What to Look For
Physicians, like everyone else, come in all varieties of professional excellence and individual temperament. When you engage the services of a physician, you are generally seeking two main qualities: competence and compassion. Almost all other desirable characteristics can be summarized by those two qualities.
The relative importance of those qualities varies depending on your needs. If you are seeking a specialist from whom you primarily want technical expertise, you might tolerate poor communication and long waits in the office. However, when selecting a primary care physician, you might focus on the doctor's compassion. Your primary care doctor should have enough concern to give counsel and act as a guide and a support. This is particularly helpful when you need specialty care and must navigate the sometimes bewildering maze of clinics, specialists, and preauthorizations.
Cost is also an issue. Some insurance policies contain words and concepts that are difficult for lay people to understand. Terms like health maintenance organizations, co-pay, out-of-plan, and preauthorization may imply restrictions on which doctors you can see, where you can be treated, and how much it will cost you in addition to your monthly insurance premium. You should understand these terms before you need a physician.
Why People Go to a Doctor's Office
The most common diagnoses for which patients visited a doctor's office in 1991 are listed below. Most of these disorders are best treated by a primary care doctor.
| Visits to a Doctor for the Six Most Common Patient Diagnoses (1991)* |
| Principal Diagnosis | Visits |
| 1. High Blood Pressure | 22,188,000 |
| 2. Normal Pregnancy | 20,657,000 |
| 2. Adult Examination | 18,221,000 |
| 4. Infant/Child Examination | 17,271,000 |
| 5. Upper Respiratory Infection | " 16,928,000 |
| 6. Ear Infection | 16,185,000 |
*Data from Schappert, National Ambulatory Medical Survey: 1991 Summary. National Center for Health Statistics, 1992.
Identifying Competence
Measuring physician competence is difficult even for professional review organizations. It is especially hard for patients to measure their specific physician's competence in treating their particular problem. Unfortunately, there is almost no objective way for a lay person to measure physician competence until after medical services have been received. However, there are a few measures you can take of a physician's competence.
Ask what others have experienced with a particular doctor. This is a subjective measure but still the best for most people. What is the general reputation of your potential physician and those who practice in the same group with him/her? You can always find a few patients or parents who were dissatisfied, but if you never find any positive comments, beware. Some insurance plans have patient satisfaction survey data that can help you quantify the happiness (or lack thereof) with various medical groups within the medical plan. The State of Minnesota has even done a statewide survey of satisfaction with various medical plans, although clinic-specific information is still hard to find.
This technique is most effective when you ask the opinion of someone who works in the medical area. A medical professional who knows your potential physician or, better yet, who knows many physicians in the same specialty often has inside information not available to the public. Even if you don't know anyone, you can sometimes call the hospital unit where you or your child will receive care (e.g. labor and delivery unit, nursery, etc) and ask them to recommend a doctor. It may take more than one call to find someone who will give you their opinion, but people who work in the labor and delivery unit are likely to know quite a lot about the doctors that practice there.
Identifying Concern
You can identify concern more easily than technical competence. It is something you learn by assessing your own feelings more than by asking questions.
Compassion and concern can be found in all types of physicians and is not limited to those in certain types of practice. This is one of the advantages of treatment in a large practice -- you have a number of physicians from which to choose. Don't be afraid to change physicians if you don't feel comfortable with your doctor. Having confidence in your doctor's competence and concern for you is an essential ingredient for a satisfying physician-patient relationship.
Gender
Many people do not use gender as a criterion for choosing a doctor; however, women constitute an increasing percentage of physicians entering practice. Numerous studies have shown that female and male physicians approach their patients differently. A study of university-based pediatricians showed that women spend more time and engage in more social interchange with their patients than do male physicians. In this study, parents (more mothers than fathers) were more satisfied with female than male physicians.
Plainly Speaking
Your satisfaction with the health care services you receive is largely dependent on the physician(s) you choose. Both competence and compassion can be assessed. When possible, you should search carefully for both primary and specialty-care doctors. The best information remains insider recommendations. Unlike the stock market, insider recommendations are perfectly legal in health care and you should use them whenever possible.
