How to Checkup on Your Doctor
You can flip through Consumer Reports to find vacuums and cars, but it’s way harder to ascertain the quality of your doctor. Here’s what to ask your doc.
© iStockphoto/ThinkstockStudies find that people tend to evaluate their doctors based on criteria that have nothing to with the quality of care provided, such as waiting times, friendliness of the office staff, and how long the doctor spends with them. Sure, we all truly appreciate pleasant interactions. But deep down, we also know that just because Dr. Jones compliments you on your new dress and his office manager Sally asks about your daughter doesn’t mean you’re getting quality care.
And without that quality care, you’re more likely to wind up sick and hospitalized, not to mention spend a lot more money on your health. Sadly, a 2010 report from the Dartmouth Institute for Health Policy & Clinical Practice found that the overall quality of care provided by primary care physicians to Medicare patients throughout the country was “less than ideal.”
You deserve nothing less than ideal care, however. Here are some questions you should ask to make sure you get it.
Do you practice within a health-care system?
You may love your doctor of 40 years, but if he’s still operating a solo practice unaffiliated with a health-care system (think Mayo Clinic in Minnesota or Geisinger Health System in Pennsylvania), you’re missing out. Studies find that these integrated systems of care—in which primary-care physicians work closely with specialists, doctors communicate with one another about their patients, and clinicians get feedback about their performance—provide a much higher quality of care, often at lower costs!
Is your office computerized?
You want a practice that keeps your medical records on a computer—not stuffed into an overflowing file cabinet. Electronic health records (EHR) are poised to revolutionize the quality of medical care. For instance, if you have diabetes, the EHR can remind your doctor to check your blood-sugar level, examine your feet, and test your cholesterol levels—all are important for reducing your risk of complications. Plus, other doctors can access your medical records, helping to avoid redundant tests, monitor prescriptions, and provide a comprehensive look at your overall medical history.
When did you graduate from medical school?
It might seem counterintuitive, but studies find that the longer doctors have been practicing, the less likely they are to provide quality care. The reason? Medicine is a continually moving target, with new procedures, tests, and drugs. Yet doctors get into a rut, continuing to practice the same way they always did despite new scientific evidence. If your doctor has been in practice for a long time, it’s perfectly fair to ask what kind of ongoing training he or she is getting.
Are you licensed? Board certified?
Has your doctor ever lost her license in another state? Been convicted of Medicare or Medicaid fraud? Is he board certified in family medicine, internal medicine, or some other specialty?
Do you participate in pay-for-performance programs?
Many employers, insurers, and even Medicare-run special programs offer doctors higher payments if they meet certain quality parameters, like ordering mammograms for all eligible women and screening for cervical cancer. Studies find doctors who sign onto these programs deliver consistently better care than those who opt out. You can see if your doctor participates in the Medicare quality reporting program at cms.gov/pqrs. To download the list, click the “Eligible Professionals Who Satisfactorily Reported Physician Quality Reporting Measures” link.
Are you an internist?
Internists receive more training in conditions common in older people, like diabetes and heart disease. At least one study found that Medicare patients with diabetes got better care from internists than general practitioners. And make sure your doctor has a lot of patients with the same conditions as yours; practice really does make perfect.
Do you know my name?
It’s not that a doctor should memorize the personal histories of every patient they have. They carry too big a load for that. But at minimum, before they come in the examination room, they should review your background, come in prepared, and be genuinely interested in what you say and how you feel. Doctors that see patients as nameless, emotionless bodies to be treated, just aren’t delivering ideal care.
See also: How to Find a Better Doctor