Departments
Health Matters
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Week of 10 October 1997 |
Vol. I, No. 7 |
Health
Choosing a new doctor
Do you have any tips on choosing a primary-care physician and establishing a relationship with him?
Choosing a physician is one of the most important medical decisions a person will make, according to Warren Hershman, M.D., a primary-care physician at Boston Medical Center and an associate clinical professor of medicine at Boston University School of Medicine. The goal is to find a physician who is technically competent and accessible and with whom you can develop a good relationship.
"The three things people need to keep in mind when choosing a primary-care physician," he says, "are the characteristics of the physician, the system of care he or she is a part of, and the managed-care contract under which the physician works."
Among the characteristics Hershman considers important are the physician's competence in practicing medicine and his accessibility -- both in proximity and his willingness and ability to respond to questions and problems.
"Rather than simply looking at a directory of physicians, I recommend that people talk to friends who are happy with their doctor and get referrals from them," he says. In addition, you can get referrals from area doctors, hospital administrators, and other individuals who have a good knowledge of local health care.
But once you do choose a doctor and have an appointment or two with him, you're not bound to that physician indefinitely, says Hershman. "Even though hopping from one doctor to another leads to suboptimal care, if you don't feel comfortable, look around until you find a physician whom you trust."
Hershman says health-care consumers should look for physicians who work in a health-care system that provides a continuum of care, including tertiary services for complex health problems. Also, he says, you should consider the quality of the hospitals and other physicians with which the physician is affiliated.
In today's managed-care environment, you as a consumer must also understand the restrictions under which your primary-care physician operates. Most, if not all, managed-care plans limit the services physicians can offer patients (including certain tests and procedures) and how frequently those services can be delivered. In addition, many health plans are "capitated," meaning that the physician is paid a predetermined amount per month to manage an individual's care and must accept the risk of providing care above and beyond that amount. "People need to be careful consumers," says Hershman, "and read information from their health plan closely regarding the restrictions attached to their physician."
Once you have chosen a physician, your first visit will go a long way toward establishing a relationship with him or her. This is the time to discuss your medical history and health-care goals and to ask questions about how your care will be delivered. Addressing these issues at the first visit is often more important than the physical exam itself. "It is best to establish this relationship before a crisis or urgent problem occurs," says Hershman.
In addition to treating patients, Hershman says, primary-care physicians play a leading role in preventive medicine -- as well as serve as advocates to help their patients through today's managed-care maze.
Says Hershman: "As a primary-care physician who is responsible for the overall health of my patients, I view myself as their Ôhealth conscience.' I can treat them when they are ill, but I can also help them develop healthful habits that will prevent them from getting ill."
"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on choosing a primary-care physician or other health matters, call 638-6767.