Click to open document as a PDF Choosing
a Doctor Mrs. Wiley
had a big surprise the other day when she called her doctor to make an
appointment. The receptionist told her that Dr. Horowitz was retiring at
the end of the year. After all this time — after decades of flu, bladder
infections, and that nasty broken wrist; after helping her through the
menopause — now this desertion! Mrs. Wiley didn’t know what she would
do to try and find a new doctor. Uncle
Willy was grumbling to his nephew Matt. This new managed health insurance
plan seemed like a good idea at first, but now he wasn’t so sure.
What’s a primary care doctor anyway? Can’t he just continue to see Dr.
Bissell for his arthritis? Matt sighed wondering how he was going to help
Uncle Willy find a whole new set of doctors. Stories like these are becoming all too common. Finding good
medical care can be tricky at any age but for older people this task may
be even tougher. Yet, it is important to have a primary care doctor who
knows you and all of your health problems. Even if you see other doctors
for certain health conditions, for example, a heart specialist
(cardiologist) for heart disease, your primary care doctor is needed to
work with those specialists and coordinate all of your health care. Choosing a doctor is one of the most important decisions
anyone can make. The best time to make that decision is while you are
still healthy and have time to really think about all your choices. If you
have no doctor or are thinking of changing doctors, the following ideas
may help you find a doctor who is right for you. What
Should You Look for in a Doctor? Of course you
want a doctor who is well trained and competent. A doctor who knows you
well may be better able to help you prevent some health problems and
manage those that do come up. In choosing a doctor some other things to
think about are: $
Board certification.
Board certified doctors have extra training after medical school to become
specialists in a field of medicine such as family practice, internal
medicine, or geriatrics. $
Communication style.
Because communication is key to good health care, you want a doctor who
will listen carefully to your concerns, answer your questions, and explain
things clearly and fully. $
Type of health
insurance — does the doctor accept Medicare predetermined payments? See
sidebar on managed care for more information. $
The location of the
doctor’s office, will it be easy for you to get there? $
Where patients get lab
work done — in the doctor’s office or somewhere else? $
Whether the office
staff will process your medical insurance claims for you. $
Which hospital the
doctor uses to treat patients. $
Whether the doctor
works with a group of other doctors. If so, who are the others and what
are their specialties? $
Who covers for the
doctor if he/she is out of town or not available? $
Whether, with your
permission, the doctor will share information with a family member. $
Which languages the
doctor speaks. A good first step is to make a list of the things that matter
most to you. Then, go back over your list and rank them in order of
importance. What
Type of Doctor? For
your primary care doctor, you might want a general or family practitioner,
an internist, or a geriatrician. $
General practitioners
provide health care for a wide range of medical problems. They do not
focus on any one area of medicine. $
Family practitioners
are similar to general practitioners, with extra training to focus on
health care for all family members, regardless of age. $
An internist is a
doctor for adults. Some internists take additional training to become
specialists. For example, cardiologists are internists who specialize in
diseases of the heart. $
Geriatricians
specialize in the care of older adults. A geriatrician is trained in
family practice or internal medicine, but has additional training in
caring for older people.
Finding
a New Doctor Once
you have a sense of what you want in a doctor, ask people you know about
doctors they use and like. Friends, coworkers, and other health
professionals may be helpful. You can make it easy for them to tell you
about the doctors they like by asking questions, such as, “What do you
like about Dr. Smith?” A doctor whose name comes up often might be a strong
possibility as a choice. It may help to have several names to choose from
in case the doctor you select is not taking new patients or does not take
part in your health insurance plan. If you belong to a managed care plan, you can get a list of
doctors from the plan’s membership services office. Your choices will be
limited to those doctors who are part of the plan. If you need more help finding names of doctors, contact your
hospital of choice, local medical society, local physician referral
services, nearby medical schools, or university medical centers in your
area. How
Do You Make an Informed Choice? Once you have chosen two or three doctors, call their offices.
The office staff can give you information about the doctor’s education
and training. They also can tell you about office policies, standard
insurance the office takes, payment methods, and the doctor’s hospital
admitting privileges. You may want to make an appointment just to talk with a doctor
before deciding on a Make a list of questions you want to ask the doctor. For
example: $
What age groups make
up most of your practice? $
How do you manage
patients with lots of health problems? Do you usually treat everything, do
you refer patients, or are there some problems older people just have $
What do you think are
the most important preventive care issues for older adults? How do you
manage them? $
What’s the best way
for me to prepare for an office visit with you? For example, should I
bring my questions in writing? $
Would you provide your
instructions in writing for me? $
May I bring a family
member (spouse, daughter, or son) to my office visits with you? $
If I give you
permission, are you comfortable talking with my family about my condition?
$
How do you involve
your patients in health care decisions? $
Do you see many patients with the same chronic health problem
that I have (for example, diabetes)? After the meeting, ask yourself if you felt comfortable and
confident with this doctor. Were you at ease asking questions? Did the
doctor clearly answer your questions? If you are not sure, schedule a
visit with one of the other doctors on your list. The
First Appointment After
choosing a doctor, make your first medical appointment. During this visit,
the doctor will probably take a medical history and ask questions about
your health. There may be questions about the health of your family
members as well. The doctor also will examine you. Be sure to bring your
past medical records (or have them sent). Also bring all of the medicines
you take with you to show the doctor. Include both prescription and
over-the counter drugs, even vitamins, supplements, and eye drops. Make a
list of any drug allergies or serious drug reactions you’ve had. During
this visit take time to ask any questions you may still have about the
doctor and the practice. Once you have found a doctor you like, your job is not
finished. A good doctor-patient relationship is a partnership. Both you
and your doctor need to work together to solve your medical problems and
maintain your good health. Finding a medical practice that is well suited
to your needs is an important first step. Good communication with the
doctor and the office staff is the key. Where
Can You Go for More Help? The following
professional groups may be able to help you find a doctor: American
Geriatrics Society (AGS) American
College of Physicians-American Society of Internal Medicine American
Academy of Family Physicians American
Medical Association American
Osteopathic Association Centers
for Medicare & Medicaid Services For More
Information NIA
Information Center
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