Needle in a Haystack: Looking for a Health Care Provider

We’ve discussed when you might want to look for a new health care provider. MiddlesexMD advisor Dr. Sheryl Kingsberg minces no words on that point: If your health care provider isn’t addressing your sexual health concerns, find a new one. If your current physician isn’t listening or is talking down to you, find a new one. If you are uncomfortable and can’t communicate with your provider—you guessed it—find another.

Gulp.

Changing physicians is a daunting task. The process is fuzzy, and credible information is hard to come by. Maybe that’s why we put up with less-than-ideal situations for so long.

But the relationship with your doctor is too important to settle for an uneasy status quo. Trisha Torrey, who writes extensively about the issue, says it’s like choosing a spouse, except that you may be more intimate with your provider.

If you’ve been dissatisfied with your provider or are just putting up with a situation because you’ve been avoiding the task of finding a new one, here’s a plan of attack.

If possible, out of fairness to your current physician, try to address with him or her the reason for your dissatisfaction. If you aren’t a good “fit” with her personality or style of practice, a heart-to-heart might not be very productive. It’s unlikely that he can change such basic traits. But if you have a problem with her staff or have health care issues (such as sexual complaints) that haven’t been addressed, you should give your doctor an opportunity to discuss the causes of your dissatisfaction.

Also, as Torrey points out, “nice” doesn’t necessarily equal “competent.” A good bedside manner is pleasant and soothing, but for my money, I’d rather have competency.

If you’re convinced that you need a different provider, don’t leave your old provider until you’re sure you have a new one. You don’t want to come down with a cough or find a lump without a regular physician. According to a 2008 article in the New York Times, “Studies have found that it is hard to get an appointment at short notice when cold-calling, and that patients with a regular source of care get better care, even when they are uninsured.”

Then, as you begin your search, consider these issues:

• Insurance and hospital affiliation. Finding out what providers are covered by your insurance is probably your first order of business, unless you’re okay with paying for medical service out-of-pocket. Call your company for a list. Does the hospital a physician is affiliated with make a difference to you? That could also factor into your search.
• Age. Do you want an older person with more experience but who may or may not be as familiar with the latest treatment options? Or do you want a younger provider, who may be around for your golden years, but who lacks long-term experience (at this point).
• Language-gender-culture. Are any of these variables important to you? Would you prefer a provider of the same gender? Do you have religious or cultural preferences or prohibitions? Do you have a hard time understanding accents?
• Special health concerns. If you have diabetes or allergies, do you want your primary care provider to have more expertise in that area? Some general practitioners have extra training in various subspecialties.
• Location and hours. Do you want a provider near at hand, or are you willing to travel to someone you’re comfy with? Would evening hours be a bonus so you don’t have to take time off work?

Once you’ve mulled over these parameters, your next challenge is to find solid, trustworthy information about the providers on your short list. The bad news is that it may be easier to get information about a washing machine you want to buy than about a doctor you’re considering. Websites that provide information and ratings on physicians are in their infancy, and sites that feature patient reviews have to be carefully vetted for objectivity.

“The truth of the matter is that people are hard pressed to make well-informed decisions when they choose a doctor, and they’re doing it blind,” said Joyce Dubow, a senior adviser in the office of policy and strategy at AARP in an article in the New York Times.

When you call your insurance company for participating providers, ask if they have a review system or an “honor roll” of providers. Some companies are starting to do this.

Some online sites rate physicians, but they vary in quality and credibility. You wouldn’t trust a review of a washing machine from the company that sells it; neither should you find a doctor on a site hosted by a pharmaceutical company. Pay attention to who created the website, who funds it, who makes money from it, how complete it is, and how current it is. Check out healthgrades.com for basic information; reviews are often available if you Google the doctor or practice name (just use your judgment on what's a credible review source). 

Doctors must be licensed to practice in a state, but board certification indicates a higher level of competency. Most providers are board-certified, and yours should be as well, either with the American Board of Medical Specialties for MDs, the American Osteopathic Organization for DOs, or the American Board of Physician Specialties, which accepts both disciplines. A doctor may be certified with other boards as well, but these three are widely recognized and demand a certain level of competency and achievement. To find a health care provider with specific menopause-care knowledge, you might start with the North American Menopause Society's website at menopause.org; there's a practitioner search you might find helpful.

Word of mouth is still a common and effective way to get information about local providers, especially if the word comes from someone in health care. I found a terrific dentist from a hygienist who taught at a dental school. Another woman found her internist from a trusted pharmacist. Ask family and friends who they see and how they like the person.

Check social media sites and search engines like Google. It’s easy and worth a shot, just make sure you’re getting information about the right person.

Finally, schedule consultations with the providers on your short list. You’ll probably have to pay for the appointment, but you’ll be able to assess the provider’s attitude and personality, the office environment, and, very importantly, the attitude of the staff.

Bring a list of questions, such as whether she schedules same-day appointments for illness, how he handles emergencies, whether you’ll see the doctor or members of the staff (physician’s assistants or nurse practitioners), how she handles prescriptions, where he went to medical school, how long she’s been in practice (if you haven’t ferreted this out already). Ask about board certification and any special training. And tell him or her you want to feel free to discuss matters of sexual health.

Finding a provider is a challenge, but it’s a critical and long-term relationship, so it’s worth putting in the effort upfront in order to avoid ongoing dissatisfaction down the road. And take heart from Dr. Sheryl: “If a women is smart enough to have found the MiddlesexMD website, she’s savvy enough to ask friends and other health care providers and to do some basic research to find someone she’s comfortable with.”