Most people don’t check on the level of competence of their doctor. Instead they typically see someone through a referral or recommendation from a friend, colleague, or often from another doctor who is suggesting a specialist referral. Or they are frequently given a list of “accredited providers” by an insurer. Sometimes they go on the internet and do some investigations – after all most doctors now have websites or at least have some information available about them on the web, but how much? And is it the right information that really lets you judge their competence, qualifications and experience?
There are ten types of questions you should ask. No doctor should be offended by any of these questions, and they should all be able to respond easily, although you won’t tend to find all the answers to most of these on many medical websites.
Talk to your doctor about these questions, or find the answers from his or her administrative staff before you make an appointment. Remember to be friendly, businesslike, and don’t take “no” for an answer. You are paying for the consultation. As the patient you are the customer. It is good to think of yourself as a customer in this situation, and make sure you check out the product, the doctor and their treatment, you are thinking of buying properly. You must be satisfied with both the consultation and the consultant. These rules apply equally for any type of health professional, whether you are seeing them face to face, or electronically on the internet or by telemedicine.
Ask:
· What are your qualifications and credentials? This includes the MD qualification and Board Certification for specialist expertise
· What experience do you have in offering face-to-face? Many surgeons will, for instance, advertise their infection rates and the numbers of operations they have performed.
· Are you registered to practice in your own state or country, and do you have appropriate malpractice insurance? You can often go to the State Medical Board website and find out if the doctor has ever been in trouble.
· Do you adhere to a documented code of ethics? Which one?
· What clinical and administrative guidelines for practice do you use? Check them out.
· What areas do you have expertise in, and what evidence in the form of professional recognition, publications or lectures do you have to confirm this? What hospitals or health systems have accredited the doctor to allow them to admit and treat patients?
· Do you communicate with colleagues for continuing medical education, professional supervision and self-development?
· Do you provide face to face and online treatment for patients if required? How do you communicate electronically with your patients?
· What are your billing procedures?
· Do you record consultations electronically in any way and, if so, what are your consent and confidentiality procedures for this. How do you keep your clinical records, and is it possible for patients to share in accessing these?
The practice of medicine is changing rapidly and doctors are becoming much more consumer centric. None of the questions above should cause offence. Doctors are increasingly being trained to communicate well with their patients, and to give sufficient information so that patients can make well informed decisions about their care. Seeking out information about your doctor is part of that decision making process, and will allow you to have more trust in the doctor that you choose for yourself and your family.
This article is taken from “Your Health in the Information Age – how you and your doctor can use the internet to work together” by Peter Yellowlees MD. Information and links from the book are at www.informationagehealth.com. The book can be bought from Amazon and most online bookstores.
I like that you have given a guideline for patients to follow to check out their doctor. You are correct in stating that the provider should not be offended. You could call it 'informed consent' in a way.
ReplyDeleteMany times in the business world consumers ask similar questions, check out businesses with the Better Business Bureau, and even check their D&B score (Dunn & Bradstreet --financial rating--www.dnb.com).
But, I would like to pose a few questions--Is this mostly subjective? Do these questions really demonstrate competence? I personally feel it does not. Physician profiling can sometimes destroy the doctor-patient relationship by creating distrust based on opinions.
First, in Florida and many other states, there are large populations of physicians that have the degree of 'DO' and not 'MD.' Even though both physicians are equally qualified to provide care to patients, I as a practicing physician, and an 'MD,' still hear patients refer to the 'DO' physicians as less qualified. This bothers me because some of the physicians that I consider excellent may be discounted just because of the predetermined opinion of the patient.
Additionally, many specialties in medicine have a higher risk of law suits and or 'disciplinary action' by a state board of medicine. For example, OB/GYN's and Plastic Surgeons will be more likely to have a mark against them than say a psychiatrist (no offense intended).
Moreover, many primary care doctors are now chosing to either be 100% outpatient doctors and not admit or have privileges at hospitals. Others choose to make their practice 100% hospital-based. Making a decision on a provider just because she does not have privileges at a hospital in this case would be unfair. In addition, those physicians that serve as hospitalist may not have patient ratings since they typically only see the patient while they are hospitalized.
As for the continuing medical education, this is required by all states.
I do agree that asking about board certification is important. State Boards of Medicine were created to protect the public by creating a minimum standard for practicing that should give the general public a sense of competency.
Now what about likeability? Healthgrades.com is a good source of information not only about what other patients think of the provider but also about how the provider's office functions. Additionally, the consumer has the option of doing a background check and state license check.
But does likeability reflect competency? I looked myself up on Healthgrades.com (Pembroke Pines, FL) and found that my patients like me. Then I looked up one of my colleagues that I know does not have the greatest bedside manner but is an outstanding physician. His patient scores were very low. Does that mean he is a bad doctor? I think not.
To review, an informed patient is a good patient. Check out your providers; but, use the information appropriately.
Thanks for the stimulating post.
Jonathan S. Ware, MD