S/O Finding a doctor

[creekland]

I was reading through that reporting a doctor thread and it took a different turn in my mind...

 

How do you go about finding a doctor?

 

When we were young we were dragged taken to the neighborhood guy pretty much everyone went to (very rural area), but only when we needed something (shots, patching up).  It was first come, first seen.  I don't recall annual appts.

 

In my older life I suppose I've continued along that line.  When pregnant I asked my friends who they went to when having their kids and found my OB/GYN who I really liked.  Once my kids were born I asked my friends who they took them to and found our pediatrician - no problems.  Once they got older, we kind of quit doing the annual stuff and they only go to the local family doctor now when they have needs of some sort.  Hubby and I rarely go anywhere at all, and again, only when we have needs (tick bites, update vaccs, etc).

 

When youngest developed epilepsy we were told (from the ER) to visit our family doctor, so took him in only to be told "it's beyond my scope, go see the neurologist," and, of course, handed a bill for that advice.  What, exactly, was the point of the FD visit?  So again, that sort of reinforces my "needs only" upbringing.

 

How common - or rare - is this?

 

And for those of you who visit a doctor on a more regular basis - how do you find someone?  When I do my "asking around" here I rarely find someone who likes who they see - and if they do - it tends to be a specialist (cardiologist, cancer, etc), not a GP.  Otherwise, I mostly hear complaints - not terribly encouraging.  And is there a point to having a family doctor (if healthy) other than being sure "basics" are ok?

 

If I look on google I see lists of various doctors (GPs or specialists), but so few ratings they are generally meaningless whether good or bad.

 

I guess I still see "medical" life as more of a "needs only" sort of thing, but it has been something I've been pondering a bit more lately.

[Loowit]

My doctor is the same doctor I saw as a child.  Well actually it is the same clinic, the doctor I saw retired long ago.  It is a family medical practice.  When I moved out of the area for a while I looked up providers that my insurance covered and pick the one closest to me.  It worked out pretty well.  I did have a doctor I saw once who I didn't like so I changed.

 

My children go to a local pediatric clinic.  I picked it for two reasons.  One, my best friend recommended it as it is where she went as a child and loved it.  Second, the only other pediatric clinic in town was one my sister went to and had several problems with doctors and nurses.  All of the other doctors my children have seen were referrals from their pediatrician.  I have asked for referrals for a second opinion when I didn't like the first specialist we saw.  That has only happened twice though.

[Mergath]

Before we had a regular doctor, we went to a few until we found one we really liked, and then made him our official family doctor.  If we need to see a specialist, we ask him for a referral because he gives great advice and we trust him completely.

 

I've also found that the best doctors in a given clinic always have the longest wait to get in, and the really poor ones can usually see you the same day, so you could always call and ask which doctor has the longest wait for an appointment and start from there. ;)

[umsami]

I hate finding doctors. We've moved almost every 2 years for the past 10 years so I've faced it way too much.

 

In general, I:

1) Used to post on a parenting board called Mothering in their finding your tribe area for a suggestion. I was not as crunchy as some of the Mamas, but I did get wonderful recommendations for a midwife and OB.  I don't post there anymore, so I tend to skip this part.

 

2) Google for names…and also use my insurance company's find a provider tool

 

3) Take those names to Vitals.com  I tend to ignore the negative reviews (well, see if the positives balances them out), but try to find a doctor with at least 5 positive reviews.  It's pretty easy for somebody to be upset and write a negative review…I think it takes more motivation to write a positive one.

 

 

And then given that, I also look at drive times, etc.  In general, I'm not willing to drive more than 30-40 minutes.  When we lived in Brooklyn, I preferred walking distance and then a direct subway route.

[Butter]

The one we had in MD - and loved so much - was actually in the military when Jamie's dad retired to MD and since his dad was retired Navy, it happened that that doctor was the one he was assigned to on base.  Later the doctor retired from the military and opened his own practice and so Jamie's parents, my parents, and our family all were seeing him in his private practice by 1999.  So for my family it was word of mouth and for Jamie's family it was by assignment.

 

Here in TX, it's been a mix.  Jamie's co-worker's wife works for the doctor Jamie, Ani, and I see so the co-worker recommended him (he doesn't see kids under 12 and Cameron was under 12 when we moved here).  That doctor referred Ani to a pediatric neurologist for her migraines.

 

For the boys' pediatrician, I just did a search for in network providers on our insurance website and went with the closest one.  We're very happy with them and practically everyone we know with kids see them.  They have a bazillion doctors, but you can request the same one every time and rarely see someone else (usually only if someone is sick on a day off for the doctor).

 

I did the same search and pick the closest for our dentist (and the kids' orthodontist is in the same practice).

[happypamama]

Well, Creekland, I would highly recommend my family doctor to you; feel free to PM me. :)

 

I found our group practice by seeing who my insurance company covered that was close to me. I didn't love the first doctor (a guy) that I saw there, but he did the job (prescribing my asthma inhaler, I think; it's straightforward and easy enough to do). but then I saw that they were adding a new female doctor to their group (which has several docs and an NP), and since we were looking for someone to care for our children anyway, including an impending newborn, I signed up to visit her myself. I liked her a lot and have been taking all of the children to see her for a couple of years now. I really like that she sees me as well as all of the children (DH is signed up to see one of the other male docs in the practice), and she's been great. I've had no problem getting referrals to specialists from her as needed, but she's not at all pushy and is happily comfortable with our slightly alternative lifestyle (nobody bats an eye at us homeschooling, for instance). I call for a well check when I need something; they can usually get us in within two weeks or sooner. The NP takes sick visits the same day or within a day or so, if the regular doc isn't available (and when I was pregnant and my asthma flared, my doc squeezed me in, at my request that she treat me, not the NP, because she'd treated my asthma before).

 

Otherwise, I ask friends who they use (one friend recommended the same practice, although she and her children see one of the other docs). I don't see an OB/GYN; I use midwives for pregnancy stuff, and my family doc does my well woman checks. MWs I found by looking to see who was in our area and then by interviewing them until I found one that clicked with me. I think you can make an appointment to interview a doctor to see if he/she is right for you. (I used my first appointment to get a feel for the doctor regarding my children; I would not have taken them to her if I hadn't liked her.) Specialists I have found through our family doctor; they take care of finding out who is on our insurance and set up the appointments. In one case, I absolutely adored the specialist and didn't hesitate to take a different child to that same specialist when he needed someone; our doctor happily wrote the referral for me when I asked.

 

I think it's not a bad idea to have a family doctor that you see at least every few years. If you're an established patient, you're protected in case they stop taking patients, but you develop a problem.

[Pawz4me]

One of my best friends has worked as a secretary/administrative assistant in medical offices around this area for many years.  She's always my starting source when I need to find a doctor.  She knows so many people who work behind the scenes in medicine in this area that she can always find me a good recommendation from someone who knows.  And my sister-in-law's sister is a nurse, so she's always a good source, too.

[snowbeltmom]

How common - or rare - is this?

 

And for those of you who visit a doctor on a more regular basis - how do you find someone?  When I do my "asking around" here I rarely find someone who likes who they see - and if they do - it tends to be a specialist (cardiologist, cancer, etc), not a GP.  Otherwise, I mostly hear complaints - not terribly encouraging.  And is there a point to having a family doctor (if healthy) other than being sure "basics" are ok?

 

If I look on google I see lists of various doctors (GPs or specialists), but so few ratings they are generally meaningless whether good or bad.

 

I guess I still see "medical" life as more of a "needs only" sort of thing, but it has been something I've been pondering a bit more lately.

 

Your experiences growing up were very similar to mine.  Up until this year, all of our doctors have been chosen based on "asking around."  That approach has worked well for us.  This year, my son needed surgery and "asking around" was not going to work since we did not know anyone that had had this particular problem.

 

I googled and found a list of "top ten" doctors who perform the surgery.  I then researched the five that were closest to us, with the closest being 4.5 hours away.  We ended up choosing the doctor 4.5 hours away.  While we were waiting, we struck up a conversation with another couple.  They had flown with their son from Florida to see this doctor and had also found the doctor through "googling" as well.

 

 

[creekland]

Well, Creekland, I would highly recommend my family doctor to you; feel free to PM me. :)

 

 

This conversation is partially coming off an at-work lunch room conversation too (not just that thread).  There are two main family practices around here that most use to some extent (us included).  No one (from the lunch table) thinks highly of them, but for just "general" or "basic" things (shots, colds/flu, ticks) it seems difficult to want to travel further as they can certainly handle those.

 

We also have Urgent Care clinics (as per that other thread) and it would seem that they can handle similar things too.  My youngest actually used them last year for ankle X-rays after he opted to run/jump down a set of stairs in gym class "because it's safer that way."  :glare:  Urgent care can handle stitches and similar things here too - even some pretty neat glue a science teacher had after cutting her finger last year.  It was a deep cut, but now you can't even tell it happened.  (We science folks like to watch some of those things in action... kind of morbid I guess, but we band together as nerds.)

 

Folks around here travel further for specialists (one pretty much has to) and they tend to like their specialists at least for cardiology and cancer.  Those usually do come as referrals.  I guess that's the norm - at least for rural areas.

 

Of course, then there are the stories that would rival the other thread and can involve specialists... kind of scary to think about - esp when one knows the people and knows the stories are true.

 

It all left me wondering how one goes about finding a "good" doctor.

 

Maybe we just need another topic for our lunch discussion tomorrow.  Or better yet, we need to hire a teacher whose other half has medical connections... :tongue_smilie:

 

[creekland]

Your experiences growing up were very similar to mine.  Up until this year, all of our doctors have been chosen based on "asking around."  That approach has worked well for us.  This year, my son needed surgery and "asking around" was not going to work since we did not know anyone that had had this particular problem.

 

I googled and found a list of "top ten" doctors who perform the surgery.  I then researched the five that were closest to us, with the closest being 4.5 hours away.  We ended up choosing the doctor 4.5 hours away.  While we were waiting, we struck up a conversation with another couple.  They had flown with their son from Florida to see this doctor and had also found the doctor through "googling" as well.

 

This would work well and is a great suggestion if one knew what a specific problem was - as you did.  I don't think it works so well at figuring out a problem if there is one though.

 

[happypamama]

I guess the question would be: what constitutes a "good" doctor? For me, that means that the doc is up on current recommendations (which ours seems to be -- I don't get conflicting advice about her re: the baby, for instance), a good bedside manner (check), she spots things that could be a problem and isn't afraid to admit when it's out of her league (my MW for DS3 heard a mild heart murmur at his newborn check; our doc listened, heard it, and decided that seeing a specialist was a good idea). I recently discussed with her when she thinks I should start diabetes testing; I am 37 and have a family history of it. I felt that her recommendation was reasonable -- aim for a generally lower-carb diet and start testing in a year. But I haven't seen anything major be missed as of yet, so I don't know. Maybe it depends on what you want the doc to do/be?

 

We've had good success with the urgent care clinics here a few times too, as well as, unfortunately, the ER (such as when DD got stung by a bee and swelled up -- we didn't mess around with urgent care then, straight to the ER), and I feel like we're in an area with a lot of choices in a short distance. But even our specialist visits have been relatively uncomplicated (ENT and allergist visits, an orthopedic consult for a minor issue, speech therapy, reading of my infant's EEG by the pediatric cardiologists), so it hasn't been a matter of looking for the absolute best. It could be (and likely is) that I've just been lucky enough thus far not to need anything too complicated, so what's here has been good enough. I know I am on FB boards with local moms, mostly of babies, but those sorts of things seem really helpful; I see people asking for recommendations for doctors, childcare, plumbers, whatever, and I'm not sure you're going to get better than that for run-of-the-mill stuff, kwim? There just don't seem to be boards like this one for finding doctors. ;)

[Catherine]

I'm full of opinions on this one : )

 

I found my PCP by looking at who was covered by my insurance locally and then I noticed one of them went to my medical school. I've only seen him a handful of times, fortunately, and he has been absolutely wonderful. All of my preventive care I get at my gyn, a CNP, though that will change in the next year or two. My method won't help most of you though. I think word of mouth is valuable, but I would also trust the recommendation of a doctor that you trust. So when my wonderful pediatrician retired, he recommended a couple of replacements. I saw one of them once, loved him, then he moved away and I gave up.

 

I want to address a part of what you've said here because I think it's important. A significant part of what PCPs do is preventive care. Since I was a PCP for 13 years, I have an opinion about this. Many, if not most, people do not see the value of preventive screening for cancer or other conditions. I found a part of my work involved informing people quickly and dispassionately about why I recommended mammograms, colonoscopies, paps, and vaccines. Some people availed themselves, some didn't. It's really not my business if my patient chooses not to avail themselves of preventive care. But it is unquestionably my job to ask, and educate. Since I am convinced of the benefit of these tests, I would consider myself negligent if I did not offer them. However, I've noted a distinct dislike\disapproval both here on this board (I'm not picking on you Creekland) and in RL, so I learned how to offer without passing judgement. Hopefully, any good PCP will also adhere to this doctrine of avoiding judgement.

 

The days of really excellent diagnosticians are waning, IMO. We rely so heavily on the results of "objective" tests that our clinical assessment counts for little in many people's minds. But I still personally believe that excellent diagnostic skills are the cornerstone of good medicine. Finding a good diagnostician is paramount, IMO, if one has a problem that is not already figured out. Specialists, I have had to learn again and again, generally lack this skill. I am not exaggerating in the least when I say that I have seen people die needlessly because of poor history-taking and examination skills. Conscientiousness is paramount and, IMO, may sometimes be in short supply.

 

So I just don't have a great idea at all of how to help you! Just FYI-I looked up 2 doctors on Vitals.com that I consider the pinnacle of good bedside manner, trustworthiness, and diagnostic skill. Neither had any reviews, and both had gross mistakes in their basic profile.

 

I only have one other thought. Ask around about who doctors see in your area. Ten to one you'll get a sense of consensus about it.

[creekland]

I only have one other thought. Ask around about who doctors see in your area. Ten to one you'll get a sense of consensus about it.

 

And this only works if one knows doctors IRL (at least, those who live close by).  We have all sorts of people in our inner circle (or acquaintances) through all socio-economic classes, but... not any doctors.  Maybe they have their own circle?

 

[creekland]

I guess the question would be: what constitutes a "good" doctor? ... Maybe it depends on what you want the doc to do/be?

 

 

You know, I'm not really sure I can answer that question.  I've had so little experience with anything in the medical field that it's difficult for me to come up with what I "want" to see.  I know I'd prefer someone others liked (since word of mouth worked in the past).  I know who I've seen (locally) I haven't been impressed with due to not remembering critical details, not giving much info and just assuming one ought to "jump" if told to "jump." That's really not my style.  I know I cringe at some of the horror stories I've been witness to (via word of mouth - I wasn't actually there - but I've no reason to doubt what happened as I do know those involved rather closely).

 

But what characteristics do I want?  Someone with intelligence, esp medically, more of a peer than a king/queen, and general characteristics of those I enjoy having as friends I guess.

 

I want to address a part of what you've said here because I think it's important. A significant part of what PCPs do is preventive care. Since I was a PCP for 13 years, I have an opinion about this. Many, if not most, people do not see the value of preventive screening for cancer or other conditions. I found a part of my work involved informing people quickly and dispassionately about why I recommended mammograms, colonoscopies, paps, and vaccines. Some people availed themselves, some didn't. It's really not my business if my patient chooses not to avail themselves of preventive care. But it is unquestionably my job to ask, and educate. Since I am convinced of the benefit of these tests, I would consider myself negligent if I did not offer them. However, I've noted a distinct dislike\disapproval both here on this board (I'm not picking on you Creekland) and in RL, so I learned how to offer without passing judgement. Hopefully, any good PCP will also adhere to this doctrine of avoiding judgement.

 

 

And I've been thinking more about this one too.  I've never been to any doctor (up until the last couple anyway) who hasn't chewed me (ditto for hubby) out for not aligning with the preventative way of thinking.  It's a big part of what has us only going when absolutely necessary, but we do see it as part of their job, so just complain about it to each other and go on with our lives, bracing ourselves if we need another visit - cancelling anything not needed (say, follow ups to things like pneumonia once one is better).

 

It all probably comes from going along with how things were as we grew up as I can't really put a finger on any other reason aside from the "not such a fun thing to do" and/or "stress" factor.  Considering I tend to chide many (at school) on sticking with doing things "the way they always have" without a respectable reason they hold themselves - usually thinking living "green" or "sustainable," but still the same idea - in the future I might have to give considerable thought to coming up with my own reason... (or changing my way of doing things away from "how they were always done").

 

But that's for future thought... For now... there is something that needs to be figured out and I sort of promised hubby I'd deal with it in June (after school is out).  I COULD wait until June and then make a decision on who to call/go with, then act surprised when it takes another month or two to get an appt... but I'd kind of be mad at him if he made the same promise to me and didn't follow through in a timely manner, so it seems a little unfair to do that.  Plus... it's getting to the point of bugging me enough to be a bother too, so is difficult not to think about.

 

So, I have about a week (+/-) to decide if I want to:

 

- Go to the local family doctor I've seen twice and not been impressed with and hope for something better this time (or a referral that turns out ok)

 

- Skip the family doctor and just pick a specialist at random who I'm fairly sure would be in the correct field for this issue - then hope for the best.  (Already tried the word of mouth deal and got nowhere due to no one needing this sort of specialist.  These specialists - according to the internet - don't need referrals and we're not tied to insurance requiring them.)

 

- Drive a bit of a distance away (over an hour) to change family doctors based upon word of mouth and hope for the best.

 

- Or something else I'm not thinking of?

 

It's not really a poll as my life definitely isn't a democracy up for voting, but this is a subject on my mind right now and the Hive has always been terrific for offering well thought out pros and cons to assist in contemplating things.

 

Any thoughts are welcome.  Finances/insurance are not an issue in the decision - other than we can't afford to fly somewhere exotic for this (which, if we could afford it, would likely be my first choice!).

[shanvan]

I'm full of opinions on this one : )

 

I found my PCP by looking at who was covered by my insurance locally and then I noticed one of them went to my medical school. I've only seen him a handful of times, fortunately, and he has been absolutely wonderful. All of my preventive care I get at my gyn, a CNP, though that will change in the next year or two. My method won't help most of you though. I think word of mouth is valuable, but I would also trust the recommendation of a doctor that you trust. So when my wonderful pediatrician retired, he recommended a couple of replacements. I saw one of them once, loved him, then he moved away and I gave up.

 

I want to address a part of what you've said here because I think it's important. A significant part of what PCPs do is preventive care. Since I was a PCP for 13 years, I have an opinion about this. Many, if not most, people do not see the value of preventive screening for cancer or other conditions. I found a part of my work involved informing people quickly and dispassionately about why I recommended mammograms, colonoscopies, paps, and vaccines. Some people availed themselves, some didn't. It's really not my business if my patient chooses not to avail themselves of preventive care. But it is unquestionably my job to ask, and educate. Since I am convinced of the benefit of these tests, I would consider myself negligent if I did not offer them. However, I've noted a distinct dislike\disapproval both here on this board (I'm not picking on you Creekland) and in RL, so I learned how to offer without passing judgement. Hopefully, any good PCP will also adhere to this doctrine of avoiding judgement.

 

The days of really excellent diagnosticians are waning, IMO. We rely so heavily on the results of "objective" tests that our clinical assessment counts for little in many people's minds. But I still personally believe that excellent diagnostic skills are the cornerstone of good medicine. Finding a good diagnostician is paramount, IMO, if one has a problem that is not already figured out. Specialists, I have had to learn again and again, generally lack this skill. I am not exaggerating in the least when I say that I have seen people die needlessly because of poor history-taking and examination skills. Conscientiousness is paramount and, IMO, may sometimes be in short supply.

 

So I just don't have a great idea at all of how to help you! Just FYI-I looked up 2 doctors on Vitals.com that I consider the pinnacle of good bedside manner, trustworthiness, and diagnostic skill. Neither had any reviews, and both had gross mistakes in their basic profile.

 

I only have one other thought. Ask around about who doctors see in your area. Ten to one you'll get a sense of consensus about it.

You have mentioned several things I think count in the definition of a 'good' doctor.  Offering options, listening carefully to the patient, not passing judgement, and good diagnostic skills.  I finally found a doctor who fits that description.  I did find her by asking around.  Before I became her patient I went through 3 other doctors who were recommended to me.  Prior to that I had a falling out with my long time family doctor b/c he refused to listen to me and would not perform a simple test.  I was shocked by his arrogance.  Apparently he had me fooled all those years.  As long as I was a good little patient and did exactly as he said then things were fine.  One of the worst doctors I've ever seen was recommended to me by a fellow Christian.  He was a terrible communicator and a horrible listener.  He asked me something about hobbies or things I like to do and I said I was a baker.  HE thought I was telling him my profession and that I was becoming delusional.   :huh: He used Bible verses against his patients (if he thought they weren't the right type of Christian), prescribed all the latest drugs at the drop of a hat, and when his patients reported the terrible side effects they felt, he began suggesting they actually had mental problems.  The woman who recommended him is no longer a patient either.  My mother and my Dh wanted me to report him to someone, but he had me so upset I just wanted to get away and forget the whole thing.  

 

At any rate I finally found a great doctor who actually treats me like an individual.  My kids really like her too.  I switched the entire family to her practice about 6 years ago.  Initially I heard about her from an acquaintance, but I remember I looked her up online before I went to the office.  She is the one who helped me wean off the med the other doctor prescribed--and she has it in my chart that I am allergic to it and all of it's cousins.

[creekland]

 

At any rate I finally found a great doctor who actually treats me like an individual.  My kids really like her too.  I switched the entire family to her practice about 6 years ago.  Initially I heard about her from an acquaintance, but I remember I looked her up online before I went to the office.  She is the one who helped me wean off the med the other doctor prescribed--and she has it in my chart that I am allergic to it and all of it's cousins.

 

I'm beginning to think we should go back to our plan of living on the road after our youngest leaves for college.  One of the perks could then be easy access to good options for doctors via the Hive.  We'd just plan our road trips according to where we'd need to be and when.  ;)

 

We postponed our plan to live on the road until after we finish with college bills... so another 4 years minimum with more added if middle son heads to med school when he's done (as is his plan now).  Of course, if/when he finishes med school training then I could just check with him...  He's definitely one I would trust.

 

But in the meantime...

 

I guess there's always the run away from life and hide method.

 

[JFSinIL]

When we were about to be first-time parents, we looked up and then made appointments and interviewed three different doctors - the one we went with ended up our four kid's doctor for over 20 years!

 

We went with word-of-mouth to find our wonderful dentist.

 

Our kid's neuro back in the day - again, word of mouth.  Note - we were in a PPO and had a lot of choices.

 

Now, thanks to job-loss and Obama-care, our choices are limited.  But we still see who is in our plan, then do internet or word-of-mouth research as much as we can.

 

My one disabled son is on Medicaid now , and finding a decent primary-care doc has been hard, as so few take medicaid (and I don't blame them).  I found one guy who I hope to drop soon as I find someone better, but at least I got a referral from him to one of the best neuros in the state for my son's needs.  I am surprized the neuro takes Medicaid - but am glad he does.

 

[Catherine]

And this only works if one knows doctors IRL (at least, those who live close by).  We have all sorts of people in our inner circle (or acquaintances) through all socio-economic classes, but... not any doctors.  Maybe they have their own circle?

Maybe. None of my closest local friends are doctors. I just mean to ask the ones you know-like the one you saw already. Or the neurologist your son sees. Any nurses you know. Word of mouth is the best way, I agree, and I would add that finding someone who is in an a group practice that is salaried, rather than strictly fee for service, helps to guard against overuse of services and unneeded tests. Academic practices, large groups, etc. tend to be this way. So if you cannot find contacts in your community who are in the know, or someone good via word of mouth, another approach is to find the nearest academic medical center and look for their faculty practices, which often have satellite offices that might be closer to you. This is how my parents, in the sticks of upstate NY, found a gem of a hospital: Bassett Hospital, which is a satellite campus of Columbia University's medical school. 5 hours from NYC! They have gotten excellent care there.

[creekland]

I just mean to ask the ones you know-... Or the neurologist your son sees. 

 

Now that's an idea... youngest and hubby are going there today on a regularly scheduled appt.  I'm not with them since I'm at school (on break for a few more minutes), but I told him - if there's time - to ask...  Considering he's been more in favor of getting this looked into than I have been, I suspect he'll have time.  ;)

[Trish]

One of my best friends has worked as a secretary/administrative assistant in medical offices around this area for many years.  She's always my starting source when I need to find a doctor.  She knows so many people who work behind the scenes in medicine in this area that she can always find me a good recommendation from someone who knows.  And my sister-in-law's sister is a nurse, so she's always a good source, too.

 

I second this advice. The medical insiders know -- and if they don't have personal experience, they still get the inside word on who is good, and who isn't.

 

For example, where we live, there are a couple of guys my husband says are "terrible surgeons."

 

But, they still have plenty of patients! He won't send anybody to them, but still has to deal with them on a polite, professional basis of course.

 

Also a good doctor can sometimes save your life without you even being aware of it. I have seen/heard about this happening on a number of occasions, and it sort of fascinates me (in a creepy way, I guess) that the patient probably had no idea that their (bad or clueless doctor or nurse practitioner) had given an order, or advice, or a prescription that could easily have killed them if the next doctor down the line didn't catch it and give contrary orders.

 

Also, no big deal is made about this to the patient, which is why they oftentimes don't even know.

[G5052]

We ask around with both doctors we know and also nurses (always good for the "inside" view), but we also use the local magazines who do issues on "top doctors" and such.  Of course you have to still do your homework.

 

And we're not afraid to leave a doctor if we repeatedly get frustrated with them or their staff.  We had an internist that we loved, but his medical assistant and the office staff was a complete mess with lost test results, attitude, billing errors, etc. etc.  Whenever we brought up with him, he just shrugged.  So when his assistant made a potentially life-threatening error, we left and wrote him a letter.  We never heard back, but about a year later they really cleaned house and fixed the issues.  They even called me to invite us back.  By then we had a found another doctor who we liked, so we just stayed with her.

 

If you have a chronic condition or are about to have major surgery or significant treatment, I'd go see at least three specialists and pick the best one. Yes, it costs money, but a bad specialist can also damage you or even kill you.  If you're going to be spending a lot of time seeing them, you want someone you can work with and trust.  We also look at the hospital they're associated with.  Hospitals really vary in their rate of infection, specialities, billing department, etc. etc.

[Alice]

I'm a believer in preventative care. As a pediatrician, that's kind of our main focus. I feel like I've gotten up on that soapbox here several times in the past so I'm not going to do it again except to say that I think one of the reasons to establish a relationship with a doctor you trust is so that you can avoid this very situation: needing a specialist/physician and not having one. I go for regular yearly physicals, and partly it is so I have someone I can go to when I am sick who knows me. I see more and more people using Urgent Cares as their primary medical site and I think that leads to all sorts of problems. 

 

As to how to find someone, I think the best way is just to talk to your friends and other people you know. You can ask other doctors but unless you are asking for a specialist referral I think it's not that reliable. I get asked all the time if I know pediatricians in this area (by people who don't live close enough to go to the office where I work). I do know pediatricians but I know them socially. I don't really know what kind of doctors they are. They seem like nice people but it's not like I have any insight into what kind of  medical care they provide. I do know pediatric specialists because I refer to them all the time. I know which GI doc I'd never refer to and which Ophthalmologist I took my own kids to and which Infectious Disease doctor I call to consult just because he is absolutely brilliant. I also don't know adult doctors that well. I get asked that a lot too and unless I'm recommending one of my own docs I don't really know the best OB or the best internist. But I'm recommending them from my perspective as a patient, not a physician. 

I think ER docs are the exception, they tend to know everyone because they see who comes in to the ER and how it is handled. My sister-in-law is an ER doctor and she's the person I ask when I've needed a doctor for myself. That's probably also true of hospitalists now. And nurses are probably the absolutely best source. If you want to find an OB or pediatrician the absolutely best people to ask would be the Labor and Delivery or Post-Partum nurses. 

 

Magazines and lists like the top docs can be helpful, but are somewhat misleading. The way the one around here works is that doctors are asked who they would take a family member to. It's a bit of a cliquey way of making a list. So it skews towards bigger practices, those that are better known, and those that are less alternative/more conservative in approach. It also tends to bias against part-time doctors or those who aren't partners.  I'm in a group of 12 and only two docs in our practice every make the list. Those are the ones whose names are on the practice. Maybe the rest of us are truly not as good or maybe when other doctors are asked they say "oh, Joe Smith is good" meaning that Joe Smith's practice is good. The person who I think is the best doctor in our practice (not  me :)) is not on the list and probably never will be because she is part-time. It doesn't really matter except that people looking for physicians don't think about all that and want the "top doctor". 

 

I think Internet review sites are also a potential source of information but also have problems. Often there are only a few reviews per doctor but one bad review can make it seem like someone is much worse than they are. The reviews are anonymous and there is really no accountability or way for someone to answer a bad review. A practice or physician that has bad review after bad review should probably be avoided but someone who has only one or two bad reviews could be someone who has a disgruntled patient. 

 

The bigger question in my mind is what makes a good doctor. We all have styles and approaches and are going to naturally attract different patients. I tend to be more hands-off and tend to have patients want to see me who appreciate that. They want to have well baby care but they don't want me to tell them not to co-sleep or how to feed their baby. There are other patients who really want a physician who is much more prescriptive and who gives them more of a formula to follow. That's just not me. Even something like antibiotics can be tricky. I see patients who seem to be convinced they need antibiotics for things like colds and patients who are very reluctant to use antibiotics for an ear infection. Is a good doctor one who does what a patient wants? Maybe sometimes or even often but not always. 

 

Bad doctors are probably easier to define: don't listen to the patient, not willing to admit fault, not keeping up with what is new, not willing to learn new things, not open to other ideas, lazy, rude. But good doctors might seem good to one person and not so good to another. So I go back to what I said in the beginning, I think asking your friends, coworkers, others in the community who they like is probably the best way to find a doctor. When I do prenatal visits for people considering our office I really encourage them to see a few different people in the first few weeks and ultimately to pick the doctor in the practice that best matches their style/personality as a parent. 

 

[creekland]

As to how to find someone, I think the best way is just to talk to your friends and other people you know. You can ask other doctors but unless you are asking for a specialist referral I think it's not that reliable.

 

You were correct that asking youngest's neurologist didn't work...  According to hubby, it took a bit to come up with a name and, here at home as I'm googling it, it doesn't appear to be a good fit (kinda low ratings and for all the "wrong" reasons).

 

Asking friends/family/co-workers, etc, doesn't work in this case as none have any experience with the type of specialist I'm expecting to need.

 

Chances are, if I went to the local doc for a referral, it could end up with the same guy since it's the same overall medical group.

 

Rural options just aren't as plentiful as those who live nearer to civilization.

 

So... I'm highly leaning toward ignoring it for longer...for now at least.

 

Maybe taking a vacation elsewhere and working the medical stuff into it isn't such a bad idea.  That, however, can't happen in June.  It needs to wait until at least mid-August.

 

Decisions, decisions.

 

Give me algebra, calculus, chemistry, physics, or even speeches to do in front of large groups any day... they are FAR more preferable.

 

[Alice]

 

Rural options just aren't as plentiful as those who live nearer to civilization.

 

 

 

 

This is sadly very true. Where I did my residency we routinely had people travel 4-5 hours to see one of the specialists. We also had traveling clinics that we would do where we'd go see patients 7-10 hours away and stay overnight for a few days. Now I live somewhere where people think it's too much to drive 15 minutes. :)

 

One other thought would be to call whatever the appropriate department at the nearest academic medical center to you is and ask them if there is anyone closer to you they would recommend. Although for some specialities you might really be limited to only one or two choices. 

 

Or you can just hold out for that son of yours to become a doctor. Then you can be like my Mom (and every other doctor's Mom I know) and just call him with all your questions. :)

[creekland]

Or you can just hold out for that son of yours to become a doctor. Then you can be like my Mom (and every other doctor's Mom I know) and just call him with all your questions. :)

 

We've already warned him that this will be the case.  He didn't believe us, so checked with friends of his who confirmed the truth in it all.  ;)

[Laura Corin]

When we moved here I asked around.  Hobbes' karate teacher recommended a particular doctor who is part of a practice of six or seven doctors.  Over time, I have started using that doctor for the boys and another doctor from the same practice for me.  We have to go to a GP in order to get a referral to a specialist.  That's fine by me - I have got referrals where necessary, but often the GP could sort it out.

 

L

[LMV]

My stepson's pediatrician relocated when I was pregnant with our oldest daughter so I interviewed five pediatricians locally that others I trusted had recommended and selected one.  The doctor our kids still see had just finished residency and was joining her dad's practice when I was pregnant.  She has a more than adequate fund of knowledge, old school exam skills, the ability to listen and communicate well, and she can (and does) coordinate care like it is her job (which I guess it is).

 

During the years we were living out of state I did ask her for suggestions before we left but she really didn't know anyone to recommend.  This wasn't that surprising since I was essentially asking her for pediatrician ideas for a state she has never been licensed in.  Ironically the pediatrician we ended up with (after initially establishing with one who was fine but just couldn't/wouldn't accommodate acute care appointments, we switched to the guy who actually worked our daughter in when her asthma flared because she was sick and then admitted her) was someone she knew from residency.  When I called to find out what the copying fee was for her to send records to the third pediatrician (since the original guy refused to re-release her records to him) she told us that if she had known he was in the area she would have recommended him without reservations.  When we came back here I knew we were going to go back to our daughter's original pediatrician so I just made sure she had all the records and we went forward. 

 

 

 

I think ER docs are the exception, they tend to know everyone because they see who comes in to the ER and how it is handled. My sister-in-law is an ER doctor and she's the person I ask when I've needed a doctor for myself. That's probably also true of hospitalists now. 

 

There is some truth to this. I definitely have inside information on physician quality and approach at times.  It isn't something I volunteer but I'll try to share it diplomatically, in HIPPA compliant fashion and without details, if asked.  I'm currently working in a hospital where a lot of my husband's relatives have admitting privileges so that adds another layer to my input.  They are all more than competent, great diagnosticians, and good listeners so they're often who I would recommend but sometimes I realize that won't come across well and will just recommend whoever our kids have seen in similar situations or who I think I would want my husband to see if he was in the situation because obviously his relatives are not options for our family for obvious reasons. 

[texasmama]

When I needed a PCP, I asked a neighbor for a recommendation. Her dh is a doctor. I loved the doc she recommended and then she retired. The doctor who took her place was okay. Then she left. I now see her replacement, whom I love. We could hang out and be friends. Great lady. :)

 

So it was a referral from a neighbor and then luck. This is in a smallish town.

 

I found my last OB asking a friend who had several babies for a recommendation. Love the OB too.

 

Found my dentist asking a friend for a recommendation. He is great.

 

I trust these three doctors to recommend any specialists I might need.

[creekland]

When I needed a PCP, I asked a neighbor for a recommendation. Her dh is a doctor.

 

I do like the word of mouth method... and absolutely love our dentist (found that way).

 

I just need to go to the admin at our school and tell them the next person they hire has to be married to someone influential in the medical field, because, to our knowledge, none of our neighbors are moving soon.  ;)

 

The ER method here could be a wee bit risky - considering many of the "cringe" stories I know about started there - some that were definitely life threatening.   One of these was a student at our school who went there with chest pains, was examined, and sent home - had he not insisted to mom that something was WRONG, and she listened to him (BIG NOTE to all of us parents) - he would have died within a couple of hours - the second time they airlifted him to a nearby teaching hospital with surgeons waiting at the other end. 

 

Other times they are just "wrong."  With my own youngest they insisted seizures he was having were not epilepsy and there was no need to return him there if they happened again.  Once with a specialist it was quickly determined that it WAS epilepsy and his specific seizures could have been worrisome when they were at their worst (as had happened at school a couple of days after the ER visit with me telling the school nurse the ER told us not to return... so she opted not to call the ambulance even though that was her first instinct).  We now have emergency meds on hand (as does she) if he gets that way again, but at that time, neither of us had that.  As a pro (I suppose), we know our guy wasn't taking any drugs... that was the ER's first instinct (kinda understandable, so not really a complaint with that).

 

Small towns see a lot of "average" and, IMO, are perfectly adequate for dealing with "average."  When it comes to the fringe ends of things, it can get dicey.

 

It makes it tough to want to go anywhere without good recs - esp if one doesn't exactly have medical knowledge themselves to know if what they are being told is correct or not.

 

But I'll figure something out sooner or later.  It'll only be an hour+ drive to get to some folks with better online reps (though limited data :glare: ).  I just have to figure out whether to go east, west, north or south...  I wonder how well a dartboard would work...  Has anyone tried that?

 

 

[Lizzie in Ma]

Word of mouth is how we found our family practitioner.

[shanvan]

 

Other times they are just "wrong."  With my own youngest they insisted seizures he was having were not epilepsy and there was no need to return him there if they happened again.  Once with a specialist it was quickly determined that it WAS epilepsy and his specific seizures could have been worrisome when they were at their worst (as had happened at school a couple of days after the ER visit with me telling the school nurse the ER told us not to return... so she opted not to call the ambulance even though that was her first instinct).  We now have emergency meds on hand (as does she) if he gets that way again, but at that time, neither of us had that.  As a pro (I suppose), we know our guy wasn't taking any drugs... that was the ER's first instinct (kinda understandable, so not really a complaint with that).

 

Small towns see a lot of "average" and, IMO, are perfectly adequate for dealing with "average."  When it comes to the fringe ends of things, it can get dicey.

 

It makes it tough to want to go anywhere without good recs - esp if one doesn't exactly have medical knowledge themselves to know if what they are being told is correct or not.

 

But I'll figure something out sooner or later.  It'll only be an hour+ drive to get to some folks with better online reps (though limited data :glare: ).  I just have to figure out whether to go east, west, north or south...  I wonder how well a dartboard would work...  Has anyone tried that?

We had a very similar local ER experience, except in our case my Dd was having an allergic reaction--hives, tongue itching, throwing up -- and they insisted she probably had a virus and didn't need to see an allergist.  We went to the allergist anyway and surprise!  She has multiple food allergies and has had a couple more anaphylactic reactions.  

[creekland]

We had a very similar local ER experience, except in our case my Dd was having an allergic reaction--hives, tongue itching, throwing up -- and they insisted she probably had a virus and didn't need to see an allergist.  We went to the allergist anyway and surprise!  She has multiple food allergies and has had a couple more anaphylactic reactions.  

 

It's definitely things like this that make me pause - and cringe - and probably assist my mind in wanting to put things off... and I know of many more similar deals I'm not putting on here.  I don't know if it's just due to being in a small town, or working at school and hearing more due to a wider circle of people I come in contact with, or a combo of both.

 

I fully get that medical science is not an exact science - it's far from it.  I fully respect anyone choosing a medical career.  It'd take a LOT for me to even consider reporting or suing anyone for any sort of wrong decision or action (they'd literally have to be drunk or something).

 

But it's also something I'd prefer to stay far away from - or want to have a LOT of trust in the individual making the decisions.  And that's difficult for me to do when I don't know them and the stakes can be high.

 

This really could be why most moms call their kids if their kid went to med school. I know him.  I'd trust him with my life... He just needs to rush these next 6 - 7 years!  ;)

[shanvan]

 

This really could be why most moms call their kids if their kid went to med school. I know him.  I'd trust him with my life... He just needs to rush these next 6 - 7 years!   ;)

I did attempt to convince Ds the other day that he really did have an interest in becoming a doctor.  I don't think I got anywhere, unfortunately.  He said he doesn't want to take on such a big responsibility.  I can't blame him.  

 

With the ER though, I have no medical training and even I knew Dd was having a reaction to something she ate, which I thought was the trail mix I put in her stocking.  It was full of tree nuts.  

 

​We've switched allergists too.  The first one, who did diagnose her food allergies was a little strange and kept insisting she must have asthma too and tried to get me to put her on meds for it.  New allergist tested her again on the asthma--no evidence at all and Dd has never had any complaints.  I tried to tell the first allergist that, but he wouldn't listen.  Finding the right doctor can be exhausting!

[creekland]

I did attempt to convince Ds the other day that he really did have an interest in becoming a doctor.  I don't think I got anywhere, unfortunately.  He said he doesn't want to take on such a big responsibility.  I can't blame him.  

...

Finding the right doctor can be exhausting!

 

I spent years trying to convince my guy he might want something else.  Now I'm finding I'm glad he didn't listen to me... but it'll still be years away - IF he doesn't change his mind (he hasn't so far AND he's done well with all the weeder classes in college including Orgo - actually he'll be a TA for Orgo next year).