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How to hire a Medical Doctor?

A doctor debate started on a recent thread.
Hiring is a constant theme on this board.

How do you find a good doctor? Interviews? Word of mouth? Throw the phonebook down the stairs and see which page it lands open on?

Personally I've tried to go with word of mouth. The usual end result is anyone who says "my doctor is great" has a doctor who no longer accepts new patients. Everyone else says either "let me know when you find one" or "my doc is just OK". Well, except for the people who tell me of the things their doctor did to them which made them much worse, but thankfully that's rare.

mb
Thursday, June 05, 2003

Here in Ontario the way to hire a doctor is 'take the first one who will accept you', because most are full.

David Clayworth
Thursday, June 05, 2003

At least in the US, the hiring of the doctor is largely controlled by health insurance requirements.

Wayne Earl
Thursday, June 05, 2003

When I taught in Primary School in Riyadh in the early nineties an average of 60% of the parents were doctors.

I didn't have a just have preferential access to a doctor but to a dermatologist, a heart surgeon, a dental surgeon and every other speciality you could think of.

Pity I was scarcely ever ill!

Stephen Jones
Thursday, June 05, 2003

Some publications list "the area's best doctors".

I picked up a copy of Washingtonian (?) Magazine at the supermarket, cross-referenced it with my health insurance company's list of providers, and just started calling around. Yes, you'll have to make 20 phone calls, and hear "we're not accepting new patients" 19 times. Suck it up; it's your health we're talking about.

BTW, do *not* just go through the provider directory and pick the guy with the most convenient location. I did that approach first. He sucked.

Joe Grossberg
Thursday, June 05, 2003

I second the situation in Ontario. I commute 40 minutes to work and my family doctor is 20 minutes in the opposite direction. I was lucky that my girlfriend met our family doctor through work.

It seems to me that finding a family doctor (here at least) is much like finding a new job. Networking is extremely important.

SuprDude
Thursday, June 05, 2003

Here's what I do, at a minimum:

1)  I check the disciplinary records for any doctor that I have contact with (or am thinking of having contact with).  New York State conveniently puts all those records on-line:

http://www.health.state.ny.us/nysdoh/opmc/main.htm

2)  I do all my own research.  The University of Rochester allows community members to use the school's medical library (you just can't take materials out of the library).  I would guess that many other universities have the same policy.  The best place to get journal references is through Medline:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

Then, you can look up the full-text articles at the library.

Many medical articles are more accessible than you might think.  Most people who are reasonably intelligent could probably figure out journal articles without too much trouble.

Yeah, doing your own legwork can be a hassle, but it sure beats the alternative.

Alex Chernavsky
Thursday, June 05, 2003

If you're talking about selecting a Primary Care Provider for an HMO you'll want to take a look at this month's Men's Health.  Their article is quite informative and covers many of the things you don't know when looking for a good GP.

Here's one - look for an internist instead - they have to take classes every year, get recertified regularly, and have extra schooling on the types of things you'll be going to see them about - "Why is my arm all green?"

Lou
Thursday, June 05, 2003

I fear this topic will be deleted shortly but since you asked- there is no way reliably to select a doctor, especially without any specific criteria.  I think most people want a doctor who seems sympathetic and "listens".  Neither of these indicate whether or not the doctor will do what is medically proper in any given situation.  Many, possibly most ,of us will never (until life's end) have a serious illness which will not eventually resolve on its own.  Most of us will never have a disease which is particularly difficult to diagnose (i.e. the average doc will miss it but a great doc will pic it up).

The only good suggestion I have read here is to check the doctor's disciplinary record.  The bad doctors, over time, may build up a record.  Beware, though, using lawsuits filed as a criteria- this tends to have more to do with specialty and personality than actual incompetence.

Also, my opinion is that "100 best doctor" lists are likely to be crap.  They may sell magazines but I fail to see how they could be reliably compiled, once again, in the absence of good criteria.

Erik Lickerman
Thursday, June 05, 2003

I (also in Ontario) use the family practice clinic of the local teaching hospital.

Christopher Wells
Thursday, June 05, 2003

self diagnosis baby!

Seriously though, I haven't seen a doctor in years. The last time I saw a doctor was back in 1995, when I'd had a climbing accident, and had broken my leg.

When I get sick it is typically a cold (about twice a year). The rest of the time, I just 'listen' to my body, eat when I'm hungry, drink when I am thirsty, and rest when I am tired.

Never understood the whole "you have to see a doctor every three months nonsense." I really do have better things to do with my time, and I hate the smell of surgeries.

PS. The best cure for a cold, is Lemsip, Paracetemol, herbal tea, honey  and (the most important ingrediant) Scoth whisky. One large mug of that and a good nights sleep, I get up feeling like a Swiss watch.

tapiwa
Friday, June 06, 2003

Lemsip contains Paracetamol already, so make sure you don't overdose by taking the 2 at the same time...

deft
Friday, June 06, 2003

Well, lets see, I've got a physiotherapist, two surgeons, two psychiatrists[1] and I'm about to gain an endocrinologist when I can get round to making an initial appointment.

An awful lot of these I was referred to by each other, and the start point was wandering through the appropriate part of a suitable phone book[2] and then talking my GP into writing referal letters to people she's never heard of in specialities she's never dealt with before. (Fortunately she's cool about doing this.)

The surgeon, for example, I was sent to by the physio department when my "ligament damage" failed to improve over time. {It later transpired this was because what was actually hurting was a wrongly healed fracture site...}

At the time it was very much "right, you'll be needing to go talk to our knee specialist then".


GP-wise I asked the local health authority for a list of local surgeries and found the one closest to the house on the basis that having a doctor's I can crawl to seems a reasonable sensible idea...


And some of us have to go every month to have our blood pressure checked, three monthly checkups is a **luxury**


[1] Both of whom are more bonkers than I am.

[2] Location of such, exercise for reader.

Katie Lucas
Friday, June 06, 2003

You saw a doctor when you broke your leg?!?

Hah! Wuss!!

PROPER software engineers just carry on. Fractured femoral condyle (didn't actually know this was what had happened) on an Easter Sunday.

They got me home on the Sunday and asked if I wanted to be taken to A&E, and I absolutely refused to spend the rest of the day sitting in a waiting room. So I just took loads of painkillers and then we all went to the cinema, me propped up by a couple of friends...

Was back at work on the Tuesday... bit heroic and all that, but there was software that needed writing.

I managed about four months walking[1] around before finally the other half got fed up of me eating painkillers and still having it hurt and made me go to the doctors.

Where they diagnosed the aforementionedly whined-about "ligament damage" and sent me to physiotherapy.

It was another couple of months before anyone actually found the big hole in my bone caused by the fracture not healing properly and even then they made me hobble about with it like that (on crutches admittedly) for three months to see if it would heal up on its own.

It was coming up on ten months after the actual injury before I found myself in hospital having dead bone drilled out of me.


<smiles and accepts applause of audience gratiously>


And that was easily the DUMBEST, STUPIDEST thing I've ever done in my whole entire life. Never, ever, ever, ever do anything as stupid as this.

Because of course by then things in my knee were really messed up - two and a half years on, I still can't walk properly.

So I cannot emphasise this enough: When you break bones, go to A&E.


[1] Mmmmm. Weeeelll... sort of limping badly more than walking.

Katie Lucas
Friday, June 06, 2003

> I managed about four months walking[1] around before finally the other half got fed up of me eating painkillers and still having it hurt and made me go to the doctors.

There's an RTFM lesson in there: the label on a packet of Tylenol says "If pain persists for more than 5 days, consult a doctor." The last time I didn't want to go on living without exceeding the recommended dose, I took myself to hospital where they found and fixed an abcess.

Christopher Wells
Friday, June 06, 2003

Don't forget to check the waiting times.

This is my biggest complaint, and I've dealt with it two ways.  Normally, if it's just me, the doc is allowed to be fifteen minutes late.  After that time, I go to the front desk and tell them that my appointment was fifteen minutes ago, and that I will be leaving in five minutes.  Then if I'm not in the exam room in five minutes, I go back to the front desk and tell them goodbye, and leave.

If they do send me to an exam room, I give the doc another ten minutes, and then I do the same thing as before, give 'em five minutes and then walk.

Sometimes it works, sometimes it doesn't.

With my wife, I give it ten minutes and then start to complain at five minute intervals.  After thirty minutes I start billing at my consulting rate.

If you can't see me at the time you said you would because you're too busy, then you shouldn't have scheduled it.

My current doc, has an average waiting room time of 7 minutes, and an average of an additional five minutes in the exam room.  He's terse, but dammit, I'm not paying him to talk about the weather.

Also, always remember, if your doctor calls you by your first name, then you call him by his or her first name. Tends to bring the annoying ones down a peg or two.

Steve Barbour
Friday, June 06, 2003

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