Comments on: How do you find a good doctor, and what kind of questions should patients ask? http://www.kevinmd.com/blog/2009/01/how-do-you-find-good-doctor-and-what.html medical blog Fri, 19 Mar 2010 06:41:55 -0400 http://wordpress.org/?v=2.8.4 hourly 1 By: Michael Kirsch, M.D. http://www.kevinmd.com/blog/2009/01/how-do-you-find-good-doctor-and-what.html/comment-page-1#comment-89444 Michael Kirsch, M.D. Tue, 27 Jan 2009 19:14:00 +0000 http://clients.emmense.com/kevinmd/2009/01/how-do-you-find-a-good-doctor-and-what-kind-of-questions-should-patients-ask.html#comment-89444 I read the Times piece and have written a few of my own over the past few years. I am skeptical of the various iterations of quality initiatives that do more to burden physicians than they help living, breathing patients. Everyone wants to maximize medical quality, but there is no reliable way to measure it, despite the government's many clumsy programs that claim they can do so. As for choosing a 'quality physician, check out http://mdwhistleblower.blogspot.com/2009/01/measuring-physicians-performance.html. If choosing a good doctor were easy. there wouldn't be so advice out there on how to do it. I read the Times piece and have written a few of my own over the past few years. I am skeptical of the various iterations of quality initiatives that do more to burden physicians than they help living, breathing patients. Everyone wants to maximize medical quality, but there is no reliable way to measure it, despite the government’s many clumsy programs that claim they can do so. As for choosing a ‘quality physician, check out http://mdwhistleblower.blogspot.com/2009/01/measuring-physicians-performance.html. If choosing a good doctor were easy. there wouldn’t be so advice out there on how to do it.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/how-do-you-find-good-doctor-and-what.html/comment-page-1#comment-89188 Anonymous Tue, 13 Jan 2009 05:26:00 +0000 http://clients.emmense.com/kevinmd/2009/01/how-do-you-find-a-good-doctor-and-what-kind-of-questions-should-patients-ask.html#comment-89188 To Family Practitioner: If the appointments are 15 minutes long, the doc is either a genius, sloppy, or works for a clinic over whose scheduling he/she has no control. As to asking nurses or PTs who's the best physician I strongly disagree. They may know who has the best bedside manner and who is the most personable, but their level of training is not high enough to know who is practicing the best medicine. The physician at my practice who is widely popular with the nurses and their families is someone I'm not happy having my patients see even as an urgent care visit. To Family Practitioner: If the appointments are 15 minutes long, the doc is either a genius, sloppy, or works for a clinic over whose scheduling he/she has no control. As to asking nurses or PTs who’s the best physician I strongly disagree. They may know who has the best bedside manner and who is the most personable, but their level of training is not high enough to know who is practicing the best medicine. The physician at my practice who is widely popular with the nurses and their families is someone I’m not happy having my patients see even as an urgent care visit.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/how-do-you-find-good-doctor-and-what.html/comment-page-1#comment-89182 Anonymous Mon, 12 Jan 2009 21:34:00 +0000 http://clients.emmense.com/kevinmd/2009/01/how-do-you-find-a-good-doctor-and-what-kind-of-questions-should-patients-ask.html#comment-89182 Nobody is going to be a completely objective source in any of those examples, but ER docs do look at medlists and compare them to patient histories and know the availability of the physician. There is little allied health professional interaction with most PCPs. The converse is true as well, a ER doc that has never heard of a local PCP maybe a PCP that gives all of his "complicated" patients to an internist or a partner and is not necessarily keeping them out of the hospital. Nobody is going to be a completely objective source in any of those examples, but ER docs do look at medlists and compare them to patient histories and know the availability of the physician. There is little allied health professional interaction with most PCPs. The converse is true as well, a ER doc that has never heard of a local PCP maybe a PCP that gives all of his “complicated” patients to an internist or a partner and is not necessarily keeping them out of the hospital.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/how-do-you-find-good-doctor-and-what.html/comment-page-1#comment-89178 Anonymous Mon, 12 Jan 2009 20:40:00 +0000 http://clients.emmense.com/kevinmd/2009/01/how-do-you-find-a-good-doctor-and-what-kind-of-questions-should-patients-ask.html#comment-89178 ER physicians as judges of PCPs? Hmmm...<br/><br/>As much as I love the analogy with the other examples (implying ED docs are our allied professionals), I'm not sure ED folks are in possession of all of the right information.<br/><br/>The best PCP is the one the ED doc has never heard of...because he or she keeps his or her patients out of the ED! ER physicians as judges of PCPs? Hmmm…

As much as I love the analogy with the other examples (implying ED docs are our allied professionals), I’m not sure ED folks are in possession of all of the right information.

The best PCP is the one the ED doc has never heard of…because he or she keeps his or her patients out of the ED!

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/how-do-you-find-good-doctor-and-what.html/comment-page-1#comment-89176 Anonymous Mon, 12 Jan 2009 16:38:00 +0000 http://clients.emmense.com/kevinmd/2009/01/how-do-you-find-a-good-doctor-and-what-kind-of-questions-should-patients-ask.html#comment-89176 The simple answer on how to choose is where the rubber meets the road. You want to find a good OB?talk to several delivery nurses<br/>Good orthopedist talk to local PT<br/>General Surgeon-scrub techs and floor nurses<br/>Internist- ICU nurse<br/>PCP-local ER physicians and so on and so forth. The simple answer on how to choose is where the rubber meets the road. You want to find a good OB?talk to several delivery nurses
Good orthopedist talk to local PT
General Surgeon-scrub techs and floor nurses
Internist- ICU nurse
PCP-local ER physicians and so on and so forth.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/how-do-you-find-good-doctor-and-what.html/comment-page-1#comment-89172 Anonymous Mon, 12 Jan 2009 12:32:00 +0000 http://clients.emmense.com/kevinmd/2009/01/how-do-you-find-a-good-doctor-and-what-kind-of-questions-should-patients-ask.html#comment-89172 "a caring attitude can mask poor quality medicine"<br/><br/>This is nonsense, and reinforces the stereotype that the really brilliant doctors, like tv's Doctor House, can not be bothered with a caring attitutde.<br/><br/>I spend so much time in my practice being asked to make excuses for these "brilliant" doctors that sometimes I feel I should get a public relations fee. And, yes, I try not to send patients to such doctors but frequently it is out of my control, determined by factors such as few local choices, or the relationship gets started by the ER, or referral patterns are detemined by who is on the patient's insurance plan.<br/><br/>Fact: a caring attitude IS good quality medicine.<br/><br/>What should a patient look for in a doctor?<br/><br/>For primary care, other than word of mouth, a simple question is how much time is allowed per appointment. If the answer is less than 15 minutes, that doctor is either a genius or sloppy. And there are not many geniuses around and geniuses in medicine tend to be slow anyway.<br/><br/>For specialists, ie surgeons: how many hospitals do they have privileges at? If more than 2 hospitals, I would question their ability to attend to your needs in the event of an emergency. <br/><br/>A family practitioner “a caring attitude can mask poor quality medicine”

This is nonsense, and reinforces the stereotype that the really brilliant doctors, like tv’s Doctor House, can not be bothered with a caring attitutde.

I spend so much time in my practice being asked to make excuses for these “brilliant” doctors that sometimes I feel I should get a public relations fee. And, yes, I try not to send patients to such doctors but frequently it is out of my control, determined by factors such as few local choices, or the relationship gets started by the ER, or referral patterns are detemined by who is on the patient’s insurance plan.

Fact: a caring attitude IS good quality medicine.

What should a patient look for in a doctor?

For primary care, other than word of mouth, a simple question is how much time is allowed per appointment. If the answer is less than 15 minutes, that doctor is either a genius or sloppy. And there are not many geniuses around and geniuses in medicine tend to be slow anyway.

For specialists, ie surgeons: how many hospitals do they have privileges at? If more than 2 hospitals, I would question their ability to attend to your needs in the event of an emergency.

A family practitioner

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