Choose your primary care physician with particular care

I told a friend what I did recently to get in to see a dermatologist and she was shocked.

“You wrote a letter asking her to take you as patient?” “Wow!” “Yes,” I admitted. “I’d called her office for an appointment; she wasn’t taking new patients; I needed to resort to an over-the-top approach.”

You see, I’d researched her (ok, I Googled her) and after reading her background, schooling, and patient reviews, I really wanted her as my doctor.

So, just like high school kids in the college application process, I decided to plead my case, in written form. I told her who I am, what I do, and why I need her. She must have appreciated my unique approach, for I got a call from her staff telling me to come in, in a week’s time.

When we met, she told me other potential patients have waylaid her at school bus stops where her children (and presumably theirs) gather, but she had never gotten a letter before.

I found her everything I hoped for. First, she gave me the most thorough skin exam I’d ever had (even combed through my hair in segments to find hidden skin problems), and she never rushed our meeting, spending 30-40 minutes with me. I’d confirmed with office staff—beforehand—that I’d be seeing her—and not a physician’s assistant (no offense to those, but I wanted the doctor, especially for my initial visit).

My former dermatologist (to whom I’d gone for 25 years) had retired abruptly, and I found myself scrambling to find a replacement. The doctors my friends raved about were “not taking any new patients” (blame the high incidence in my state of older Irish people with problematic skin; I figure in that group). So, I had no choice but to launch my campaign.

My first realization of just how important these people are came in 2002, when I was diagnosed with breast cancer. I found out during a routine mammogram. The radiologist took the proactive step to ask me if I had a surgeon (as I stumbled about in a daze). When I said “No,” she pressed a card into my hand with the name of a surgeon she trusted. It was that action on her part that set me on the successful course I followed.

Over the next two years, I had 5 surgeries, and today, eight years out, I continue cancer free. My doctors have pretty much all been named “Top Docs” within my home state, and I bother to know such details. I owe my life to the wonderful surgical talent of one (who performed the mastectomy), as well as the reconstruction wizardry of another. My plastic surgeon made me whole again, when I had little motivation to “Go forward.”

I was so impressed with my doctors, I honored them in my story “I Got the News All Women Dread,” in which I detail my journey through diagnosis, mastectomy, and reconstruction. It appeared as the Cover Story in Providence Journal’s “Lifestyles” Sunday magazine, December of 2004. I wrote it to demystify a process that often terrifies, giving patients hope.

But if our specialists have been critical to our well-being, the most important person, today, among all our doctors is our primary care physician. He’s the lead conductor of our multi-talented medical orchestra, a young man who has a healthy respect for his patients and youthful energy (he’s still in his 30′s). I like that, since I’m of an age when I don’t want to “break in” another.

It was he who detected my husband’s carotid artery problem (husband called it “corroded,” which turns out is an apt description), setting him up with a vascular surgeon. His former primary care doctor completely missed it, though it was 98% blocked, a serious omission since the broken neck my husband suffered last April (in an auto accident) might have signaled his death, if that artery hadn’t been cleared.

Choose your primary care physician with particular care

Dr. Lamendola starts out asking questions, pumping information into his laptop computer graced by picture of his 3-month-old son Nathanael (Biblical name and spelling). Next, he examines us. All of our specialists (and we have many) have already sent copies of reports to him (we’ve instructed them to do so). In this way, he acts as the personal medical warehouse we’ve all been led to believe is coming. He interprets test results with a clear idea of helping us manage present health problems, while avoiding future ones.

In the last analysis, Biddy suggests: Choose your primary care provider with particular care for he/she is the central cog in your important team of health providers. There’s a reason they’re called primary care: An excellent choice here can spell the difference between life and death. How do we know? My husband’s living proof.

Colleen Kelly Mellor blogs from the perspective of a chronic patient at Encouragement in a Difficult World: Biddy Bytes Blog.

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  • jeff newman

    I think the topic of your article is essential to obtaining adequate medical care but the art and science of choosing a primary care physician is obscure to me. Some have recommended canvassing nurses to see who they think is most knowledgable and has enough time. Could you make some specific recommendations on the methods you used to choose your pcp? Thanks

    • Colleen Kelly Mellor

      Yes, canvassing knowledgeable people who see these medical professionals in action every day is good indication, but in the end it is the “comfort level” I feel with a physician, how does he/she respond to me, that makes the critical difference as to how I choose. That and their professional training, of course…But it’s ever a mix, and pretty much, that mix is 50/50…

  • Maggie

    If you’re going to ask a nurse, it needs to be a nurse who works at the hospital where the doctor is based and/or has privileges….they’re the ones who see, hear and know each doctor and their compentency level. It helps to be able to ask a few nurses or doctors if you know some – the big question is, if you had to have XYZ done, or be seen for ABC, who do you trust? If it’s surgical, “who has the best hands”? Who do you want doing your anesthesia?

    Nurses and docs, along with other auxillary medical personnel know who is who and who sucks better than any bio or resume can tell you!


    Maggie is, to quote Mona Lisa Vito in “MY COUSIN VINNY”,

    “Dead on balls accurate”

    Circulating OR nurses and OR techs as well as surgical residents really hold the key to the competency castle.

  • Anonymous

    Any thought on the idea that if one is choosing between several primary care physicians who otherwise appear equal by other criteria (e.g. nurse referrals), to choose one similar to yourself (e.g. age, gender, lifestyle, genetic background, etc.) to increase the chance of the primary care physician having personal experience with the types of things patients may be concerned about?

    For example, a women in her first pregnancy may find a female physician who has already had a child to have more first hand experience, while an older man may find an older male physician to have first hand experience with prostate issues.

  • http://nostrums.blogspot,com Doc D

    I understand why people search for comfort levels and understanding…and testimonials by other care givers. Those are important.

    But a direct assessment of professional competence is number one on my list. And I’m convinced you don’t have to be a doctor or nurse to do that. Common sense works; things like “If it sounds too good to be true, it is,” and the like.

    Some of the best care I’ve had came from folks who were short in the simpatico department. Some not-so-good came from people I was very comfortable with, and had tops reps among the cognoscenti.

    Not trying to undermine the points in this excellent post, just make the case that there are multiple approaches to making a good choice when the issue is complex.

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