How to Choose a Doctor

[TromboneAl]

I had mentioned to my doc that I had been reading about the paleo/low-carb diet, hoping to get his take on it, since I'm on niacin and simvastatin. Instead, he proceeded to draw a "plate", and show me that two portions of starch, with a low-fat meat, a vegetable, and low-fat milk, was the suggested "diet:. Haven't bothered with that subject again...

At least my current doctor agrees with me on low-carb and some other topics, so one concern is that when I switch, I'll get a doctor who I'll have to fight on topics like this. It might be good to have a different viewpoint, but I couldn't stand a doctor who follows the Dept of Agriculture's recommendations.

Here's my food plate:

 

[DangerMouse]

I actually found my Dr via Yelp recommendations and find her to be the best I have ever been to. Unfortunately for me I received notification this week she is shifting to a Personalized Care Program at a cost of $2,000 a year so I will not be able to continue with her as the amount of visits I make annually does not justify the cost. I do understand why she is doing so.

However I know Yelp is not fail-safe as the first Dr I chose from there was top rated and I thought he was awful.

 

[MikeD]

This is what initially attracted me to my current doc. He really sat down and listened, paid attention, and got to know me. I was amazed, since I'd been used to assembly line care in the past.

But after 10 years, I've realized that that quality is useless if he's not a good doctor.

-------------

Here's another example of something he said. You tell me if it's bonkers or not:

I had gotten an A1C test at a health fare, and showed him the results. He said "That test is totally useless, because there's no point in having a test if there's nothing you can do based on the results."

I agree with the general principle, but don't think it applies to the A1C. So, am I crazy or is he?

I quoted your whole post because it kinda all applies to the bonkers question and my answer.

I think that there is something you can do about a high A1C value. If it's higher than what you want you can take diabetes meds or modify your diet. If my previous statement is true than his statement is false (bonkers).

I, too, value a doctor who listens and doesn't cut me off and just give stock, generic answers. I try to listen to them too. though and try to figure out why they say some of the things they say. With a new doctor, they may have a reflexive response to the same old tired questions or be on guard about the question of the day if it's been in the media lately. I also give them a second chance in case they were in a bad mood unless the response to me is outrageously inappropriate. Depending on how late the guy is for my appt, he may be rushing for a reason. If he was on time and rushes through the appt that sets my alarm off.

Another advantage I personally have is that my wife is an extremely good judge of character. She knows me well after 35 years of being married and can evaluate someone's compatibility with me well. I usually bring her along on my first visit with a new Dr. If she gets the same impression as I do then I go with it. I always say that I wished she could go along with me on job interviews to spot incompatible bosses out to me. I am usually blind to hidden character flaws at first. She is not talkative (unlike me) and has the ability to listen well.

Also, it's harder to find the first good doctor then the second or third. There seems to be no one good way to determine the first's quality. But once you're sure you have found someone you can trust, I think the best way of finding additional good doctors is to ask a known good guy for reccs. They will not recommend a bad guy but will mention a good guy. There is no way a Dr. will say something bad about a fellow traveler but their answers will filter out the poor ones.

Mike D.

 

[Rich_by_the_Bay]

Here's another example of something he said. You tell me if it's bonkers or not:

I had gotten an A1C test at a health fare, and showed him the results. He said "That test is totally useless, because there's no point in having a test if there's nothing you can do based on the results."

I agree with the general principle, but don't think it applies to the A1C. So, am I crazy or is he?

His logic would be sound if his facts were correct, but they aren't.

Maybe he was ticked at you getting tested at a health fair rather than his office? Either way, it doesn't bode well...

 

[TromboneAl]

Well, it just seems to be two different ways of looking at things.

But my behavior might be very different if my A1C were 4.0 versus 8.2, so how could the test be useless?

 

[simple girl]

Here's another example of something he said. You tell me if it's bonkers or not:

I had gotten an A1C test at a health fare, and showed him the results. He said "That test is totally useless, because there's no point in having a test if there's nothing you can do based on the results."

I agree with the general principle, but don't think it applies to the A1C. So, am I crazy or is he?

Well, I'm certainly not well versed in A1C results, but from the little bit I've picked up reading here on the ER board, I would venture to say he's incorrect. That response certainly would give me pause, too, Al. What a shame to have to look for another doc...since it is indeed so hard to find one you connect with AND is highly qualified.

So far, so good, regarding my new doc, but if I felt he was off the mark on something I would be searching for a new one, too. He was sooooooo thorough - and didn't hold me to talking about the "one thing" I went in there for. I left with new meds for my GERD, a referral to a gastro doc for further consultation, an epi-pen for bee sting allergy, and scripts for cholesterol testing. Oh, and not to mention nice kudos for my health/exercise habits and a nice Steeler's story to boot.

 

[TromboneAl]

Here's another question: I am looking at a list of physicians in my area who take Blue Cross. I'm guessing that I should be looking at Family Practice, Internal Medicine, and General Practice, right? What's the difference between those groups?

 

[haha]

But my behavior might be very different if my A1C were 4.0 versus 8.2, so how could the test be useless?

Al, this is pretty abstract. If the number in question were either of these, it wouldn't be useless.

Anyway, I assume your number was in some grey zone, where I think that reasonable people may differ on what if anything should be done.

You don't need a doctor to do whatever you want to do anyway.

Ha

 

[simple girl]

Here's another question: I am looking at a list of physicians in my area who take Blue Cross. I'm guessing that I should be looking at Family Practice, Internal Medicine, and General Practice, right? What's the difference between those groups?

I don't know about those, but I find it interesting that the doc I went to was D.O. - first time I've even been to a D.O. I did notice a more "whole person" approach to my case, and he certainly seemed to have an interest in preventative healthcare. Just thought I'd mention this since it may be an extra factor for you to take into consideration if this approach interests you.

 

[TromboneAl]

Al, this is pretty abstract. If the number in question were either of these, it wouldn't be useless.

Yes, but he was saying that the test is useless, and since one doesn't know your result ahead of time, I think he was wrong. Maybe he meant "Don't worry Al, you're not going to get diabetes and you're going to eat low carb anyway." but that isn't what he said.

 

[Ronstar]

I need to find a new general practice doc since mine moved out of the area. I can't make sense out of (or trust) online ratings. I'm going with recommendations from a few docs, nurses, and friends/relatives that know the local doctors.

 

[haha]

Yes, but he was saying that the test is useless, and since one doesn't know your result ahead of time, I think he was wrong. Maybe he meant "Don't worry Al, you're not going to get diabetes and you're going to eat low carb anyway." but that isn't what he said.

Since you showed your result to your doctor, isn't it very likely that your result created the context of his remarks?

Anyway, I believe this discussion is moot as you seem to have decided to change docs.

Ha

 

[obgyn65]

Maybe he meant "please make sure you follow up with me if your A1C results > 7" ? Otherwise I agree what he said to you does not make much sense. It sounds like he was upset with you or something. I am sorry this happened to you, TromboneAl.

Here's another example of something he said. You tell me if it's bonkers or not:

I had gotten an A1C test at a health fare, and showed him the results. He said "That test is totally useless, because there's no point in having a test if there's nothing you can do based on the results."

 

[Rich_by_the_Bay]

Here's another question: I am looking at a list of physicians in my area who take Blue Cross. I'm guessing that I should be looking at Family Practice, Internal Medicine, and General Practice, right? What's the difference between those groups?

IM - adults only, no obgyn, surgery, etc. Nowadays likely to do office or hospital care only, one or the other - a trend.

General practice - a disappearing option, historic holdover from when some docs would do only 1 year of post-MD training.

FP - 3 year residency like IM, but includes pediatrics, obgyn in some cases, more office ortho, procedures; a broader scope than IM, but less training in core internal medicine issues (heart, diabetes, lung disease, etc.)

Either FP and IM would be a good choice. I chose IM both as my career and for my own doctor.

 

[kat]

Thanks for asking this question, Trombone Al. It's useful to me too, and I appreciate that you asked.

 

[TromboneAl]

Thanks, Rich, that's just what I needed to know.

A nurse friend has given me three recommendations. Now, I currently have no need of a doctor. Should I wait until something comes up?

 

[Rich_by_the_Bay]

Thanks, Rich, that's just what I needed to know.

A nurse friend has given me three recommendations. Now, I currently have no need of a doctor. Should I wait until something comes up?

Suppose you need him/her in an emergency, and the practice is closed to new patients? I'd schedule a new patient appt next time anything comes up, or if it has been more than 2 years or so since your last check-up.

 

[Nords]

A nurse friend has given me three recommendations. Now, I currently have no need of a doctor. Should I wait until something comes up?

Yeah, when you're feeling like crap or hemorrhaging from a yardwork injury, that's always the time I feel like introducing myself to a new doctor.

Perhaps it's worth phoning the office to check that they'll take you as a patient, visiting to see what the environment is like, and maybe even chatting up a patient or two in the lobby to see how long they wait to be seen? I bet the receptionist would even want to fill out paperwork to start a patient record, and that's probably a lot more enjoyable when you're healthy.