The Doctor Won't
See You Now

With the nation's health care in crisis, many Americans may become victims of managed costs rather than victors of managed care. Since it's natural to assume the care your doctor provides you and your family is genuine and appropriate for your long-term health, you may never question diagnoses, medication prescriptions, or recommendations following a clinical visit. But what if you do and your concerns go unheeded? Your family's health is important, and if your doctor doesn't take interest in your questions or seems to be running an assembly line medical practice, it's time to find a new health care provider. Here are 15 signs you should dump your doctor.

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How to select a competent health care professional

Finding a doctor that meets your family's health care needs may seem like a challenge, especially if you are limited by your health insurance policy. However, there are ways to find the best possible medical care.

Ask around

Word of mouth carries a lot of clout when it comes to a doctor's competence and bedside manner. Asking people you know about the doctors they currently use as well as the ones they have left can provide helpful insight. Dr Lewin says, "Ask friends, relatives, other doctors and nurses and -- if you work outside your home -- ask colleagues who might be working from the same list of doctors who participate in your healthcare plan.

Consider credentials

By far, says Dr Lewin, a doctor's clinical competence should be a key factor in your decision-making; ask for credentials and areas of expertise to determine if a particular doctor is qualified to meet your family's needs. Dr Lewin suggests, "Choose the best hospital convenient to you and try to limit your search to doctors affiliated with that hospital – so that you have easy access to both in case of an emergency. The hospital affiliation is important, because hospitals must scrutinize and verify all doctors' credentials (including medical school, post-graduate training, board certification, references from supervisors and malpractice history) prior to granting "admission privileges" – so a lot of your work will have been done for you."

Doctors who are board certified have completed an approved residency program and have passed a comprehensive written – and sometimes oral – examination in a specialty such as internal medicine or family practice. To be board-certified in a subspecialty, such as cardiology, a doctor must first be certified in the specialty, then complete an approved fellowship program and pass a comprehensive examination in that subspecialty. If you have specific medical issues, consider seeing a doctor who is board certified in an area that treats your medical condition.

Do your research

To double check on a doctor's expertise and history, you can always do additional research. "If you want to re-check or get details for yourself, use a good search engine to look up your state's medical board (for example, 'New York Medical Board') for a record of training, board certification, recertification and malpractice history," adds Dr Lewin.

Start with an excellent primary care provider

Dr Lewin suggests finding a primary care doctor that will help you coordinate your care. "When that works well, you get referrals to specialists highly regarded in their fields, whose bedside manner is similar to that of your primary doctor and who communicate rapidly with your doctor so that your care is well-coordinated and 'the left hand always knows what the right hand is doing.'"

"The practice should be a small private practice, with no more than three doctors being equal partners in it, not salaried docs," recommends Dr Kogan. "Running our own business keeps us up in the middle of the night thinking about our patients. A nine-to-five salaried doctor does not provide nearly as much care, attention, and concern for the patient."

Check with your health insurance

Costs are certainly a concern so check to see if your insurance covers only certain doctors within a network or allows you to see other medical professionals. "In the latter case, see how much you'll have to pay out-of-pocket…and do accept the fact that doctors discounting their fees in order to participate with an insurance plan will have to see more patients in a workday and may have less time to spend with you." In some practices, doctors may delegate patient care responsibilities to a mid-level practitioner such as a physician's assistant or nurse practitioner. Decide what works best for you and your budget.

Have an interview visit

When selecting a primary care doctor -- a doctor you'll be seeing regularly over the years for primary and preventative care -- conduct an interview visit. "You need someone with whom you can communicate openly and freely…[an interview visit] gives you a chance to evaluate a doctor's approach to health care and bedside manner," stresses Dr Lewin.

"The office should be clean and with a warm flair, not a sterile white clinic atmosphere, and the doctor should be well versed in alternative therapies as well as conventional Western therapies," says Dr Kogan. "The waiting time should be no more than 15 minutes…a crowded room means to me that the patients are being double-booked or perhaps triple-booked for the same spot and that a medical team is inefficient."

Give a doctor a test run

According to Dr Lewin, health insurance companies won't cover interview visits and that you will have to pay costs out-of-pocket. If that is not feasible, you can always try out doctors when you have a simple illness like a cold or rash, which will likely be covered under your insurance policy. The doctor you decide to use should be qualified and approachable. "As a patient, you're both literally and figuratively undressing in front of a stranger – the doctor should make that a comfortable experience," explains Dr Lewin. "You should feel free to question facts or recommendations offered so that you understand the risks and benefits of (and alternatives to) tests and treatments."

Opt for doctors who can give you clear guidance

A doctor can't literally take care of you -- you are ultimately responsible for follow through and preventative measures to stay healthy. But, adds Dr Lewin, your doctor "should be a good enough teacher that diagnoses and recommendations are clear and enable you to carry through confidently and recognize when things aren't going as planned." Additionally, your primary care doctor should be able to interpret findings from other specialists and relay them to you in an understandable and practical manner.

More on healthy doctor-patient relationships

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