Doctor Meet and Greet Questions

[Katsmeow]

We are planning to do meet and greet with a couple of concierge doctors. This would be to help me to decide which one to select. One of them is an MDVIP doctor and the other is independent. I have looked online for questions to ask and most of the suggestions are... not helpful.

I already know where all these doctors went to school and did their residency. I know how they are board certified and what hospitals they are admitted to. I have looked up their licensing and discipline information. I have Googled all of them. They are concierge doctors so I know in general about how they set appointments and about their availability (although I will ask more about this).

I will only set up appointments with doctors who take traditional Medicare.

So what questions do I ask? I saw all these suggestions to ask the doctor about their family and their hobbies and so on. One, I don't really care about those things. Two, it is none of my business.

Things I have thought of to ask about.

How things are handled if the doctor is unavailable or out of town. The MDVIP doctor is part of a multi-doctor practice. The other is just him.

Do they have an online portal and what information is put on there.

Something about specialists and referrals. I am not sure what questions to ask though.

One thing that is important to me is that the doctor and specialists are a good fit for me. I like doctors who are interested in preventative care.

I tend to be a mostly mainstream medicine type person. I certainly want doctors who are up to date and who are aware of new stuff not just how they did stuff 10 years ago.

I very specifically want to be referred to a cardiologist who believes in the virtues of keeping LDL low. My last cardiologist had a goal for me of LDL under 50 (which I achieved) and I have no real interest in one who thinks LDL doesn't matter or who thinks 100 is good enough (for someone with my risk level).

I know the "meet and great" is not to talk about specific medical concerns and that is fine. But I don't want to pay a large concierge fee and then find out the primary care doctor doesn't think LDL matters or refers me to specialists who are more relaxed on LDL than I want.

So any help with how to discuss this kind of "approach" question is important. Basically I want someone up to date, in the mainstream of thought, but who is aware of new advances and so on.

Any other questions that I might want to ask?

 

[nwsteve]

One question I would ask to confirm. Will you be my advocate and review treatment proposed by specialists outside your practice and proactively intervene as necessary?

 

[Scrapr]

I think you got the important stuff. How is the hand off to specialists? Any restrictions? How is the "hand back" to the VIP doc? What is the process to do an MRI? In house? Outside sub contractor? Cost? General philosophy...pills vs take care of yourself. Do you have any chronic ongoing conditions? Ask about long term treatment & studies? What is the process to get an appointment? Hours/days/weeks? Maybe bring up your use of Ivermectin & how it cured your cancer.....(see if he laughs or does he get squinty eyed?)

Maybe take note of how interesting he is? Easy to talk with? ie: general demeanor. My GP & I chat on my regular check ups & he takes notes as we go along. Just general life stuff. The half hour just flies along. It's pretty easy

 

[RetiredHappy]

The few that I can think of to add to what you have covered above:
- Do you have his cell phone number to text and the expected turnaround time?
- Can you email him and what is his expected turnaround time?
- Be specific and ask about what are the doctor's thoughts wrt to to your CAC scores and the doctor's thoughts about LDL level.
- How well is the doctor networked with other specialists? What sort of referrals and the ability to fast track to be seen?

 

[Katsmeow]

I think you got the important stuff. How is the hand off to specialists? Any restrictions? How is the "hand back" to the VIP doc? What is the process to do an MRI? In house? Outside sub contractor? Cost? General philosophy...pills vs take care of yourself. Do you have any chronic ongoing conditions? Ask about long term treatment & studies? What is the process to get an appointment? Hours/days/weeks? Maybe bring up your use of Ivermectin & how it cured your cancer.....(see if he laughs or does he get squinty eyed?)

Maybe take note of how interesting he is? Easy to talk with? ie: general demeanor. My GP & I chat on my regular check ups & he takes notes as we go along. Just general life stuff. The half hour just flies along. It's pretty easy

Those are good things to know. If I am doing concierge I expect to ordinarily get a next day appointment (both practices indicate they do this). I don't think I could pull off the Ivermectin/cancer question but that would be pretty fascinating to see how he responds....

I do put a lot into just how well I get along with the doctor. One of the big things for me is does the doctor treat me like an intelligent person or do they talk down to me. Do they make recommendations or commands? In a regular appointment I usually figure this part out pretty quickly and if the doctor doesn't "pass" then I don't come back. Here, though, I want to get a handle on that before I financially commit.

The few that I can think of to add to what you have covered above:
- Do you have his cell phone number to text and the expected turnaround time?
- Can you email him and what is his expected turnaround time?
- Be specific and ask about what are the doctor's thoughts wrt to to your CAC scores and the doctor's thoughts about LDL level.
- How well is the doctor networked with other specialists? What sort of referrals and the ability to fast track to be seen?

From the information I've received on both of them they do give you their cell number and email and the turnaround is supposed to be pretty quick (although I agree I want to get clarification on this).

I do think I will want to discuss the CAC/LDL stuff directly since that is important that I am in sync with the doctor on it.

Good question on the specialists. They all say they will refer you and coordinate but good idea to find out how.

One thing I do want to ask specifically about is how he handles Prolia injections. Medicare will pay these under Part B but Prolia is expensive so lots of doctors don't want to front the cost to buy it. At my old doctor, he (along with many other the primary care doctors in the area) referred me to an Infusion Center and they did the injections (they didn't mind getting the medication since they were doing the injections for lots of people). My doctor did all the pre-visit lab work. So I want to make sure how they handle this so that is handled properly since the medication is so expensive if it isn't done right.

 

[badatmath]

Do let us know how the meeting goes!

 

[grayv]

How many patients do you have? Are you limiting the number?

 

[eytonxav]

Do they do tele-visits?

 

[RetMD21]

One of the big things for me is does the doctor treat me like an intelligent person or do they talk down to me. Do they make recommendations or commands?

Since the cardiology issue is a major one why not ask about referral? If he/she says I just refer to x and let him/her handle it that would be a red flag. OTOH if he says x seems accommodating but it not we'll get you a different one.

 

[OldShooter]

I used to tell my troops that when developing a relationship with a new person of significance to me (employee, customer, vendor, etc.) I listen for two things. I want to hear "I don't know." and I want to hear "I screwed up." These would be an initial indication that the person is someone I can probably trust. Nobody knows everything and everyone screws up from time to time. A person who doesn't easily admit to this is a person who I probably won't be able to trust.

So I would listen for that type of thing. The docs ought to have a humble attitude regarding your health history and issues a la "I don’t know." and you might further test their ego by asking "What would you say has been your biggest mistake as a doctor?"

I saw a cardiologist one time who argued with me about my symptoms. "I don't think it was like that." "You probably didn't have that happen." This type of of "I know better." stuff. I finally badgered him into pulling up the (computerized) records, which he reluctantly admitted proved him wrong. With that kind of arrogance, if he hasn't already killed someone I'd expect that he probably will.

If possible, try to get a sense of how he treats his staff. Total absence of "please" and "thank you', for example, would cause me to move on. You want to see a comfortable and well-functioning team, not a kingdom.

 

[Koolau]

I have found by experience that "bedside manner" is not the most important factor in choosing a doctor. My current PCP is "just acceptable" on beside manner, but excellent in catching things that may be life threatening to me. (He's caught 3 things that could have ended my life prematurely.) I think I'll stay with him.

 

[Katsmeow]

Since the cardiology issue is a major one why not ask about referral? If he/she says I just refer to x and let him/her handle it that would be a red flag. OTOH if he says x seems accommodating but it not we'll get you a different one.

Yes, I have been working a list of things to cover and I have a whole section about how he does referrals and how he selects who to refer to. I want someone who will be somewhat flexible in referring to someone that seems reasonable for my situation and will suggest someone else if necessary.

I have found by experience that "bedside manner" is not the most important factor in choosing a doctor. My current PCP is "just acceptable" on beside manner, but excellent in catching things that may be life threatening to me.

I think it all depends on what you mean by bedside manner. There is no question that there are doctors who are personable and pleasant to be around but who aren't necessarily great doctors.

I do not want a doctor who is rude or dismissive and who doesn't listen to me. I want someone who answers my questions. I want a doctor who is open to changing his/her mind. When I look back some of my best doctors are the ones who gathered new information and changed their mind. In some cases I asked questions and raised issues which led to the doctor deciding to do something different. I want someone open to that kind of thing (if warranted, of course). But, I am OK with them being businesslike and I don't need them to be my best buddy.

 

[Koolau]

Yes, I have been working a list of things to cover and I have a whole section about how he does referrals and how he selects who to refer to. I want someone who will be somewhat flexible in referring to someone that seems reasonable for my situation and will suggest someone else if necessary.



I think it all depends on what you mean by bedside manner. There is no question that there are doctors who are personable and pleasant to be around but who aren't necessarily great doctors.

I do not want a doctor who is rude or dismissive and who doesn't listen to me. I want someone who answers my questions. I want a doctor who is open to changing his/her mind. When I look back some of my best doctors are the ones who gathered new information and changed their mind. In some cases I asked questions and raised issues which led to the doctor deciding to do something different. I want someone open to that kind of thing (if warranted, of course). But, I am OK with them being businesslike and I don't need them to be my best buddy.

Heh, heh, I agree with you - up to the point of the doctor changing his mind. In 3 years, my doc has put me onto 3 life-threatening issues. I didn't believe him. He insisted on tests that I really didn't want to go through. But, I did all the tests and all 3 confirmed the Doctor's suspicions. 3 for 3 ain't bad. From now forward, I'm listening more and talking less (not that he won't listen - but he's not afraid to tell me what I should do.) YMMV

 

[RetMD21]

Yes, I have been working a list of things to cover and I have a whole section about how he does referrals and how he selects who to refer to. I want someone who will be somewhat flexible in referring to someone that seems reasonable for my situation and will suggest someone else if necessary.

Sounds like a good plan. I know there are academic concierge doctors but I am not sure how well that model works for the patients. Consults are constrained to be within the doctors employed by the university and switching consultants within the group has generally been restricted. Maybe the concierge doctors have a special deal.

 

[RetiredHappy]

My concierge doctor is very good in getting another specialist if I don't like the first one whom he had referred to.

He is thoughtful when referring specialists. For instance, he said to me that he knew that I preferred a doctor who would explain in details, and so he referred me to the younger of the 2 brothers who were gastroenterologists in the same practice.

 

[Katsmeow]

So we had sort of narrowed down to 2 doctors to do meet and greets.

The below is just a bit about how we did that for those who might be trying to do the same sometime. It is particularly hard for us as we are in an area where we know no one.

I had asked for referrals from several Delaware related groups I am in and I got several suggestions. Some sounded fine but were geographically undesirable when there were others much closer.

All but one of the concierge doctors suggested were with MDVIP. The exception is a doctor who has had a concierge practice for 20 years. I got several glowing recommendations of him. There was really only one negative. He is 67. My thought was that I didn't want someone too old who might be nearing retirement and, potentially, might not have kept up with stuff. On the other hand, I didn't want someone super young who might be very up to date but lack real world experience. I felt the ideal would be someone in between. Of course, I didn't want to stereotype based upon age.
After all I know that I keep up with stuff. So, DH called and his concierge practice was several hundred dollars a year less expensive than the MDVIP doctors. Yay! But, the person who answered the phone seemed disinterested. She said they were changing their computer system and needed to input 1200 other people before they could get to us so they would call us in a month or two for the meet and greet. In our case, we have stuff we need to do medically (we had to delay some things when we moved) so we don't want to wait 2 months to maybe be seen. Also if they have 1200 active patients then that is way too many for a concierge practice. So, we crossed him off the list.

There was one MDVIP practice that I particularly liked. This location has several different MDVIP doctors at it. I liked to idea of having easy alternatives if the doctor is away and there is something urgent.

DH and I had a somewhat difficult time deciding which doctor to pursue talking to. (I guess we could each do different doctors but seems more convenient to have the same one). One doctor was young (40) and did have good recommendations for him specifically. I had also received general recommendations for the practice. But, 40 was definitely on the younger side. He is only about 8 years out from all of his training.

The other doctor was an absolute perfect age - mid-50s. Unlike most of the MDVIP doctors, he had a video he had done in addition to his written profile. I think he did the video a few years ago when he changed to concierge as he explained his reasoning. He was very clear and personable.

The only negative is that he had a few low (1 star reviews) online. I recognize that it is hard to keep everyone happy. And, I think some of these (maybe all) were before he transitioned to concierge. They were basically complaints about not enough time and that kind of thing. On the other hand, there were many other positive reviews about him taking a lot of time on appointments, etc. And, I did get an enthusiastic recommendation for him in my searching. DH preferred him just based upon age.

DH called the direct line to the person who answer's his calls. (Apparently there is a general number which can take time to wade through). But his profile had the number of his office. DH really loved the person who answered the phone. She was friendly, helpful, enthusiastic. She said we could meet with the doctor in two weeks (would be sooner but he is on vacation).

So we will likely go and check him out and ask all the questions....

He is thoughtful when referring specialists. For instance, he said to me that he knew that I preferred a doctor who would explain in details, and so he referred me to the younger of the 2 brothers who were gastroenterologists in the same practice.

Yes that is the kind of thing I would want.

 

[braumeister]

The other doctor was an absolute perfect age - mid-50s.

Doctors aren't allowed to retire early?

 

[RetMD21]

....

All but one of the concierge doctors suggested were with MDVIP. The exception is a doctor who has had a concierge practice for 20 years. I got several glowing recommendations of him. There was really only one negative. He is 67. My thought was that I didn't want someone too old who might be nearing retirement and, potentially, might not have kept up with stuff. On the other hand, I didn't want someone super young who might be very up to date but lack real world experience. I felt the ideal would be someone in between. Of course, I didn't want to stereotype based upon age.
After all I know that I keep up with stuff. So, DH called and his concierge practice was several hundred dollars a year less expensive than the MDVIP doctors. Yay! But, the person who answered the phone seemed disinterested. She said they were changing their computer system and needed to input 1200 other people before they could get to us so they would call us in a month or two for the meet and greet. In our case, we have stuff we need to do medically (we had to delay some things when we moved) so we don't want to wait 2 months to maybe be seen. Also if they have 1200 active patients then that is way too many for a concierge practice. So, we crossed him off the list....

1200 and looking to add more at age 67 seems sketchy to me.

 

[braumeister]

1200 and looking to add more at age 67 seems sketchy to me.

MDVIP says their physicians have a maximum of 600 patients, so the 1200 figure sounds bogus. Perhaps it was just that person's way of saying "a lot".

 

[ivinsfan]

1200 and looking to add more at age 67 seems sketchy to me.

Perhaps it's 1200 patients or former patients. contacts and or employees, maybe vendors. But I can see that being a concierge doctor comes with it's own set of hassles. Some of the questions here are strange. The person would be your doctor not your employee!

 

[Katsmeow]

Doctors aren't allowed to retire early?

Yes, of course, they are. But, I hope mine doesn't....

MDVIP says their physicians have a maximum of 600 patients, so the 1200 figure sounds bogus. Perhaps it was just that person's way of saying "a lot".

The doctor where they talked about 1200 was not an MDVIP doctor. And, it is possible that the 1200 includes some people who aren't current patients. If we could have seen that doctor within a reasonable time (not 2 months) then we would have asked about the patient load.

 

[RetiredHappy]

My concierge doctor has maximum of 450 patients. I tried to get my friends to be his patients and they had to join a waitlist, but I was told that they get to the top of the waitlist and will be interviewed first, due to my referral.

 

[grayv]

My concierge doctor has maximum of 450 patients.

what is your annual fee?

 

[RetiredHappy]

what is your annual fee?

$2,500 per person, $4,800 for a couple. Our friend goes to another concierge doctor who charges $3,600 pp whom we believe is not as knowledgeable as our concierge doctor.

 

[brett]

I am 71. Had a physical 12 years ago. It was all good...no issues whatsoever. Never been back. No need. Last physical before that was in 1986 for employment purposes.

Have not had a prescribed drug for at least 20 years, perhaps longer. I think the last one was from the dentist which I did not have to have filled.

But it is time. Doing a meet and greet with my spouse's physician next week. A few minor age issues but mostly I want to get a complete blood work up to ensure that I really am in good health, etc. Fingers crossed.

Looking forward to the process. My spouse, a retired nurse, has been reminding me of my commitment to do this for the last five years or so.

I expect to receive a questionnaire to complete in the the next day or so. My vaccinations etc. are all on line so the clinic will have access to them. At this point I really do not have any questions for the MD.