been great because I have more doc options and my doc is good for some things and not as good at others.

In short, if you pick wrong you're stuck for, at most a year until you can pick again, so look into the other things that people suggest, but don't get terribly hung up on it. Ultimately you'll want to get a great doc that can help you quit smoking and start caring about your health some, but it's okay to spend a little bit of time fishing around for that perfect person.
posted by jessamyn at 12:39 AM on July 28, 2007

Last time I did this, I looked for internists on my insurer's list that were somewhat nearby, and then started with the ones who attended the most prominent schools. If I had had a personal recommendation, I would have gone with that... but I didn't.

Feel free to set up appointments with a few physicians based on recommendations from friends and your gut feeling. Towards the end, ask them what they think about the other physicians on your list.

I'm not sure how well that would go over, honestly.
posted by grouse at 4:34 AM on July 28, 2007

1) Ideally, find a primary-care doctor that is part of a group practice that is closely affiliated with the world-class medical center; there's usually one or more that carries the medical center's brand name. (Depending on the state, the group may or may not actually be owned/managed by the medical center.) These doctors will be most familiar with the specialists at the center, and your records will generally be accessible throughout the system, saving time, money (maybe for your insurance company, but still), and aggrivation.

2) If it's difficult to find a doctor who accepts new patients in your area (as it often is), try to find a doctor who is new to the area. Yes, it's a crap shoot, but if a doc who has been with the practice for a while and has room for new patients, well, there's probably a reason.

3) Be prepared for the PCP to ask you what kind of approach you prefer during your first appointment. My PCP knows that I'm a numbers-and-logic guy so she puts everything in terms of probabilities; that's not the approach she takes with everyone.
posted by backupjesus at 6:02 AM on July 28, 2007 [1 favorite]

I used a lot of the same criteria to pick my family physician here in Toronto, but one additional factor I looked at was age. I wanted someone who had qualified as a family physician for at least a couple of years, but my somewhat arbitrary cut-off point for age was about 40 years old. I wanted to choose a good doctor I was comfortable with who wouldn't retire for 20 years or so. There are no guarantees with this method, of course. I have lost one FP who simply walked away from her practice one weekend, and lost another, a really nice man, when he died suddenly in a car accident this year.

There's a lot to be said for a doctor you can stay with for years. My younger sister has been seeing the same FP since 1975, and he knows her and her health history thoroughly, giving her excellent care and clearing the path to specialists countless times.
posted by maudlin at 7:26 AM on July 28, 2007

• choose a doctor close to where live, within walking distance if possible.
• choose a doctor affiliated with your favorite local hospital, so that's where you get admitted if you need to be hospitalized.
• visit the office and make sure you like how it feels. Is it hectic, busy, messy, friendly? You can actually tell a lot from that.
• some doctors will speak with you for a few minutes about their approach &etc before you become their patient. I avoided an incompatible doc once by doing this.

posted by alms at 8:05 AM on July 28, 2007

Here's the advice I was given by my mom, who is a physician herself:

1. About 10 years out of medical school. That way they're current, and experienced as well.

2. Specialized in internal medicine (an internist). Preferably with board certifications in that and other useful specialities.

3. Graduated from a reputable school, if that kind of things matters to you.

And where to get this information? My insurance provider's (Aetna) website had all of it on one easy-to-search database. I imagine you could call and ask too. I'm wary of rate-my-MD sites, just owing to the vagaries of review sites in general.

Of course, the really good ones have a hell of a wait time for a new patient appointment, so start calling now.
posted by Mercaptan at 9:31 AM on July 28, 2007 [2 favorites]

I forgot one of the best ways of all: ask a nurse. They know not only which ones are the most technically competent, but they can tell you what kind of personality they have. They can also tell you who they've chosen to go to based on the above. I've done this in the past and it has never failed to be an excellent way to find someone good.
posted by la petite marie at 10:48 AM on July 28, 2007