Cool, I have health insurance. Now what?

In My Humble Opinion
1

I haven’t been to a doctor in a few years, so I’m assuming getting myself checked out is a good idea. My insurance company has a website where I can search for local doctors who take my insurance. There are a lot. Not a bad thing, but I’m not sure where to start. I have choice of “Family medicine” (over 100), “General Practice” (four), and "Internal Medicine (over 100). I’m not entirely sure what these terms mean.

Once I’ve called around to find someone who does take my insurance (I’m told these lists are often inaccurate) and has time to see me (also not always the case), what then? If I just show up saying, “I haven’t been to a doctor in a while, please determine my healthiness,” will any doctor know what to do, or do I need to ask for specific tests and stuff? If the doctor turns out to be a hack (it happens), I probably wouldn’t even notice. Anything I should look out for?

Any answers to relevant questions that I didn’t have the foresight to ask are very welcome :slight_smile: .

2

If you have kids, you may want a “family practice” so the whole family can see the same doctor (this is helpful on a number of levels). But if it’s just you, go for someone in general practice if you like.

Definitely call before you just show up at the office. Explain that you haven’t seen a doctor in a while, and need a check up. Find someone who is not booked six months in advance. It may take a while for anyone to squeeze you in, though, because initial visits take a while.

Expect the doctor to take a complete medical history and order some baseline blood work. If you have specific problems, he/she may order other tests as well. They will probably then make a follow-up appt. to discuss the findings of your blood work.

If you have special issues, the general practitioner will be able to refer you to a specialist to have it taken care of.

Check the fine print on your policy to see if you need a referral to see a specialist. I don’t, but then, my insurance rocks a lot harder than most people’s. (I don’t say that to sound snarky; I’m grateful all the time for kick-ass insurance, but my health sucks, so we really needed the best insurance we could afford).

Doctors seem to like to write prescriptions for stuff, so be prepared to walk out with a handful of those. If you think the reason the doc wants you on a specific medicine, question it. If the medicine turns out to be expensive, ask for samples.

But while I do think a lot of docs write too many prescriptions, I’m also a firm believer in “better living through modern pharmacology”. :wink:

Good luck! Let us know what you find!

Oh, one more thing. It seems you can choose from a lot of doctors. I think it’s important to have a good rapport with your doctor. If you don’t “click” with the first doctor you see, move on to the next one.

3

My advice:
Ask people you know and trust who their doctor is. If you know people who work in the medical field, even better. Ask those people why they go to their docto – if their reasons are good ones (like my doctor is a fabulous doctor, he stays up-to-date on medical news, he takes a personal interest in the health of his patients, he isn’t a prescription-writing machine) then see if that doctor is on your insurance’ list. If he/she is, call and say “Hi, this my name is Ruken, and I am newly on XYZ insurance. I would like to set up an initial consultation with Dr. So-and-so.”

At that point, if the doctor is no longer accepting new patients (or your insurance at all) they should let you know. You will be set up with a (usually) 10-15 minute meeting with the doctor, where you can basically interview them. Remember, the doctor works for you. Make a list of questions that are important to you – do you want a doctor who just writes a prescription when you are sick or do you want one who will run bloodwork or other tests to be sure of what he is treating instead of just treating symptoms? – and bring the list with you. In that meeting, you can usually decide whether or not you’re going to like this doctor. After you have decided, you can call back for a general physical checkup.

I find it funny that people spend more time interviewing gardeners than they do the people who basically can decide whether they live or die. It’s very strange. I talk to people all the time who say “man, my doctor is such an ass” or “my doctor put me on paxil and I told him it was making me have hallucinations and I didn’t like it, so he increased the dosage.” WTF? Seriously, my doctor has a shiatload of patients, but you know what? When I walk in there, I am the only patient that matters and if he forgets something about my medical history, he looks in my chart – he is an amazing doctor, and I wouldn’t trade him for the world.

Good luck finding a good doctor!

4

A-freakin’-men! I don’t know why people keep doctors they don’t like. I had a urologist for about two years who sucked. I kept him because he was a very proficient urologist, and he was proactive with my treatment. But I didn’t feel like I could talk to him. Plus, he was not a big believer in pain relief! He’d diagnose a kidney stone (I get them a lot) and schedule a time to take it out, but wouldn’t give me pain meds in the meantime! He’d say “Well, if the pain gets that bad, you need to go to the ER”. The only reason I stuck with him as long as I did is that there are not a lot of urologists around here.

Finally, though, I found another one, and dumped the guy I couldn’t talk to. When I first met my current urologist, he put his hand on my shoulder, looked me in the eye while we were talking, and before I left his office, he said “Do you need to keep something on hand for pain?” I told him what Dr. P had said about needing the emergency room if the pain is that bad. My new doc said “Well, there’s probably some validity to that statement” (you know a doc would never say anything bad about another doc), “but there’s no reason you can’t get a little more comfortable before you head out to the ER, or maybe if you have something at home you can take, it can get you through until morning and then you can call us”.

I’ve been with my current urology practice for almost five years now, and I love them!

Definitely find a doctor you like! It makes it so much easier to talk to them about “touchy” issues.

5

I’ve worked for two different health insurance companies and had three or four different insurances and I have never heard of a doctor scheduling this sort of meeting.

But then, I chose my doctors pretty much by the “close my eyes and point” method so what do I know? Always had excellent luck, too. Excellent doctors and easy on the eyes, too. Made those hernia checks a lot more fun.

6

“Doctor, you forgot the digital rectal exam.”

“Mr. Otto, that’s not standard practice for a hangnail.”

7

I once chose a doctor because he had the same name as a Star Trek character.

The bad news is, it was Worf.

8

Internal Medicine docs just focus on adult medicine.
Family Medicine docs are just what it sounds like: they will see the whole family, from newborn babies to grandma. Some of them do obstetrics/prenatal care too, though that’s not as common as it used to be.
In a rural area, FM docs tend to be “jack of all trades” since they’re often the only docs around. More typically, in suburbia, there really isn’t that much difference between FM and general IM docs since a lot of people in urban/suburban areas take their kids to pediatricians instead of FM docs.
“General Practice” is being phased out in America. It’s a doc who did an internship (1 year of residency, as opposed to the 3 year residencies that FM and IM docs do).

I think one reason people are so arbitrary about picking a doc is because it’s not very easy to judge the quality of a doc from the outside looking in.
I know a Family Medicine doc who, as someone also in the medical biz, I know is very intelligent, well-informed practitioner who makes his medical decisions based on the current evidence.
However…
One of the reasons I consider him a great doctor is because he refuses to prescribe antibiotics for viral upper respiratory infections. Unlike most docs who will do that just to get the patient out of their office without a hassle (a lot of patients insist on antibiotics even when they don’t need them), he recognizes that it is no favor to the patients to encourage antibiotic resistant bugs and risk possible negative side effects from the antibiotics. He is notorious for taking the time to discuss with the patients why they don’t need antibiotics instead of just bending to their wishes.
Of course, if you talked to those patients who are convinced they need an antibiotic anytime they’re sick, they might say he’s a terrible doc because he’s not giving them what they want. They don’t have the medical knowledge to realize that what they want is not in their best interest.
So, unfortunately, you can’t always say that a doc is good or bad just based on if you like their personality or if they give you what you ask for. I do think it’s a good start if the doc is willing to explain things to you and take time to discuss things with you, though.

9

Sadly, I am too young to qualify for a routine prostate exam (despite the family history). So I have to rely on laypeople.

10

I had my first last week after a bout of prostatitis. The doctor was very careful to explain what he was doing, etc. etc. etc. I didn’t bother to tell him he wasn’t visiting uncharted territory.

11

They actually do, if you ask. If they don’t or won’t, I would be leary about seeing them as they obviously don’t care whether their patients like them or not. While I have known a few doctors who were great at what they did but had lousy bedside manner, the truth is, if I can’t stand you, I really don’t want you having my life in your hands, y’know?

12

Why would you assume that?

I think that’s a terrible assumption.

I’d work on changing my mindset.

13

Why is it a terrible assumption? Do you think annual physicals are a bad idea? How about changing the oil in your vehicle?

14

Well, not only is it about maintenance, but, to me, it’s about having a doctor you know and trust when something does go wrong. Even if the OP has no immediate health concerns, he’s almost bound to have one eventually (not to mention problems his blood work might turn up that he doesn’t even know he has). When a semi-emergent problem crops up, if you have no regular doctor your choices are: the ER (which doesn’t do follow-up, takes forever, and your insurance might decline payment for if they decide it’s not a “real” emergency), a walk-in clinic (which takes half of forever, doesn’t do follow-up, and your insurance might not pay for, plus you may or may not get a competent doctor), or scrambling to find a primary care physician in a hurry.

I don’t like any of those choices. I’d much rather have a health-provider network in place before a serious or potentially serious situation rears its head.

Of course, anyone’s mileage may vary.

15

As mentioned, they will and that is how I found our current doctor. He is fabulous. I was getting ticked off when every office staff would huff that the practice was closed to new patients (where do they find these people that work in medical offices?). Our doctor had just started his own practice with another experienced doctor and said that he would always make time for us which he has. You can call at 8 am and be seen by 10 am every time. We have had a few medical emergencies and ended up in the ER and he would just show up the next morning to consult with the ER staff to see what else needed to be done. You can’t get much more attentive than that.

As for the OP, if you are single or married with no kids, any of those types of doctors would work. I don’t know if it was just a fluke but a new practice has worked out well for us.

16

Yes.

I replace the food that I put into my body on a regular basis.

17

Would you care to elaborate on why you think an annual physical is a bad idea?

18

I hope that you do not die of a disease that would have been caught during a routine physical and health screening.

Because that would suck.

19

Annual physicals aren’t needed for younger people, but regular ones are. My GP found a serious problem with my thyroid 15 years ago, by doing the touch test. Just last year a check of my pulse before giving blood turned up a case of atrial fibrillation, which could have easily killed me if not treated.

What you don’t know can hurt you.

20

Yet another reason why this is a good idea is to have a baseline in case something does go wrong later.

I have one more piece of advice - think about what happens when your doctor is on vacation or unavailable. I had a good GP in a single doctor office in NJ, but now I’m in a big group. The advantage is that I can always see someone, and they have all my records. I can also go straight from a checkup to the lab without making other appointments or driving across town. They also have a good on-line presence, so I can order refills of my way too many prescriptions easily. It’s still worth interviewing the doctor, but if in six months you decide you’d rather have another, you can change easily.