Your Guide to Choosing Quality Health Care

Choosing a Doctor

Contents

• Decide What You Want and Need in a Doctor
• Make a List of Doctors
• Check on Quality
• Contact the Doctors' Offices
• Talking with Your Doctor
• Your Personal Health History
• Urgent or Emergency Care Centers
• Sources of Additional Information

It is important to choose your doctor with care, because quality varies. For example, the Pacific Business Group on Health asked patients of California doctors' groups how they rated their care. The results? More than 80 percent of the patients said they were satisfied with their care. But fewer than two-thirds were happy with the ease of getting that care.

This chapter can help you choose a primary care doctor who will meet your needs and give you quality care. The information also may be useful in choosing any specialists you might need. Primary care doctors are specially trained to serve as your main doctor over the long term. They provide your medical and health care, help you stay healthy, and help to manage your care. Your primary care doctor can refer you to specialists (doctors who treat only certain parts of the body, conditions, or age groups) if you need them.

Quick Check for Quality

Look for a doctor who:

• Is rated to give quality care.
• Has the training and background that meet your needs.
• Takes steps to prevent illness-for example, talks to you about quitting smoking.
• Has privileges at the hospital of your choice.
• Is part of your health plan, unless you can you afford to pay extra.
• Encourages you to ask questions.
• Listens to you.
• Explains things clearly.
• Treats you with respect.

Internists and family physicians are the two largest groups of primary care doctors for adults. Many women see obstetricians/gynecologists for some or all of their primary care needs. Pediatricians and family practitioners are primary care doctors for many children.

Physician assistants, nurse practitioners, and certified nurse midwives are trained to deliver many aspects of primary care. Physician assistants must practice in partnership with doctors. Nurse practitioners and certified nurse midwives can work independently in some States, but not others.

Doctors and Health Plans

If you already are in a health plan, your choices may be limited to doctors who participate in the plan. But if you have a choice of plans, you may want to first think about which doctor(s) you would like to use. Then, you may be able to choose a plan that has your choice of doctor(s).

Top of Page

Decide What You Want and Need in a Doctor

What is most important to you in a doctor? A few ideas are listed below. Add your own to create a list that will help you choose a doctor who is right for you.

My doctor must be highly rated by a consumer or other group. You will want to find out who did the ratings. Is the information reliable? Who collected it? Does the group have something to gain from the ratings?

Notes:

____________________________________________________
____________________________________________________
____________________________________________________

My doctor needs to have experience with my condition(s). Research shows that doctors who have a lot of experience with a condition tend to have better success with it.

Notes:

____________________________________________________
____________________________________________________
____________________________________________________

I want a doctor who has privileges (is permitted to practice) at the hospital of my choice.

Notes:

____________________________________________________
____________________________________________________
____________________________________________________

My doctor must be part of my health plan.

Notes:

____________________________________________________
____________________________________________________
____________________________________________________

Additional items:

____________________________________________________
____________________________________________________
____________________________________________________

Top of Page

Make a List of Doctors

• If you are in a managed care plan, check the plan's list of doctors first.
• Ask doctors or other health professionals who work with doctors, such as hospital nurses.
• Check the "Physician Select" service of the Web site of the American Medical Association. This can give you lists of doctors, by specialty, who practice near you. You can also check on training and board certification: http://www.ama-assn.org/aps/amahg.htm.
• Call a doctor referral service at a hospital. But keep in mind that these services usually refer you to any of the doctors on the staff of that hospital. The services do not have information on the quality of care these doctors provide.
• Some local medical societies offer lists of doctors who are members. Again, these lists do not have information on the quality of care these doctors provide.
• Ask family, friends, neighbors, and co-workers.

Write your list here.

Name: _________________________________

Telephone: _____________________________

Name: _________________________________

Telephone: _____________________________

Name: _________________________________

Telephone: _____________________________

Top of Page

Check on Quality

Once you have a list of doctors, there are several ways to check on their skills and knowledge, and the quality of care they provide:

• Find out if a consumer or other group has rated doctors in the area where you live. Again you will want to find out how reliable the ratings are.
• Information on doctors in some States is available on the Internet at http://www.docboard.org. This Web site is run by Administrators in Medicine—a group of State medical board directors.
• The American Board of Medical Specialties (1-800-733-2267) can tell you if the doctor is board certified. "Certified" means that the doctor has completed a training program in a specialty and has passed an exam (board) to assess his or her knowledge, skills, and experience to provide quality patient care in that specialty. Primary care doctors also may be certified as specialists. You can also check the Web site at http://www.certifacts.org. (While board certification is a good measure of a doctor's knowledge, it is possible to receive quality care from doctors who are not board certified.)
• Call the American Medical Association (AMA) at (312) 464-5000 for information on training, specialties, and board certification about many licensed doctors in the United States. This information also can be found in "Physician Select" at AMA's Web site: http://www.ama-assn.org/aps/amahg.htm.

Top of Page

Contact the Doctors' Offices

When you have found a few names of doctors you might want to try, call their offices. The first thing to find out is whether the doctor is covered by your health plan and is taking new patients. If the doctor is not covered by your plan, are you prepared to pay the extra costs?

Below are some questions you might want to ask the office manager or other staff. You may have some additional questions. Note that some of these items might have more to do with the health plan than with the doctor's office.

Things to find out from office staff:

Which hospitals does the doctor use?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

What are the office hours (when is the doctor available and when can I speak to office staff)?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

Does the doctor or someone else in the office speak the language that I am most comfortable speaking?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

How many other doctors "cover" for the doctor when he or she is not available? Who are they?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

How long does it usually take to get a routine appointment?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

How long might I need to wait in the office before seeing the doctor?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

What happens if I need to cancel an appointment? Will I have to pay for it anyway?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

Does the office send reminders about prevention tests—for example, Pap smears?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

What do I do if I need urgent care or have an emergency?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

Does the doctor (or a nurse or physician assistant) give advice over the phone for common medical problems?

Doctor A: ____________________________________

Doctor B: ____________________________________

Doctor C: ____________________________________

You may also want to talk briefly with the doctor by phone or in person. Ask if you are able to do this and if there is a charge.

The next step is to schedule a visit with your top choice. During that first visit you will learn a lot about just how easy it is to talk with the doctor. You will also find out how well the doctor might meet your medical needs. Ask yourself: Did the doctor...

Did the doctor...	Yes or No
1. Give me a chance to ask questions?	Yes	No
2. Really listen to my questions?	Yes	No
3. Answer in terms I understood?	Yes	No
4. Show respect for me?	Yes	No
5. Ask me questions?	Yes	No
6. Make me feel comfortable?	Yes	No
7. Address the health problem(s) I came with?	Yes	No
8. Ask me my preferences about different kinds of treatments?	Yes	No
9. Spend enough time with me?	Yes	No

Trust your own reactions when deciding whether this doctor is the right one for you. But you also may want to give the relationship some time to develop. It takes more than one visit for you and your doctor to get to know each other.

Top of Page

Talking with Your Doctor

Research has shown that patients who have a good relationship with their doctors tend to be more satisfied with their care—and to have better results. Here are some tips to help you and your doctor become partners.

Give information. Don't wait to be asked!

• You know important things about your symptoms and your health history. Tell your doctor what you think he or she needs to know.
• It is important to tell your doctor personal information—even if it makes you feel embarrassed or uncomfortable.
• Bring a "health history" list with you (and keep it up to date). You can use the form provided in this guide. You might want to make a copy of the form for each member of your family.
• Always bring any medicines you are taking, or a list of those medicines (include when and how often you take them). Talk about any allergies or reactions you have had to your medicines.
• Tell your doctor about any natural or alternative medicines or treatments.
• Bring other medical information, such as x-ray films, test results, and medical records.

Get information

• Ask questions. If you don't, your doctor may think you understand everything that was said.
• Write down your questions before your visit. List the most important ones first to make sure they get asked and answered.
• You might want to bring someone along to help you ask questions. This person can also help you understand and/or remember the answers.
• Ask your doctor to draw pictures if that might help to explain something.
• Take notes.
• Some doctors do not mind if you bring a tape recorder to help you remember things. But always ask first.
• Let your doctor know if you need more time. If there is not time that day, perhaps you can speak to a nurse or physician assistant on staff. Or, ask if you can call later to speak with someone.

Take information home.

• Ask for written instructions.
• Your doctor also may have brochures and audio and videotapes that can help you. If not, ask how you can get such materials.

Once you leave the doctor's office, follow up.

• If you have questions, call.
• If your symptoms get worse, or if you have problems with your medicine, call.
• If you had tests and do not hear from your doctor, call for your test results.
• If your doctor said you need to have certain tests, make appointments at the lab or other offices to get them done.
• If your doctor said you should see a specialist, make an appointment.

Top of Page

Your Personal Health History

Use this form to keep track of your health history. Print out a copy and take it with you to your doctor appointments to help keep your doctor up-to-date.

1. I was in the hospital for (list conditions):

____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________

2. I have had these surgeries:

____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________

3. I have had these injuries/conditions/illnesses:

____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________
____________________________________ Date:___________

4. I have these allergies (list type of allergy—food, medicine, etc.—and reaction):

____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________

5. I have had these immunizations (shots):

(Note: In the list below, the names of the shots follow the names of the diseases they prevent.)

For children:	Suggested age	Date(s) received
Hepatitis B (HBV)	Dose 1: Birth to 2 months Dose 2: 2 months to 4 months Dose 3: 6 months to 18 months Dose 1 or 3: 11 years to 12 years	___________ ___________ ___________ ___________
Polio (IPV)	Dose 1: 2 months Dose 2: 4 months Dose 3: 6 months to 18 months Dose 4: 4 years to 6 years	___________ ___________ ___________ ___________
Haemophilus Influenzae type B (Hib)	Dose 1: 2 months Dose 2: 4 months Dose 3: 6 months Dose 4: 12 months to 15 months	___________ ___________ ___________ ___________
Diphtheria, Tetanus, & Pertussis (DTaP, Td)	Dose 1: 2 months Dose 2: 4 months Dose 3: 6 months Dose 4: 15 months to 18 months Dose 5: 4 years to 6 years Td Once: 11 years to 16 years	___________ ___________ ___________ ___________ ___________ ___________
Measles, Mumps, Rubella (MMR)	Dose 1: 12 months to 15 months Dose 2: 4 years to 6 years or Dose 2: 11 years to 12 years	___________ ___________
Chickenpox (Varicella) (VZV)	Once: 12 months to 18 months or once: 11 years to 12 years	___________ ___________
Pneumococcal Disease (Prevnar™)	Dose 1: 2 months Dose 2: 4 months Dose 3: 6 months Dose 4: 12 months to 15 months	___________ ___________ ___________ ___________
Hepatitis A	Once: 2 years to 12 years in selected areas	___________

 

For adults:	Suggested age	Date(s) received
Influenza	Every year starting at age 65	___________
Pneumococcal	Once at age 65	___________
Tetanus (Td)	Every 10 years	___________

6. I take these medicines/supplements (bring with you, if possible):

____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________

7. My family members (parents, brothers, sisters, grandparents) have/had these major conditions:

____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________

8. I see these other health care providers:

Name:___________________________________
Why I see them:___________________________
________________________________________

Name:___________________________________
Why I see them:___________________________
________________________________________

Name:___________________________________
Why I see them:___________________________
________________________________________

Top of Page

Urgent or Emergency Care Centers

What if you get sick at night, on a holiday, or over the weekend? You can't get to your doctor, but you are not sick enough to go to the emergency room. There may be an "urgent" or "emergency" care center near you. These centers are open long hours every day to handle problems that are not life threatening. But they are no substitute for a regular primary care doctor.

To make sure an urgent or emergency care center provides quality care, call your health plan or visit the center to find out:

• If your health plan will cover your care there.
• If it is licensed. Then check to see if it is accredited by a group such as the Joint Commission on Accreditation of Healthcare Organizations (telephone 630-792-5800; Web site http://www.jcaho.org) or the Accreditation Association for Ambulatory Healthcare (telephone 847-853-6060, Web site http://www.aaahc.org). The accreditation certificate should be posted in the facility.
• How well trained and experienced the center's health care professionals are.
• If the center is affiliated with a hospital. If it is not, find out how the center will handle any emergency that could happen during your visit.

Top of Page

Sources of Additional Information

Talking With Your Doctor: A Guide for Older People

Suggests ways to discuss health concerns, medicines, and issues important to older people. 29 pages. Free.

National Institute on Aging Information Center
Building 31, Room 5C27
31 Center Drive MSC 2292
Bethesda, MD 20892-2292
(301) 496-1752; TTY 1-800-222-4225

Web site: http://www.nia.nih.gov

Talking With Your Doctor

Focuses on a healthy doctor-patient relationship and suggests questions for patients to ask their doctor. Written for cancer patients but also helpful to others. 6 pages. Free.

American Cancer Society
1-800-ACS-2345

Web site: http://www.cancer.org

Health Care's Front Line: Primary Care Physicians

Discusses choosing a primary care doctor and making the most of the first visit. Part of a series published by the Health Pages' online magazine.

Web site: http://www.thehealthpages.com

Personal Health Guide and Child Health Guide

Put Prevention Into Practice (PPIP) encourages Americans to get the preventive care they need. Two patient booklets help you keep track of preventive services: Free.

Agency for Healthcare Research and Quality
Publications Clearinghouse
P.O. Box 8547
Silver Spring, MD 20907
1-800-358-9295
E-mail: AHRQPubs@ahrq.hhs.gov

Web site: http://www.ahrq.gov/clinic/ppipix.htm
http://www.ahrq.gov/ppip/adguide/
(Pocket Guide to Good Health for Adults)
http://www.ahrq.gov/ppip/childguide/
(Pocket Guide to Good Health for Children)

Personal Health History

A confidential form that you can fill out and use to track your health and medicine history is on the American Medical Association Web site.

Web site: http://www.ama-assn.org
(Select Search, and enter "personal health history.")

healthfinder®

Provides a gateway to reliable consumer health information from the Federal Government and other organizations.

Web site: http://www.healthfinder.gov

Top of Page

---

Previous Section         Contents         Next Section    

---