how to find a good doctor?

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Permalink Reply by Ann A. on December 30, 2011 at 7:46am

I have found several variables to be strongly related to a physician's willingness to listen. Among the most important variables are: (1) how many patients does the physician schedule for each day and (2) how much time is scheduled for each patient. My primary care physician - the one I really like - schedules me for 1/4 hour. My rheumy only schedules me for 1/4 hour. As you can probably guess, the one who gives each patient more time is the one who listens.

Another variable which is important for me is the scheduling of laboratory work. My primary care physician who gives me 1/2 hour appointments has me come in for the lab work the week before our appointment. That means that during the first half of our visit, I bring up new complaints or bring him up to date on what is going on with my specialists and during the last half of the visit we go over the lab work. He hands me a copy and then we go over it together one line at a time. When  I leave his office I always feel satisfied. My rheumy rushes me through the fifteen minutes and then I stop for the blood work on the way out. They promise to send me a paper copy, but I always have to call back and remind them.

For this reason, I have asked my primary care physician (whose specialty is internal medicine) if he would consider helping me manage my lupus. He can order the appropriate blood work and both of us can read a lab print out. Then he only needs to refer me to the rheumy when the blood work is too out of whack for him to deal with it. But the great thing about this doc is that he pays more attention to how I feel than he does to the paperwork.

In addition to lupus, I have Hashimoto's autoimmune thyroiditis. For years I was only being treated with synthetic T4. And even though the lab work said I was fine, I felt terrible. So on one of my thyroid sites, I searched for a physician in my area who was willing to also treat thyroid problems with T3. That is how I found the internist who is currently my primary care physician. On this combination of medicines the blood work indicates that I should be showing symptoms of hyperthyroidism. But I am not. I feel better than I have in years. So I am hoping that if he is in charge of all of my medication he can orchestrate a symphony that works for me instead of the paper.

So, I suggest

asking how many patients are seen in one day

how much time each patient is given

blood work scheduled before appointment so that it can be discussed

willingness to try integrate treatment approaches that are not considered to be standard practice in conventional medicine but which work for some patients.

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Permalink Reply by siskiyousis on December 30, 2011 at 7:57am

Those are excellent points...the bests rheum dr i had...was hours behind but he spent as much time as we needed with him...he was my first one. Also my primary care dr..who also was internal medicine doctor..was one who diagnose me and was honest enough to say she did not know enough. I have had some great doctors...when i moved out in country...we just have limited doctors here...seems like most would rather be out playing.

 But you are right about time. My old lupus dr here...I was one of his orig patients...he has gone from allowing half hour to now it is ten minutes...i finally had it with him because i lost my teeth due to dry mouth. Dentist kept bugging me to get him to prescribe this drug...he kept saying it was not that bad..well once i lost front teeth..he said he would...was too late.

so i been trying doctors that people or doctors up here say are okay...but so far i think they are horrible. My primary doctor just wants one so when i am sick...he can send me to him and help me get better. He does not know how to treat SLE , RA and fibro..though he tries with fribro..and does any test i feel i need. 

 but asking about times is great point....i just wish the office people would answer truthfully so i dont waste their doctors time or mine. 

i like all your ideas....i am going to jot them down and use them to make calls or when asking people about their rheum doctor even. Thank you so much!!

Ann A. said:

I have found several variables to be strongly related to a physician's willingness to listen. Among the most important variables are: (1) how many patients does the physician schedule for each day and (2) how much time is scheduled for each patient. My primary care physician - the one I really like - schedules me for 1/4 hour. My rheumy only schedules me for 1/4 hour. As you can probably guess, the one who gives each patient more time is the one who listens.

Another variable which is important for me is the scheduling of laboratory work. My primary care physician who gives me 1/2 hour appointments has me come in for the lab work the week before our appointment. That means that during the first half of our visit, I bring up new complaints or bring him up to date on what is going on with my specialists and during the last half of the visit we go over the lab work. He hands me a copy and then we go over it together one line at a time. When  I leave his office I always feel satisfied. My rheumy rushes me through the fifteen minutes and then I stop for the blood work on the way out. They promise to send me a paper copy, but I always have to call back and remind them.

For this reason, I have asked my primary care physician (whose specialty is internal medicine) if he would consider helping me manage my lupus. He can order the appropriate blood work and both of us can read a lab print out. Then he only needs to refer me to the rheumy when the blood work is too out of whack for him to deal with it. But the great thing about this doc is that he pays more attention to how I feel than he does to the paperwork.

In addition to lupus, I have Hashimoto's autoimmune thyroiditis. For years I was only being treated with synthetic T4. And even though the lab work said I was fine, I felt terrible. So on one of my thyroid sites, I searched for a physician in my area who was willing to also treat thyroid problems with T3. That is how I found the internist who is currently my primary care physician. On this combination of medicines the blood work indicates that I should be showing symptoms of hyperthyroidism. But I am not. I feel better than I have in years. So I am hoping that if he is in charge of all of my medication he can orchestrate a symphony that works for me instead of the paper.

So, I suggest

asking how many patients are seen in one day

how much time each patient is given

blood work scheduled before appointment so that it can be discussed

willingness to try integrate treatment approaches that are not considered to be standard practice in conventional medicine but which work for some patients.

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Permalink Reply by Ann A. on December 30, 2011 at 9:34am

I mistyped. My primary care doc schedules me for 1/2 an hour. And he is never more than a few minutes behind. He has a neat system. His nurse knocks on the door and says, "Your next patient is here." That let's you know that you need to wind it up without him having to rush you.

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Permalink Reply by Flutterbymare on December 31, 2011 at 3:12am

Unfortunately, it's like finding a good fit. Of course it's best to get other patient referrals, i have used the internet for this. personalities have to mesh also. I think so much of it today is trial and error, sadly. Takes a lot of time, energy and money to find a good team. The trick is don't settle for less than you are comfortable with. No matter what it takes, you deserve a good doctor that will work with you.

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Permalink Reply by siskiyousis on December 31, 2011 at 11:54pm

Anna gave me some great questions to ask ahead of time. I live in a very small town in remote part of Calif. So for me to get to cities with many Rheum doctors is 3/4 hour drive...basically day or even spending the night. So i cannot just keep trying different doctors....it will wear me out. 

 I do believe in asking people, support groups etc...but you should ask person who as much like you as you can get. What i want in a dr is completely different than some other persons idea. 

I like her point of finding out how much time they spend with patients plus how many they book per day. That says a lot about the doctor. Is he into making a wad of money or really trying to help people? Help Dr is more likely to spend more time and have fewer patients per day. I had one /two like that and they are the best to me. Now if you do not like doctors who are not on time...then you hate em...but i knew they take all the time i needed to answer all my questions and try to work with me. Not just order me around like some i have known....or do nothing like others till you are hospital sick..even than i lived too far so he could not come and check on me because he books so many patients per day and sees ea one for at most..note at most.10 minutes! What can be solved in that amount of time if you have things going on? 

 So that is why i am asking how to find a good doctor ...before the appointment...if possible. Of course i still must click with them...but thank you and hope you have a Happy New Years ..healthy one!! 

Oh i am not writing directly to you...but to anyone who is reading this. I realize i need to make myself more clear...what exactly i am looking for from you out there in the forum...as support. The online  guides..i have tried to use those and i have used them too...but i often wonder if doctor has someone on his staff do it for them...and then on flip side how many people tend to do negative ones way more than positive. But i have used them despite my wondering about how accurate they are. 

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Permalink Reply by Steff-uh-nee on April 24, 2012 at 2:59pm

My husband is in the military so we move around a lot. I always start by looking for the best university hospital. I search their Rheumatologists and Nephrologists as well and look for whoever is in charge. I then google them and a few of the others on their team with the word Lupus and look for any research stuff they have been apart of. After that I take the name of the doctor I want to see to my primary doctor and they push to get me the referral for the doctor.

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Permalink Reply by Deb on April 29, 2012 at 1:40pm

I asked the nurses in the hospitals....but that was when the PCP did rounds. Here in NY things have changed so much that your doctor doesnt really take care of you in the hospital any more...the hospital staff does. But the nurses should still know...who they like, who they use...personality...etc.!!!!

 

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Permalink Reply by prtyblk1 on May 11, 2012 at 9:34am

Deb, I did a lot of internet research to find the dr. I liked a website called health grades, usually there is a patient review included as well. 

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Permalink Reply by Ann A. on May 11, 2012 at 11:57am

I am still satisfied with the PCP who schedules me for 1/2 hour. And with him coordinating my care, I am much improved. I really do think that it is because he listens to me, really hears what I have to say, and takes it into account when we work on my treatment plan. And he makes beau coup bucks from the patients who drive from all over to receive chelation therapy and IV vitamin therapy from him. Insurance doesn't pay for these treatments, so this is cash without all the insurance company paperwork.

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