How to find a doctor (Sorry, NGC)

[Gliderjohn]

I recently lost my primary physician as he moved on to a bigger and better gig. I was very comfortable with him. He was a good listener, asked questions and was pleasant. When he left I looked over the bios of the docs in my area and one stood out as far as seeming to meet my needs and is a GP.
Had my first meeting and what was suppose to be my annual physical todayl. He came in and introduced himself. Without looking or asking about my history or the stats his nurse just took, he asked me what my concerns were. I said BP (been on the borderline from what I understand and this suppose to be one of his focus areas), frequent urination, a skin spot and ear wax build up which is chronic with me.
His first response was "Giving me a laundry list once a year does not cut it with me." Acting put out he checked my ears. Other than discussing and suggesting some treatment changes for my bladder/prostrate and ordering labs, he did none of the usual checking my heart and lungs, rectal exam (not like I look forward to it), etc. that usually happens at annual exams.
How do you all go about finding a good doc and what is your definition of one?
GliderJohn

[Chuck in Indiana]

Good luck with that. My internist, Dave the doc sez he's fed up with guys that all they want to do is make money. Schedule way too many people, don't take time to do a proper exam or *listen.* Unfortunately, Dave is the same age I am, and who knows who will be left standing. Dave just got back from his vacation in Haiti, where he volunteers every year. I don't know if there are any more like him.. I hope so.

[DucatiSSsp]

Been going to the same Family Medicine practice for 45 of my fifty years.  Gone through 6 or 7 different doctors.  Don't expect to be treated for all your issues at a yearly physical.  Since ins. only pays a certain amount, they only give you a certain amount of time and tests.  When I go for my yearly physical, I feel like a head of cattle.....move 'em on through!!!  Feel like I need to find a new one myself.  I think the doctors spend much more time playing w/ their Ipads instead of focusing on the patient.  Would probably start asking friends for referrals.  Might try scheduling another visit w/ your current doctor and see if things don't improve.
Wish my sister didn't get divorced from her "Harvard Docta" husband as if we had any issues, he would call the attending physician and go over the case with them and follow up.   

[Kev m]

As far as I'm concerned the best way is to ask people you trust, hopefully another practicing physician in the area who would know the doc professionally.

A lot of people make assumptions about doctors. Like over-scheduling as a money grab. But there are a few things that generally go against this.

1. If money was the most important concern they'd not have gone into primary medicine in the first place, especially if they are younger (like trained in the past decade or so). Primary care physicians make a fraction of specialists. And they are largely being pushed out of the business by even cheaper mid-level providers (NPs and PAs with a fraction of the training).

2. I'm sure there are bad ones (greedy or burnt out), but generally speaking no physician WANTS to over book their schedule. It happens because they were held up on rounds or called to check on an emergent patient, or they are trying to accommodate the needs of their patients, or they have patients who schedule an appointment for one thing then add a second or third and they get behind. In Pediatrics the parent may bring a sibling and try for a 2-1 (oh could you just look at him too, he's had this cough for a week...). Or some combination of the above. But it's not uncommon for a physician to work an 8-10 hour shift without having enough time to eat a lunch.

[davedel44]

John,

I feel your pain.  Just lost the kindest, most caring doc I ever had. She was supportive and encouraging.

Back to my old pcp.
He's kind of curt.  I called him on it at our last visit and I thought his resident was going to shit himself.

That said I know he's a good doc and he has helped me manage  my health well.  So I'll  do my best to follow his advice.

I also know that between his teaching load and patient load he is slammed most of the time, so we discuss decisions through email and schedule  labs before visits to make the most out of our appointment time. 

If you see this guy again and his attitude bugs you tell him.
Ask him to specify how he plans to address your medical concerns.  Let him know that you're willing to put in the work to follow his suggestions, but the bottom line is he works for you. 

I'm not a real doctor, but I play one on the forum.

Dave
Galveston

[Kent in Upstate NY]

Wait until the doc sees the lab results. Then you can have a more informed conversation.

[TodkaVonic]

Doc here.

Kev is correct. Ask around. Better yet, ask a nurse or another doctor. If it's not working out with a particular doc, don't be afraid to "fire" him or her and then to move onto someone else.  If possible, think a little bit about what concerns you have and maybe write them down prior to your appointment. If it's been your experience that doctor A spends too little time with you, you can try to book a longer visit or stress at the outset that you have two or three specific issues which you'd like addressed and that the appointment time allotted, although brief, is plenty of time to get that done. And then smile. If your concerns are not met, or you have additional ones which weren't discussed, make another appointment or find a new doc.

Some notes from our side: we're all overbooked. That doesn't mean we're merely busy, it means that three or four patients have the exact same appointment time as you. There's several people with whom we work and on whom we depend and, just like any workplace, some are better/more dependable/more efficient than others.  A routine 20 minute thing can easily turn into an hour, test results may not be available even though the blood was drawn two hours ago and now the patient is sitting in front of you, and the electronic medical record, on which we all depend at all times, may, at any moment, go down. There are patients added to our schedules throughout the day and if I'm on-call, I may have to go to the OR 10 minutes ago. Throw into this mess the gravity of the decisions that are being made and the severity of missteps, and, it's a wonder that anyone is going into medicine at all.

Must be that we like to help people.

Even the old grumpy ones.

Just sayin.

[SED]

Doc,

That makes a world of sense.  I had a doc that was great.  I would ask a specific question and he would say "let me think about that" and continue his work, then answer my question very clearly - frequently referencing recent research.  He was solid and human.  He lost a patient to prostate cancer that shook him up and later decided to move to the emergency room.  Now he sees really sick people for very short periods of time - helping when they need it the most.  I asked him who he would recommend to replace him and he gave me two names, one of which is my current doc and also very good though I don't yet feel the same attachment. 

Doctors are really taxed by our medical system (a zillion things to do and a ton of responsibility in 10 minute chunks) and yet I've found a couple really good ones that will take the time to explain it to me and make it make sense. 

Thank You.

[balvenie]

I have had four doctors in a year. Found the last one by "tracking down" a doc that I saw a few years ago. Sticking with him. Liked him then and still do. Involves a bit of travelling but he is the best for me.

[oldbike54]

 My doc at the VA has something like 6,000 patients , most of us Korean to Viet Nam vets  , with some WW2 fellas mixed in. so a bunch of grouchy old bastages . I make an effort to be courteous and complimentary on my visits , his team of nurses , NP's ,and PA's are usually cheerful and efficient . Don't know how they do it 

 Dusty

[Gliderjohn]

Thanks for the responses guys. My previous doctor that I really liked was recommended to me by an RN that was also an English teacher at one of the schools I worked at. Problem is I no longer know anyone working in the medical field around here.
GliderJohn

[Kev m]

Thanks for the responses guys. My previous doctor that I really liked was recommended to me by an RN that was also an English teacher at one of the schools I worked at. Problem is I no longer know anyone working in the medical field around here.
GliderJohn

I'll assume you have no way of getting in touch with your old doc.

If that's the case, it's time to start asking friends and family in the area.

[Gliderjohn]

Quote from Kev M:

If that's the case, it's time to start asking friends and family in the area.

Yea, that's the next step. Ironically, the first three people I have talked with about this were also using the same doc I was. I think I can get in contact with my old doc. The last time I saw him he was still working at the clinic and did not seem comfortable about making recommendations. Maybe now that he is no longer affiliated he may be more open about it.
GliderJohn

[sidmonsters]

It's nice to see some balance in the discussion--too often it's "money hungry MD's" and that's that.  I am a DVM married to a family medicine goddess, and I wouldn't trade with her for anything.  The poor compensation for PCPs and insurance pressures to move patients through would give me ulcers.  She's a fantastic, caring doctor and most frustrated by the lack of time allowed for REAL healthcare.  She's not in it for the money and never has been in 25 years...but when I get 20-30 minutes face time with my patients and owners to talk through diagnostic and treatment options and she gets 10 minutes to talk with a new patient with obesity and heart disease, it's pretty obvious sum'nz outta whack.  We live comfortably, but two kids in college and two in high school means there isn't a lot of discretionary income in the bank ('cept for the 2013 Stelvio I just bought and haven't even taken delivery on yet...spring hits Ohio on Monday I hope!)

[canuguzzi]

When the Doc I was comfortable with decided to head east because the cost of living here was doing him in, prior to leaving he provided referrals and a transition plan for me including an intro to his replacement. Everything went off without a hitch and although some things are now handled by a NP, care provided has been great.

When professionals leave for some reason other than death, you'd hope they understand the implications it has to their clients or patients. They might have many but unless they are bugging out with the midnight express, referrals is too much to ask?

Maybe I was lucky but at least I know there was some thought put into the process and I wasn't left in the lurch.

[Gliderjohn]

Possible good news this morning. Ran into an acquaintance in the exercise room this morning. Got talking and he had also lost the same doctor I did. He just went to a new one for him, also for his annual and was very pleased. The experience he described sounded much better than mine was. At least I have a lead on a possible good one now. Thanks all.
GliderJohn

[TodkaVonic]

Possible good news this morning. Ran into an acquaintance in the exercise room this morning. Got talking and he had also lost the same doctor I did. He just went to a new one for him, also for his annual and was very pleased. The experience he described sounded much better than mine was. At least I have a lead on a possible good one now. Thanks all.
GliderJohn

Hey great! Good luck.

[Arizona Wayne]

Not directly related, but, a few years ago the wife & I had a MD together who over time we decided wasn't that good.  I contacted a different MD to make a switch and when I told him who my current MD was and why I wanted to change, he wouldn't take us because he played golf with our current MD.    So I ended up having to find another MD to switch, who later moved out of state.  And since then we moved out of state so we have not had the same MD for long for quite a few years now for different reasons.  I no longer assume a MD is always right on what they say.  I would like to have a MD I totally trusted their judgment on but the older I get the less  possible that seems to be.  We now spend more time with specialists than our GP.

[balvenie]

  I no longer assume a MD is always right on what they say.  I would like to have a MD I totally trusted their judgment on but the older I get the less  possible that seems to be.  We now spend more time with specialists than our GP.

Dead Right

[Kev m]

Well gentlemen, a good physician is going to (as much as they can) listen to your concerns and express their opinions hopefully without generally saying or sounding like they are 100% certain if they can't be.

That sad, look at the other side of the coin.

Think of some of the anti-science nuts they have to deal with these days like the anti-vaxxers. Doctors are human too, they have bad days, they even make mistakes. But let's be honest unless they're incompetent the tend to make mistakes on the little things. There are always exceptions but still, they're not the rule.

Currently popular and floating through the medical community:

[Chuck in Indiana]

Do not.. I repeat.. Do not google your symptoms.   

[Arizona Wayne]

Doctors are the only people I know that get paid in full whether their diagnosis/implementation is successful or not.  Even if you(patient) die they still get paid for their effort.

[Kev m]

Doctors are the only people I know that get paid in full whether their diagnosis/implementation is successful or not.  Even if you(patient) die they still get paid for their effort.

Aw hell, you're kidding me right. There are a hell of a lot of professions that get paid regardless of "success" from many lawyers (unless billing on contingency), to most administrators and managers, to the military and law enforcement.

What most of those people have in common with doctors is that they are dealing with forces that are not completely under their control so success cannot always be guaranteed.

But thank God for a lot of their efforts.

[LowRyter]

I've had four GPs in the last 20 years.  My favorite one I got back twice but he run oft about 8 years ago.

I am not sure I trust the one I have now.  I don't dislike him but I have 60% confidence.  So it goes.  I still have my butt doctor and my PT. 

Even worse is a 30 yo urologist- just say no.

[Arizona Wayne]

I've had four GPs in the last 20 years.  My favorite one I got back twice but he run oft about 8 years ago.

I am not sure I trust the one I have now.  I don't dislike him but I have 60% confidence.  So it goes.  I still have my butt doctor and my PT. 

Even worse is a 30 yo urologist- just say no.

I'm not kidding.  That is why there are law suits and liability insurance.  The other titles you reference  don't have near as many opportunities for negligence nor do the others get paid as much for every incident they deal with.  Incidents of war cannot be compared to civilian casualties.  If a medical Dr. is incompetent they should be barred from practice.   Passing tests to become a professional MD is not the same as applying what they have been taught correctly.  There are good & bad  Dr.s just like any other profession.

[Kev m]

I'm not kidding.  That is why there are law suits and liability insurance.  The other titles you reference  don't have near as many opportunities for negligence nor do the others get paid as much for every incident they deal with.  Incidents of war cannot be compared to civilian casualties.  If a medical Dr. is incompetent they should be barred from practice.   Passing tests to become a professional MD is not the same as applying what they have been taught correctly.  There are good & bad  Dr.s just like any other profession.

There are lawsuits and malpractice insurance policies more because of the overly litigious society in which we live where people far too often feel they are due compensation by the world no matter what the reason something bad happens to them.

That's not to say that mistakes don't happen.

But the thing about medicine is that we're all dying. It's just s matter of from what and when. And no matter how good a doctor is they can't fix everything. The amazing shit that surgeons and OBs do every day carries some risk with it, some unpredictable outcomes.

Don't get me wrong there are real tragedies, but I'm not even convinced they are the majority of lawsuits.

My comparison to incidents of war or even to law enforcement or fire/rescue is that just like a doctor the soldier, cop, fireman can do everything right but still have a poor outcome. That's because in all instances the outcome is determined by more than just their skills, they are dealing with forces out of their control.

[Kev m]

PS, I think the general public doesn't realize how much it takes for a doctor to practice medicine.

It's not enough to just get into medical school.

While in school they need to pass 3 separate tests (Step 1, 2, & 3) which they have finite chances to do or find another career.

After school they spend 3-7 years as a resident (basically an apprenticeship mentored and followed closely by long time practitioners).

After completion of this they are board eligible meaning they can pay many thousands of dollars to take an all day long test for board certification.

Then specialists will spend another 1-4 years with a fellowship (basically a second apprenticeship).

Then they are board eligible for the specialty test.

By the end if residency and, if applicable fellowship, they've basically been away from their families for a year or two (one overnight shift at a time). They are in their mid 30's, have 25-30 years or so in school including 7-15 years of medicine to get where they are. Plus they are quite likely a couple hundred thousand dollars in debt for student loans. While their peers graduated college or a trade school, started careers and likely enjoyed their 20's.

And then they get the privilege of basically remaining in school the rest of their lives with required annual Continuing Medical Education (CME) credits and recertification exams every 7-10 years as long as they wish to practice.

It's a long and unforgiving road which would be moronic to take just for the money because there are better opportunities for that in the legal and business sectors that begin paying dividends a decade sooner with a fraction of the time commitment never mind the lifelong CME/recertifications.

Again, that's not to say there aren't some that make mistakes or that just plain aren't nice people, but I bet many of those are just burnt out by the system.

[pete roper]

Kev is right. It's no walk in the park.

I have some issues with the medical proffesion's 'Closed Shop' but I'm not suggesting any alternative to modern, scientifically proven, medicine.

If you want that just look in the yellow pages under 'C' for charlatan and 'M' for mountebank!

Please, don't get me started, I'll get banned!

Pete

PS. Jude asked me to add 'S' for snake oil salesman.......

[LowRyter]

not to stir the pot but it's actually pretty hard to successfully sue a doctor.  Just because someone loses a lawsuit doesn't mean it was frivolous. 

[Kev m]

not to stir the pot but it's actually pretty hard to successfully sue a doctor.  Just because someone loses a lawsuit doesn't mean it was frivolous.

Just cause someone settles doesn't mean they were wrong either.