So, the other day I had my kitties at the vet for their yearly check up, and I got to thinking how much I like my vet. He takes time to actually talk to me, answer all my questions (no matter how dumb, even if I’m asking about animals not currently on his table, like my roommate’s dog). He even did research on my cats’ breed (Turkish Van) when they came in as kittens, so he’d know what diseases run in their lines. When one of them is sick, we can get in that day or the next morning. I always leave feeling well informed, and that my pets’ health is looked after.
My cats get better medical care than I do. Everytime I go to the doctor, I end up feeling rushed, confused, and vaugely defensive. I’ve been through several doctors, and I swear, they’re all the same. Out the door before I could get my mouth open. I get migraines, and I really need to sit down and discuss this with a doctor-- my bizarre symptoms, treatment options, medications, things I’ve been reading about an elevated stroke risk, and other stuff. I have so many questions.
How do I find a good doctor who will talk with me? Are there even any of them left out there?
(Asking friends for recomendations doesn’t help-- no one I know has medical conditions, and half of them are uninsured anyway. Most people are healthy at 25)
I would much rather be treated by my pets’ veterinarian than any of the physicians that I can remember.
Is it an insurance issue with physicians? Is it an ego issue? Why do they diagnose me before I talk for even 30 seconds? I don’t understand how anyone can give such poor customer service as most doctors and still be in business.
I wonder sometimes. It occured to me that I pay my vet in cash. No forms, no hassle, no insurance company breathing down his neck. Payment for services, no more, no less. Maybe that would make a difference with doctors.
Most docs schedule 2-3 patients in the same time slots and are constantly running from one to the other. I will say that my MD always sees me, never a physician’s assistant or nurse. She listens to me and takes her time. There have been nights when she’s called me back at 7:30 in the even to check on me if I’ve been in to see her. I have no complaints about her. But I love my vets. When my horse was dying of cancer my vet would make barn visits and not charge me a dime. He made calls to vets around the country looking for alternative treatments. And when he had to put her down 2 weeks before the foal we were trying to save was born, he didn’t charge me anything and called me the next day to tell me I’d done everything I could to save the baby. And my small animal vet has given me her home phone number. When my airedale was hit by a car in December she treated her for shock, gave her antibiotics, put in stitches and did x-rays all for $60. When I needed to move my horse from a boarding facility to my farm, she trailered him over 50 miles and didn’t charge me a penny. She trusts me to take a dog of hers that’s having some problems. I love her. She’s not just my vet, she’s my friend.
I don’t think the method of getting paid has a whole lot to do with why some doctors don’t take the time to listen (speaking as a doctor who is salaried, in Canada). I think we doctors have a tendency to try and come up with a diagnosis quickly because (1) if we’re right, it means we can get to what we can do to help you sooner in the session, (2) this skill was highly regarded and hence rewarded in medical school and residency, and (3) many patients seem happier when we quickly say we know what’s causing the problem, as opposed to when we keep asking questions and the unease of “you don’t know what this is yet ? oh, oh …” starts to fill the room.
Rather than answer your question of how to find a good doctor (it’s hard to find any available (for new patients) family doctors at present in Canada), I would like to suggest some ways in which you can make your sessions with your doctor more useful:
When booking the appointment, indicate to the receptionist that you will have a lot of questions for the doctor and so believe a 1/2 hour session (rather than a 10 or 15 minute slot, which is on paper the typical routine visit slot) would be better. Also, a end of day appointment may be better, to allow the MD not to have to worry than in spending more than 15 minutes with you that he or she is not causing all the other patients to have to wait.
Prepare for the session by writing down your questions, and go through the list with the MD at the session. If you want, you can help the MD by getting the list of questions to him/her prior to the appointment, so he or she can be fully prepared. Take notes on what is said at the session (doctors feel far less threatened by that than by tape recording).
Let your MD know politely that you are feeling rushed & confused after sessions with him/her, and that you would appreciate any efforts to improve this. No reasonable doctor wants patients to feel that way, so your putting up that red flag should get a (hopefully useful) change in behaviour from your MD quickly.
Consider having someone else accompany you to the session. They may come up with questions that you would not come up with at the time by yourself.
In terms of finding a new doctor: If you live near a medical school, consider becoming a patient in the family practise program of that school. Medical students and residents tend to be better listeners than staff physicians in my experience, which pays off for patients.
I’m about as doctor-phobic as one can get, thanks to some really dreadful experiences. Who’d a thunk a sick person would have to be a savvy consumer on top of feeling wretched?
It probably varies widely by luck and availability, but my experience with large practices haven’t been good. Doctors are caught in the business mire too, but that turns the whole thing into a crap shoot. I found one excellent doctor in an otherwise despicable, money-grinding ‘womens’ health center’, but she was the exception. Good news is, those lucky enough to hit her in the rota/lottery proved loyal enough to set her up in her own practice. I didn’t follow her because her her office is too far away, but she’s now a by-word for excellent care.
I lucked into my doctor, and he’s not even in general practice. His speciality is geriatrics–stop laughing–but he’s built a fanatical following because he’s gentle, thorough, up to the minute on literature and entirely humane. FWIW, I found him by just asking around. “I need a doctor. Got one? What’s he/she like?”
My fear with that is not getting adequate medication. A friend of mine got a root canal done at a dental school. She said the experience was good, but she would not do it again as the student was unable to give her painkillers, and she was in quite a bit of pain afterwards.
My dad will gladly tell you the best doctor he ever had was an OB. My mom was in there, randomly chatting about my dad and this persistant ulcer he had (this was many years ago), and this doc-- who read medical journals for fun-- told her he’d just read about a study linking bacteria to ulcers. Mom sent Dad in to see him, and a course of antibiotics cleared up the what had been a long, painfull problem. He caught my Mom’s thyroid disorder because he noticed her eyes looked different, and when I had the chicken pox in high school he put me on a shingles medication (he’d read a study again) that cut the severity in half.
He is long since retired, and in Jersey anyway. But that’s the sort of doctor I want.
Yes I agree with the previous post and would add don’t be shy about stopping seeing doctors you aren’t happy with. People will stop going to a mechanic in an instant if they don’t think he is taking good care of their car but often feel honourbound to just put up with really ordinary care from “their” doctor.
The student may not have been able to give her painkillers, but whoever was supervising him should have been able to. It sounds to me like the student was not being a proper advocate for the patient, or that the supervising dentist was not supervising properly. I don’t think that going to a training program increases your risk of not getting proper medication. I know that when my students or residents have seen a patient and have some concerns or ideas on behalf of that patient, I take them seriously; so my patients hopefully get the benefit of 2 minds trying to help them with their problems.
Keeping that sense of enjoyment about reading medical journals is crucial to being able to keep your state of knowledge current, but I must admit it can be difficult sometimes. Finding specialists who keep current outside their field is truly rare.
I personally enjoy keeping up, even outside my field. OTOH, I have found in my practice that if I’m not careful, patients start to try to use me as their primary doctor and bypass their family doctor (I treat cancer patients). This results in three bad outcomes : (a) aside from my letters, the family doctor no longer is current with what’s going on with his or her patient (which is a bad thing, especially with these patients that not only have their cancer problems but their other serious medical problems), (b) I have less time to help patients with the types of problems that truly require my expertise, and (c) it usually means that all my patients are forced to wait longer for their appointments, given that I would not be able to handle every issue for every patient (as opposed to just their cancer-related issues) in the time allotted to each patient. To avoid this, I’ve had to consciously decide that ïf it’s not related to their cancer or to the treatment of their cancer, I will send them back to their family doctor rather than deal with the problem myself. If it’s a very simple problem, I will generally choose to bend that rule.
BTW, I absolutely agree with the idea of changing/switching doctors if you are not satisfied (after giving the doc notice that there is a problem and hopefully giving him or her a chance to redeem themselves). I like the analogy with the mechanic, and would add that, like in any relationship, you get out what you put in. If you’re not happy, please squawk; if you’re starting with a new MD and you know what things you were not happy about in your relationships with other doctors, let them know up front about those issues.
When I moved here I asked my prior Dr. how to find a Dr. when I got here. He suggested that I contact the local pharmacists. He said that they deal with the local doctors all the time and know who is good and who isn’t.
When I finally got tired of all the local specialists telling me I couldn’t be cured of my stomach ailment, I sent letters to all the specialists in the country that I could find. I explained my problem, why I thought it was unique and asked them if they could help. I also asked who they would go to if they had a similar problem. I included a SSAE. I only heard back from two doctors, but I found a great surgeon to help me.
I can’t add much to what serious lark has to say. I would only say to be up front about the way your doc makes you feel; I often find that I think a patient understands and is comfortable with what’s going on, when that’s not the case at all. Once they tell me that they don’t understand, I’m happy to spend the extra time; I just don’t know that it’s necessary before that.
A resident clinic can provide you with anything that any other primary care clinic can. They may not give you narcotic pain meds, but that has nothing to do with them being residents and everything to do with narcotics not being the right medicine for the problem you have.
The odds are good that even if none of your friends has a doctor, one of them either works in the local medical community or has a close associate (SO, parent, roommate, etc.) who does. Ask around.
Full Disclosure : I am a veterinarian, so I might be biased.
Having said that, one of the nicest things about being in my profession is that I get to work with other vet.s and, by and large, veterinarians are the nicest people in the world. It would be hard to find a doctor more caring than your vet because vets set the bar so high in this area.
It’s not all about loving animals, either, as many of my clients have tons of animals but aren’t very nice people.
Vet.s are as a group smart (you wouldn’t get through, let alone into vet. school if you weren’t), care deeply about their profession (there’s no big $$$ pay off or prestige at the end of the day so they only do it for the joy of doing it), and, yes, love animals. In vet school being caring, compassionate, and a good communicator are valued and taught. It’s not just about getting the correct diagnosis and moving on. I get the sense “bedside manner” is less of a point of emphasis with physicians.
In all fairness, veterinarians have less reason to become suspicious and jaded than R.D.'s (real doctors as we call them) as we don’t see patient after patient with self-induced problems. I have people tell me the old Will Rogers line, “Veterinarians are the best doctors because their patients can’t tell them were it hurts” all the time. I always respond that it’s better that way, because my patients can’t talk they never lie to me.
As for the OP’s question. IMHO:
The best way to locate a competent doctor is to ask other doctors in the area. They know who’s good and who’s not. That’s a completely different question than locating a nice, patient, caring doctor. At the end of the day, however, I’d rather have one who knows what he or she is doing.
I’m not fond of doctors or taking medications, but now that I have health insurance for the first time in a few years, I decided to go in for a checkup. I’m relatively new to town and nobody I know was able to recommend a good doctor that was on my insurance plan–I’m in the same age group as the OP, and most people I know just don’t go to doctors unless they’re sick. Most doctors I called randomly were booked solid for a few months, but I did find a family-oriented clinic right near my house, staffed by two young DOs (Doctors of Osteopathy). They don’t take appointments, but instead take walk-in customers until 9 PM, which is perfect for me since I can go after work and not have to miss any hours. They also keep weekend hours, which is practically unheard-of, and it’s a pretty nice clinic.
The DO I talked to was very patient and cool, not at all like my parents’ older doctors with their gruff, dismissive “I’ve seen it all” attitudes and god-complexes. He was a good listener, friendly, and quick to volunteer answers for my questions. From what I’ve read, it seems like DOs are trained to have better bedside manners than traditional MDs, to be more willing to listen to patients, and to favor treating the whole person rather than the visible symptoms. I like that philosophy, and I was pretty impressed by the doctor I just saw. Maybe the OP should seek out a DO rather than an MD, if that is possible.
I think that one of the reasons physicians ‘get away’ with having such bad people skills, aside from the scheduling issues that constrain their time, is that we as patients don’t confront them about it.
It’s fairly easy to switch to a new doctor. It’s very uncomfortable to say to your current doctor why you’re unhappy with the care they are providing. I’ve been as guilty as anyone about this - but I’m trying to be better. Even if I do give up on someone and switch to a new provider, I try to write a note or make a phone call to the old provider explaining why I left. Not a pissy or whiny explanation, that’s too easy to brush off. But a rational note saying that they provide inadequate care has got to make an impact.
Finding a personality that you like can be difficult. My one hard and fast rule is I look for a doctor that is board-certified. That means they have passed additional testing, and in theory, should be more competant. Doesn’t mean that they are…
I’ve had more luck with younger doctors as well, especially with them being more “up” on modern techniques and such.
I’m lucky in that I found my current doctor who is wonderful. She spends extensive amounts of time with each patient. It is not unusual for her to spend 20 min talking with me about ongoing issues at each appointment.
Don’t be afraid to change doctors (if you’re allowed) if you’re not happy with the one you pick.
