Ask the Right Questions
It’s an open secret in medicine that doctors often receive better medical care than the average patient. Part of the reason is professional courtesy — doctors give other doctors the red-carpet treatment.
But doctors may also get better care because they know how to get it. They take time to find the best practitioners in each field, they ask the right questions, and they know the secrets of the health care system. Even patients who are limited in their choices by a managed health plan can shop around for top-level care by following some basic advice from those who know best:
Start now. The most important thing you can do for your own health, doctors say, is to build a relationship with a primary-care physician. “It’s important to get a doctor before an emergency arises,” advises Carol K. Kasper, an internist at Orthopaedic Hospital in Los Angeles. “A person shouldn’t put it off because he feels healthy. In an emergency, one can sometimes get better care faster by saying, ‘I’m Dr. Blank’s patient.’ ”
Look at the frames on the wall. When doctors walk into an exam room, they know to look for a diploma to see where the doctor went to medical school. They also look for the state license and board certification in specialties or subspecialties recognized by the American Board of Medical Specialties. And they ask colleagues where they trained — someone who has trained with another top professional will eagerly brag about it.
Choose a hospital too. Ask your physician where he or she has hospital privileges. Many doctors look for MDs who are affiliated with a medical-school teaching hospital. It requires considerable time, expertise and professional recommendations to win privileges at such a facility. “They’ve been through a filter of questions that patients can’t ask,” explains Kenneth H. Falchuk, professor at Harvard Medical School and the co-chairman of bestdoctors.com.
Pick the hospital first; then select a physician who works there, suggests Pamela F. Gallin, director of pediatric ophthalmology at Children’s Hospital of New York-Presbyterian/Columbia. Patients often are treated by a team of “invisible” doctors, including radiologists and anesthesiologists, so choosing the best hospital gives added assurance about all patient care.
Go for a pro. Whether it’s for a colonoscopy or orthopedic surgery, doctors ask their own doctors how many procedures they perform. “If I’m going in, I want a team of people used to doing this procedure over and over again,” says former emergency-room physician Kevin J. Soden in Charlotte, North Carolina. What’s the magic number? That depends on the procedure. For guidelines, consult the board that certified the doctor in his specialty.
Pay attention to details. Does your doctor perform an exam every time you visit? Does he talk to you during the checkup, explaining what he hears or sees or what your blood pressure reading is? Does he listen to what you say, or interrupt your answers?
New York cardiologist Evan S. Levine suggests checking out your doctor’s stethoscope. Ask where it came from and how it compares with other models. He says it’s a small detail that can give you insight into your doctor’s priorities. The top-of-the-line models cost about $200, and Levine says he would be wary if the stethoscope has pink tubing or the name of a drug brand — which suggests it was a freebie from a pharmaceutical representative.
Cincinnati pathologist Lawrence M. Unger suggests visiting a potential hospital. Consider: Is the facility clean? Are employees standing around socializing or are they working with purpose? Do water fountains and elevators work? Small details like these, Unger says, are good indicators of how efficiently the facility operates.
Ask to see your medical records. While the original records may be the property of the hospital or medical group, good doctors believe the information belongs to the patients, and so they will provide copies. Doctors also know that patients can ask for copies of any notes and all correspondence between their primary-care physician and specialists.
Bring a notepad. Patients should always show up to appointments with key questions jotted down, and, in the case of more serious health problems, it’s best to bring another person along to help remember everything.
“Always have a friend or family member with you during a hospital stay,” recommends Mark Jacobs, a Houston obstetrician. “If things don’t seem like they are going well, there’s a strong likelihood that they aren’t. Don’t be afraid to speak up and don’t be afraid to ask for a second opinion.”
Know when to schedule visits. Early appointments are more likely to take place on time, and everyone is simply fresher and more alert at the start of the workday. Also, some doctors warn against planning elective surgery for July or August, when inexperienced medical students begin their residencies, and hospitals can be especially chaotic. Most facilities are best avoided around holidays as well, because they tend to be shorter staffed.
Make nice with the support team. Doctors know the power the receptionist wields, controlling who gets appointments on short notice. Soden suggests getting to know the staff, coming prepared with the right forms, and bringing coffee or treats when you visit. “It’s amazing how you can get worked in if they like you,” he explains.
Ask a nurse. “Nurses see everyone in the course of their work, and know as well as or better than anyone which doctors take good care of their patients and which do not,” says Michael F. Nigro, Jr., a surgeon in Alexandria, Virginia. “And don’t ask an administrative type. Find a nurse who spends time taking care of sick patients.”
Get personal. Ask a doctor where he would send his mother. It’s a simple question that reflects exactly how doctors find their own doctors. Physicians are sometimes obligated to refer patients to a colleague in their own medical or insurance group. But when pressed, most will tell you whom they would entrust with the care of their own family.
To locate and learn about doctors and hospitals, try these resources:
bestdoctors.com: Houses a database of doctors recommended by other doctors.
ama-assn.org: Website for the American Medical Association, which allows users to find a doctor or look up credentials.
abms.org: The American Board of Medical Specialties website, which lists whether a doctor is certified in a recognized medical specialty.
healthgrades.com: Rates hospitals for various procedures.
docinfo.org: Provides access to disciplinary reports.
docboard.org: Offers licensing, background and disciplinary information on physicians.