By Liz Seegert
Change is hard, especially when it comes to health care for you or a loved one. Moving to a new location, switching employer-based health insurance or transitioning to a Medicare Advantage plan can all mean you have to find a new physician.
Finding the right provider can make a huge difference in health and well-being. But many people don’t take the time to do their homework, which experts say can result in missed diagnoses, worse outcomes, unnecessary tests, extra costs or avoidable hospitalizations. Put some time and effort into the search up front, and you (or your loved one) will fare much better over the long term.
“I don’t think the selection of a doctor should be less work than if you’re going to put an addition on your house, says AnnMarie McIlwain, a New Jersey-based patient advocate and CEO of Patient Advocators. “This is your life we’re talking about.”
If you were hiring a contractor, you would get recommendations from friends and neighbors, speak with several prospects and look at samples of prior work, she explains. Taking a similar approach to finding a new physician is the least you should do.
What to Consider When Looking for a Doctor
Suggestions from friends and neighbors are a good place to start your search, according to Dr. Preeti Malani, an internist at the University of Michigan Medical Center. The first step is to make sure the doctor (or nurse practitioner) accepts your health insurance. Your health plan’s website will have a list of participating providers, and you can usually filter by other criteria, such as gender, location, additional training or board certification.
Look at factors like where they went to medical school and their institutional affiliation.
Also, look at factors like where the person went to medical school and their institutional affiliation, since larger medical institutions tend to offer more integrated care, McIlwain says. However, while schooling is important, Malani says it’s not everything — there are great people who train at many different types of hospitals.
For some patients, location is a key consideration. That includes things such as proximity to work or home, accessibility via public transportation or whether a private transportation service, such as for people with disabilities, will take you there.
Also related to location, some people prefer a satellite clinic in the suburbs or a rural community because it’s less hectic and easier to park than a clinic in the middle of a large city. That might work just fine for healthy people. However, those with more complex medical conditions may fare better at an academic medical center with a larger team of specialists and services; these facilities tend to be located in larger cities.
“Some practices have a pharmacist, a nutritionist or social worker available on the premises. Having someone who works hand in hand with your doctor can help produce better outcomes,” says Malani.
Using Online Rating Sites
After you’ve narrowed down your options, review some of the online rating sites, like Yelp, Vitals or Castle Connolly Top Doctors. But take these rankings with some healthy skepticism, and pay attention to the comments. “Look at who’s writing and what they’re saying,” Malani advises. If comments or ratings are consistent across several sites, it’s probably a more reasonable measure.
A recent University of Michigan National Poll on Healthy Aging found that among adults age 50 to 80, 43% had ever reviewed doctor ratings, 14% had reviewed ratings more than once in the past year and 19% had done so once in the past year.
Among those who looked up ratings more than once in the past year, 67% had chosen a doctor due to good online ratings/reviews and nearly all (96%) thought that the ratings matched their experience after meeting with the doctor.
Among this poll’s group of more frequent users, more than half (57%) reported not choosing a doctor due to poor ratings. The survey found that older adults were typically not offering ratings, but were looking at them. Older adults’ voices aren’t necessarily captured and their needs might be very different than the needs of younger adults, says Malani, who directs the National Poll on Healthy Aging team.
Online rating sites can often clue you in to how efficiently a physician’s office is operated. You can see how long it takes to schedule an appointment, whether appointments tend to run on time or if the doctor is consistently behind schedule. There may be comments about whether the office staff Is friendly and helpful, too. This can be important for anyone needing assistance with forms or other paperwork.
In some parts of the U.S., it can be challenging to even find a doctor who accepts new patients. Over half of physicians surveyed in a 2017 Physicians Foundation report say they have reached a tipping point and plan to make changes to their practices. Many surveyed said they intend to take steps that will likely reduce patient access to their services, which limits physician availability at a time when doctors already are in short supply.
Communication Is Key
It takes time to build a relationship with a new physician, and you need to take charge of managing it, says McIlwain, who matches clients with primary care providers and specialists. When you see a new doctor for the first time, bring a list of key questions and one or two objectives for the visit to help make every second of that interaction count.
“A doctor or nurse with good listening skills who takes enough time to explain and answer questions means better results.”
“You obviously want the (physician) to be maximally responsive, caring and open — not dismissive. Those kinds of qualitative things you can only get at from an introductory appointment,” McIlwain says. Ask yourself if you feel a connection with the doctor and if he or she has spent adequate time getting to know you and your situation. If not, keep looking.
Communication is the most important element of a doctor-patient relationship, Malani says. That may mean the doctor explains something in different ways to help you understand an issue or a timely interaction through an online patient portal or getting your phone call or email returned promptly.
“What’s important is that someone on the care team responds to your concerns,” Malani says. “A doctor or nurse with good listening skills who takes enough time to explain and answer questions means better results.”
You may be comfortable finding a physician on your own. However, there are times when using a patient advocate can help, especially if you move to a new community or need a specific type of specialist.
As a patient advocate, McIlwain acts as the client’s eyes, ears and brain. “You are paying us to go deep with you and to arm you with the information you need to make the best possible choices, and to have the best possible relationships and outcomes,” she says.
As we age, our choice of physician becomes increasingly important. “It’s likely that we will develop some sort of health concerns, whether it’s a chronic health issue or just an acute issue, Malani says. “Keep looking until you’re comfortable with your decision, because you’re probably going to be with this person for a while.”