What qualities do you most look for in a primary care physician?

In My Humble Opinion
21

Hang out with some nurse practitioners and see what they are doing, because in my experience they are way good.

I see my doc once a year (or less) but only because the CNP I see regularly makes me see him. There’s very little she can’t do for me.

We laugh and joke. She listens to me. She asks me how I plan to reach goals and we talk about what I’m doing, what I’m willing to do and what I’m not willing to do.

If she doesn’t know something, like the lesser-known side effects of a drug, she’ll look it up right there in the exam room.

She writes everything down and refers not to just the previous appointment notes, but several appointments prior.

Most importantly, she schedules a half hour for appointments not just 15 mins. If I have to see the doctor, it’s an hour + wait. I’ve NEVER been held up seeing the CNP.

And that’s not just for the CNP I visit regularly, either. If I need a same-day appointment, I end up seeing a CNP. Pulled muscles, ear infections, flu. They all take me right away and get me fixed right up.

My doctor is not all that bad - he’s a jocular fellow. He’s just not as awesome as the CNPs he employs.

22

As a young woman, the biggest reason I’ve dropped doctors after 1 visit is they would not listen to me. It was regarding gynecological issues, so you may not be dealing with those specifics, but it’s still the most important quality.

Be professional. It seems obvious, but stroking a patient’s inner thigh and hitting on them during an exam is not a great way to proceed, and comments on what a patient does or does not do with their body hair probably won’t make them comfortable.

Be informative. What are you going to do? Where’s that gloved hand going? Should I expect it to hurt? No surprises, please.

Believe your patients, unless you actually have evidence to contradict what they’re saying. It goes along with listening. If I say something hurts (especially if it’s something you’re doing) don’t act like I’m lying.

23

Pay attention to what I say and my state of anxiety or calmness.

I fired a doc a number of years ago because he got angry with me for asking questions he could not answer.
I got very sick twice in one year from infections, and I asked, “What’s causing this and what can I do to keep it from happening?”
He got PISSED OFF at me for asking.
Not OK with me. If he would have said he had no answers for me, that would not satisfy me, but I would have felt listened to and respected.

He’s gone, and my current doc listens.

Good luck
David

24

Listen to me (are you sensing a pattern here?), and treat me as an individual.

Don’t assume that your female patients WILL want to give birth, when they ask you about permanent birth control. Some of us really don’t want kids. I don’t know about men and vasectomies, but some women know, quite early on, that they never want kids. Don’t make them throw hissy fits to get a tubal or whatever those tubal plugs are.

Yes, my weight might complicate whatever problem I’m seeing you for. However, it might be nice if you praised me for losing all that weight over the past several years. I’m still fat, but I’m nowhere near as fat as I used to be. It’s been a very long hard struggle, and I’m really not seeing much benefit from it. My arthritis hasn’t improved, nor has my diabetes. NOTHING has improved, as far as I can tell, other than the scale has a much lower number on it. So quit bitching about my weight, I’m losing it as fast as is safe, according to you. And it’s not like I could suddenly wake up with all my fat gone, is it? So work with me from where I am NOW. And sometimes my problems have absolutely nothing to do with my weight. I know I’m overweight, I’m doing what I can for it, you’ve approved my diet and exercise plans, you’ve seen my weight go down, so commenting on my weight isn’t going to do anything but make me feel worse. Treat me for my current problems, the ones I’m asking for help with.

Some of those medicines have real quality-of-life negative side effects. I’m not going to take a medicine if it’s going to make my other problems worse. I gave metformin a fair chance, but I couldn’t take the side effects. Yes, it’s very effective in some diabetics. And it did lower my blood sugar. But if I can’t get out of the house because of the side effects, I’m not going to take it.

Make sure that the office staff isn’t overscheduling you, that is, that you’re not running an hour or two late every day.

Oh, and quit grumbling about my antibiotic allergies. I don’t LIKE being allergic to six common antibiotics, and if I could change it, I would. It would make life easier on me as well as you if I could take penicillin, Levaquin, and all the others.

25

What everybody else says =)

Also - my eye doc has a web presence to make appointments, and it emails you a week before an appointment with a clicky to confirm you will be appearing for the appointment. It is wonderful [although I came down with this damned cold the day after I confirmed the appointment I should have had yesterday but had to call in and change to the 16th] If you could arrange to email out notifications of upcoming appointments, or the need to make an appointment for <whatever>

My doc schedules the annual physical for the week of your birthday, makes it sort of easy to remember.

Make it easy to email questions in to the office and actually have someone assigned to getting them answered fast.

26

Listen to what I’m telling you about what’s going on with my body. All of what I’m telling you, not just the first 2 sentences. I don’t like wasting time any more than you do; I wouldn’t bother telling you this if I didn’t feel it was relevant.

“You’re fat” is not a blanket explanation for every single symptom a person ever experiences. Yes, excess body weight causes or exacerbates many issues. I know that. But being 20 pounds overweight should not cause someone to start sleeping 18 hours a day, eat so little they lose weight even at that activity level, and turn yellow. Nor should it give someone a chronic cough, neck and back pain, or spells of being lightheaded. Depression is likewise not a blanket diagnosis for every issue, especially if the patient has no previous history of depression.

Incidentally, what did the practice patient have to say about you? And was this a standardized patient for learning exams, or someone who came in for an appointment they let you have first crack at? You have to understand and accept that not everybody is going to like you–no matter how fabulous you are, there will always be someone who doesn’t like the order you perform an exam in, or the tone of your voice, or the level of detail you want to go into in you h&p. And a fair few who simply don’t like what you tell them and therefore think you suck, plus a handful of just plain old loonybirds. You have to learn to separate valid complaints from the bullshit ones, address the former seriously, and ignore the latter.

27

I guess it depends where you live. There’s no shortage here. We had our pick of doctors.

I agree with whoever said “listens to you.” I suffered from migraines for years and years, from early adolescence on, because our family doctor hadn’t any interest in what I was saying. The conversations went like this:

ME: I am having terrible headaches that are ruining my life.
DOC: So do they feel like a tight band around your head?
ME: No, they don’t feel like that at all. They feel like…
DOC: Well, when you get those headaches that feel like tightness all around your head, that’s just stress, or possibly you need to drink more water.
ME: No, they don’t feel like that at all. That is nothing like my symptoms. They feel like a sharp…
DOC: Okay, drink more water and take Tylenol, bye!
ME: No… wait… where are you going?

Literally, for years.

When I moved out I switched doctors and was amazed to find that some family doctors actually know something about medicine. Our current family doctor listens patiently to every word.

28

This, reading the other responses makes me glad I never chose to go to medical schule and sad for some people I know that are on their way to becoming GP’s.

29

Yes, it’s a sad state of affairs when you want a person that you’re going to let ram their hand up your pussy, to show some respect. :rolleyes: If you want to fix things that don’t talk back, become a mechanic.

Honestly, there are doctors out there that don’t show a grown ass adult the respect a vet shows a dog. THAT’s what’s sad. Oddly, my sister-in-law who is in medical school shares this wacky opinion I have.

30

I’m probably older than you are; don’t call me young man.

Don’t call me by my first name if you expect me to call you Doctor whatever.

Don’t condescend to me. Ever.

If I tell you a medication is working for me, don’t arbitrarily change it without a good explanation and probably not even then. (Usually applies only on first visit.)

Don’t make me sit in your waiting room for thirty minutes past my appointment time without some sort of explanation from you or your nurse/staff as to what is going on.

Don’t park me in an examination room and leave me without someone periodically sticking their head in to let me know I’ve not been forgotten. (I’ve walked out on doctors over this.) My time is as valuable to me, at least, as yours is to you.

If I have a condition that involves chronic pain, don’t cover your ass by refusing to prescribe adequate pain medication, especially at my age.

I’m on a fixed income and have only Medicare; don’t order a bunch of tests that will leave me broke for a month after I pay my deductible.

Don’t be overly impressed by your own education; some of your patients know a thing or two themselves.

31

Missed the freaking edit window; I do wish the SuperComputer would throw that message in my face before I’ve wasted time pushing “Edit” and then typing the changes I would like to make.

Anyway, don’t tell me some new ache or pain is because I’m getting old(er). If I weren’t concerned about it, I wouldn’t mention it. You’ll come across as if you’re telling me I’ll be dead soon so I needn’t worry about it or as if you’re telling me I’ll be dead soon so it isn’t worth your time to diagnose the problem.

32

Since I’m a primary care doc, and have been for over two decades, what I look for in a primary care doc is different from what the typical patient looks for. Frankly, what I want in my own doc will turn off a lot of patients.

  1. Board Certification. Not a guarantee of competence, but the odds go up.

  2. Use evidence-based medicine.

  3. Give me what I need, not what I want. Or what you think I want. And be prepared to tell me why what I want is not what I need, and be ready to defend that.

  4. Be available. You or your associates who cover for you.

  5. Never lie to me or omit information.

  6. Don’t let me talk you into doing things you don’t believe you should do.

  7. Don’t have the reputation of being a ‘pill doctor’

33

I adore my PCP. I’m probably his youngest patient (at 40!) and I think he may be a bit younger than me - he’s in practice with his father.

What makes him so great:

If I have an emergency, I have always been able to get in same day or next day.

I’ve never been kept waiting in the waiting room to be seen. Even when I’ve booked an emergency appointment.

I am rarely left waiting in the exam room, and on the one occasion I was, I was checked on by the doctor and informed of what was going on.

When he’s with me, he’s with me. There is no checking of the watch or interruptions by the nurses. I’m not rushed out the door in ten minutes. He takes the time to make sure whatever brought me to him that day is addressed, including any questions answered.

He will explain his choice of medication, and doesn’t cop an attitude when I question why one drug over another.

ETA: He doesn’t force medicine down my throat either - and is open and knowledgeable on alternative treatments.

If he doesn’t know something, he’ll have it researched by the time of my next visit.

I get a copy of all my blood work results in the mail with a nice personal note attached.

He’s gentle in both speech and touch. Always a good thing when being poked and prodded.

34

(Note: Med school attending and cynical refugee from private practice here.)

As everyone points out, it’s important to listen to the patient–and to make sure the patient feels as if he has been listened to. If you’re really not listening and don’t care, I don’t think it’s possible to fake it, but sometimes people who care and are listening don’t make it obvious. It’s up to you to manage the impression.

When you ask the patient what’s going on, there’s an urge after about ten seconds to break in with a follow-up question to direct the conversation. Swallow it. Then swallow the next one. Just let the patient talk and keep your mouth shut.

Usually there’s a detail in there about the patient’s life. Try to call back to it at the end when you’re explaining what you’re going to do. That lets them know you were paying attention. “I expect this to be cleared up before you leave for Florida next week.” “You shouldn’t be contagious now, so don’t worry about giving it to your grandbaby.” That sort of thing.

Note that for a lot of people, “listens to me” means “does what I tell him to do”. “I told him that I just needed a few days of Avelox to clear this cold up, but he didn’t listen to me.” “I tried to explain that I need Oxycontin and Xanax for this headache, but he just wouldn’t listen to me.” A lot of patients are not interested in your opinion; they just want the drugs and the work excuse. So while listening is the most important thing you can do, you have to be able to be honest with yourself and understand whether you were really not listening, or you didn’t sufficiently give the impression that you were listening, or if you just didn’t agree with the assessment and plan that the patient had in mind.

Don’t minimize anything. If a patient comes to you with a cold, it’s probably a pretty bad cold, so even if there isn’t much you can do about it don’t act like it’s nothing. Give the patient permission to feel bad.

It’s hard as a med student, because it really takes a few thousand patient encounters before you develop some confidence and a style that works for you. You’ll get there.

35

Competency obviously, but besides that, I want convenience.

Quick-in, quick-out. open evenings (at least once a week) and Saturdays would be nice.

Respect, but be a straight-shooter. Don’t patronize.

36

Also, speak my language. Literally. It’s okay to be foreign-born and have an exotic-to-me name like “Doctor Janvarfid Phanabalapan” if you speak and understand (in my case, English) passably well.

But…if you leave off indefinite articles (a, and, the), use really strange grammar (“Please not to be taking with food, should only empty stomach”) or, worst of all, stop and search for the correct word, I will lose confidence that we are communicating effectively. We’re all familiar with stories of badly-translated assembly instructions and user manuals: funny when it’s furniture or computers, less funny when it’s my body.

37

LISTEN! Good God, that’s number one. Hear what I’m saying. I realize you deal with idiots, the insane, the demented, the stupid, the uneducated, the frightened, the ignorant, the misinformed and I’m sure some days you’re tempted to think all your patients are nutty morons but you still have to listen to all of them, along with those of us who are reasonably educated, coherent, rational lay people. It’s part of being a doctor.

Please do not assume that because I am a woman I am a crybaby about pain. If I tell you it hurts, it hurts, please do not be dismissive of my pain. (Fortunately, this has become much less common over the past few decades)

I have a life-long chronic condition. You may know more about medicine in general, but I am an expert in my own body’s reactions. Please respect my past experience. I don’t always know why I’ve experienced something, but when I say X happened it probably did.

Please pay attention to what is in my chart. I realize that, being mostly healthy, you don’t see me very often but seriously, at least glance in it. I shouldn’t have to remind you of my chronic problem, or explain yet again that I won’t get a flu shot due to the risk of anaphyllaxis.

If you are going to do something that will cause pain do not say it will be “uncomfortable”. That’s bullshit and we both know it. If it’s a little pain phrases like “hard pinch” or “feels like a shot” are acceptable. If it’s going to hurt let me know: “This will hurt but I will try to get it over with as quickly as possible.” Yes, I may whimper or make noises while in pain, it’s a normal thing people do. I’ll try to keep it as quiet as possible if you are as quick as possible.

If it’s something straightforward - “you have a strep infection” - just tell me and what to do. If there is something that has alternatives let me know.

If there are possible side effects let me know of the possibility. If relevant, let me know which ones can wait for the next opportunity to see you, and which ones might require a trip to the ER.

Please do not assume that because I am dirt poor right now I am uneducated.

When I express concern about the cost of a treatment at least act like you care - some of the best doctors I’ve had have learned to be sensitive to cost. One who saw me for an infection when I had no money and no insurance informed me that the antibiotic I needed was available for free at several different local stores - wow, that was a HUGE relief to me! It also meant I went to directly fill the prescription instead of spending days trying to scrape up/borrow/beg money before trying to fill it. Another is very good at reminding me to check with my current insurance - when referring my chronically ill husband to specialists he gives us several names to increase the chances one will be on the approved list. This doesn’t mean you do things FOR us, just maintain some awareness that money is an issue and know where to point people.

Please address me as “Ms. Broomstick” or “Mrs. Broomstick”. We are in a strictly business relationship, and a little extra formality and respect makes it a lot easier for me to sit in your office half naked wearing a ridiculous paper shirt or immodest gown, or to shove things into/up various bodily orifices. If someone gives you permission to use a first name, fine, but a lot of us prefer the formality. Especially when the doctor is half our age.

But most of all - LISTEN.

38

Can you tell us what you were dinged on? Then we could give you specific advice. We love to do that…

39

I like someone who doesn’t make me feel like I am on an assembly line, someone who will take the time to listen.

I want someone who cares, but doesn’t over-react either. (One GP cried “Mersa” for a simple stitch that had worked its way to the surface. Even the surgeon who removed it poked fun at him.)

Those are the two biggest. If I think of more I’ll come back.

40

I mean no disrespect to the poster - but this is something that would send me running from a physician’s office post-haste. I want a man or woman of science treating me, damnit, not someone who peddles or indulges in mystical woo. Recommendations of homeopathic treatments, referrals to chiropracters (except for possibly some back conditions), or herbal medications that haven’t been rigorously vetted in the peer-reviewed literature are a good way to ensure I will never, ever come back. If I’m sufficiently annoyed, I may even file a complaint with the state Board.

Medicine is science - peddling woo to indulge your patients’ superstitions is bad science.