Q My husband is 78 years old and has several chronic conditions. Unfortunately his primary care doctor is moving from the area, and we have to find a new one. Besides competency, what else should we look for at this time of our lives? Additionally, my husband keeps checking the internet for new medical information, which I think is information overload and perhaps even an obsession. Your thoughts?
A Dear S.T.:
Let’s begin with the first part of your question.
Choosing a physician is key particularly in later life when we often are confronted with more conditions and diseases. In addition to physician competency, one of the most important aspects of getting good health care is the patient-doctor relationship. And that relationship has changed.
In the past, doctors typically were in charge, taking the lead while patients followed. Today, the patient-doctor relationship is more of a partnership, with physicians often offering a choice of treatments; the decision then rests with patients.
Both often work with a team that might include nurses, physicians’ assistants, pharmacists, social workers and other health care providers.
Now to some tips in selecting a primary care physician provided by the National Institute on Aging.
• Decide what you are looking for: Write a list of the qualities that are important to you. For example, do you prefer or care if the doctor is a man or woman? Does the doctor need affiliation with a particular hospital, and does he or she speak your language? Are you interested in an individual or group practice? If it is a group practice, are you fine seeing an associate if your physician is unavailable? After writing your list, decide which qualities are most important to you.
• Identify several doctors: You can get some recommendations from your current primary care doctor, but also ask friends and relatives who have had positive experiences. Ask a few pointed questions such as, “What do you like about your doctor?” “Does the doctor take time to answer questions?” Also consult with other medical specialists whom you know. You may be required to choose a doctor from a managed care plan if you belong to a health maintenance organization or a preferred provider organization. Managed care plans often provide information about their doctors’ backgrounds and credentials. Choosing a doctor out of your network may require a payment.
• Consult reference sources: To find doctors in your area, check The American Medical Association’s Doctor Finder by typing into your browser “AMA Doctor Finder — American Medical Association.” Board certification is another consideration. To be board certified means doctors have extra training after medical school and also have passed an exam certifying their expertise in a specialty such as internal medicine, geriatrics, gynecology or orthopedics.
To determine if a physician is board certified go to www.certificationmatters.org. And finally there is a site for doctors who participate in Medicare: www.medicare.gov/physiciancompare.
• Consider an initial visit: For a first visit you might want to ask a few questions before making a medical appointment. “Do you have many older patients?” “Can I call or email you or your staff with questions?” “Do you charge for telephone or email time?”
• Make your choice: For that first medical visit, bring your medical records or have them sent from your previous doctor. Also bring a list of current medications or take them with you. If you don’t have your medical records with you, give your new doctor the names and addresses of previous physicians.
Here are a few additional questions to consider:
Is the doctor taking new patients who are covered by your insurance plan or Medicare?
Is the doctor certified?
Is the office location important and is parking available?
Does the doctor make house calls?
How do I reach the doctor for an emergency call?
Also think about bringing a family member or friend with you for your appointments. An extra pair of ears and someone to take notes helps. There’s a reason for a third chair in most examining and consultation rooms.
Next week we’ll address the second part of your question on how to evaluate online medical/health information and the issue of too much information. Physicians move, retire and some die, which requires us to be ready to find the next best doctor. Thank you S.T. for asking a question that is — or will — be relevant to many of us.
(Source: Talking With Your Doctor: A Guide for Older People, National Institute on Aging, 2016).
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