December 7, 2006 – No. 4
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Choosing Dr. QualityDefining quality health care is not easy — it means different things to different people.One federal agency comes close: “Doing the right thing, at the right time, for the right person, and having the best possible results.” Sounds good, but what does that really mean, and more important, how do you find it? It starts with selecting a primary care physician (PCP). PCPs, most of whom are family practitioners, internists or pediatricians, are mostly responsible for defining a medical problem and treating it or making referrals to specialists as necessary. PCPs are usually the first doctor seen for a medical complaint. They are responsible for the majority of an individual’s care, while specialists are a distant second. It is the PCP’s job to perform regular checkups to ensure good health and recommend required screenings to prevent or detect illnesses in their early stages. The best way to choose a primary care physician is to carefully consider the traits you desire in a doctor rather than rely on someone else’s opinion. That is not to say that recommendations from family, friends, or a hospital’s referral service don’t work out. Nor does that mean that doctors assigned through health care plans will lead to trouble. On the contrary, both of those methods may work out quite well. However you come upon a doctor to be your PCP, a productive relationship will depend on the answers to a few basic questions. Does your doctor listen to you? Does he or she explain things clearly? Are you encouraged to ask questions? Does your doctor treat you with respect? Do the recommended treatments have good results? There are also several other considerations when choosing a primary care physician: Male or female; young or more experienced Comfort is a factor. Some prefer doctors of their own sex. Others prefer an older, experienced doctor, regardless of gender. And still others may feel more comfortable with a younger doctor. Race and language also play a role, especially if a patient is more comfortable with a doctor who looks like them or shares a similar ethnic background. If language is a barrier, look for a medical office that, at a minimum, provides an interpreter. Location and access Convenience is another factor. Because the PCP is the doctor you see most frequently, consider the amount of traveling time to their office. Also consider your schedule. You might need a doctor who offers weekend or extended weekday visits. There are further considerations. How easy is it to contact the doctor’s office? Do they respond to telephone calls or e-mails? Is there someone available to offer advice over the phone for common complaints? Who covers for the doctor in an emergency or during vacations? Is it someone in the same office? Hospital affiliation and referrals Hospital affiliation and specialty referrals must be considered as well. Some people have a strong preference for a particular hospital. If so, it is important to make sure the PCP has privileges to practice at that hospital and uses the specialists there as well. Affiliating specialists are especially important to those with chronic illnesses. For instance, cardiac patients will want to maintain their relationship with their current cardiologist in addition to their primary care physician. Board certification A doctor is board certified if, after completing medical school and hospital training, he or she has passed a written (and often oral) examination in one of 24 medical specialties boards. The certification is intended to measure medical knowledge, clinical judgment, and expertise in the specialty. PCPs are typically board certified in internal medicine, family practice, and pediatrics, although some women use their gynecologist as their PCP. To check on board certification of a particular doctor, contact the Massachusetts Board of Registration in Medicine at (800) 377-0550 or www.massmedboard.org. Electronic medical records The use of electronic medical records, or EMRs, is increasing in private practice. The EMR allows your doctor to view lab and x-ray reports and coordinate your care with specialists and other health care professionals involved in your treatment. Some systems check for drug interactions or issue alerts for abnormal tests. The availability of your health information in one location improves quality and helps reduce medical errors. Preventive Care One of the roles of the PCP is to recommend and order screening tests according to your race, age, gender, and risk. Screening guidelines have been tested and developed by various private and public health care organizations. It may be possible to determine how your physician group rates in this area from information distributed by Massachusetts Health Quality Partners (MHQP), a coalition of physicians, hospitals, and health plans, whose role is to promote improvement of health care services in the state. From their web site it is possible to view clinical data, including compliance with certain screenings, for over 400 doctors’ offices across the state. Unique to the site is a rating of patients’ experience at the offices. You can find the information at www.mhqp.org/quality/whatisquality.asp?nav=030000. Your health plan is also a good source of information on doctors, and often provides a quality profile on participating physicians. |
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