Finding Dr. Right

By Kathy Steligo

First in a series on choosing or changing your doctor, and making the most of your office visits.

Just a couple of generations ago, medical care was much simpler than it is today. You developed symptoms, contacted the town doctor, and accepted his authority and treatment without question.

Today, we live in an era of patients’ rights. Each of us is entitled to a general practitioner or specialist who dispenses compassion and skill in equal parts. While this choice is our right, it is also our responsibility. Our selection is limited only by the restrictions of our health plans and our own willingness to make the time and effort to select professionals who value us as individuals as well as patients.

Choosing a doctor to direct your treatment and long-term care is one of the most personal decisions you’ll ever make. But for many of us, it’s an overwhelming task, particularly when we may be vulnerable from a fresh diagnosis. In fact, a recent survey by the American College of Surgeons found that on average, patients actually spend more time choosing a car than selecting a surgeon.

Battling breast cancer requires a team of medical professionals orchestrating your treatment; it is important that you feel confident and comfortable with each of them. Whether you need an oncologist, a radiologist, or a plastic surgeon, you should feel confident that each member of your healthcare team treats you efficiently and kindly. Odds are you’ll be much more satisfied when you invest the time to research and hand-pick your health care professionals. In most cases, you will have a few weeks between diagnosis and treatment to carefully make your selections. (Always verify this timeline with your attending physician.)

How do you find your Dr. Right? Just follow these steps:

1. Ask for recommendations. Personal referrals are always a better source of information than the telephone directory. Start your search by asking people who they recommend and why. Ask your primary doctor or gynecologist for a referral to an oncologist or other breast cancer expert. Talk with the patient advocate or physician referral representative at your breast cancer center or hospital. Nurses are often great sources of information. Seek input from relatives, friends and co-workers who have faced the same dilemma, diagnosis or treatment you’re dealing with. If you belong to a managed care plan, follow the same process for doctors in your preapproved network.
2. Choose an expert. When possible, choose an expert in the field. If you’ve inherited the BRCA gene mutation, for example, choose health professionals who specialize in genetic medicine. Considering post-mastectomy reconstructive options? Many plastic surgeons downplay procedures they don’t perform, so choose a surgeon who is experienced and proficient in the technique you prefer.
3. Check credentials. With your list of recommended physicians, you’re ready to research. Visit the American Medical Association’s website (http://www.ama-assn.org/) to verify each doctor’s credentials and training. When considering a specialist, choose someone who is board certified in his particular area of expertise. That means in addition to medical school, he has completed three to seven years of additional training and has passed required written and oral exams. You’ll find information about an individual’s board certification at the American Board of Medical Specialties (http://www.abms.org).  You may also want to prioritize your list by applying other personal criteria: perhaps you prefer a female physician, one who speaks your native language, or someone of your own ethnicity.
4. Contact the office. Call each doctor’s office to determine whether she takes your health insurance and is accepting new patients. Ask how quickly you can arrange an appointment. Doctors are affiliated, or have privileges, at certain hospitals; consider those who have privileges at a facility that is acceptable to you. Schedule consultations with the top three or four names on your list.
5. Take a test drive. You’re more likely to be satisfied with your care when you respect and trust your physician. Visiting a few provides the opportunity to compare personalities before selecting an individual who seems like the best fit for you. During each consultation, assess the physician’s people skills and personal manner. One doctor may be too aggressive for your taste; another too impersonal. You’re more than a statistic on a chart, and you deserve to be treated as an individual. Look for someone who agrees. She should also be sympathetic to your concerns, anxiety and fears.

Beware of doctors who never make eye contact, frown at your questions, or constantly glance at the clock during your appointment. Your physician should talk with you, not at you, and give you his undivided attention. He ought to answer your questions patiently, even when you ask him to repeat something, and honestly—clarifying your diagnosis, treatment, and what to expect along the way. One individual may be experienced but dispassionate and condescending, while another fills you with confidence and trust. As more than one patient has said, if you can’t hug your doctor, you probably have the wrong one.

Remember, never judge a surgeon’s ability by his brochure or website. Depend on his qualifications, feedback from other patients, and your own interaction and confidence in him. Take the time and effort to do your homework and choose doctors who treat you as part of a well-organized team. You’ll be glad you did.