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Posted: June 16, 2005

Spousal Caregiving

Insider Advice: How to Obtain the Best Medical Care

Bill Andrew

Have you ever thought about how your doctor finds a doctor for himself and his family? 

An article in the Reader's Digest June 2005 issue entitled "How Doctors Find Doctors" provided insider advice for getting the best medical care for your spouse and yourself.  According to this article, which was digested from articles in The Wall Street Journal (February 3, 10, 2004), "It is an open secret in medicine that doctors often receive better medical care than the average patient."  This column is derived from the excellent advice presented in that article and is intended to help you to improve the medical care for your spouse and yourself.

According to the article, professional courtesy is part of the reason -- doctors tend to give other doctors preferred treatment.  However, the biggest reason is that doctors know how to get that better care.  They know who to ask, they find the best practitioners in each medical specialty, they ask the right questions, and they know how to manipulate the healthcare system.  You can also obtain that preferred treatment and better care by following the advice of these same doctors.

Don't wait!  Start now to build a working relationship with a primary-care physician.  When an emergency does arise, you can often obtain better care and faster treatment by saying, "I am  Smith's patient."  Your doctor will also be the filter through which referrals are made to medical specialties that you may require for future diagnoses.

Check out the doctor's credentials!  Those fancy diplomas, licenses, and board certifications on the walls of the doctor's office and/or exam room can give you great insight into the doctor's credentials.  Doctors will always check the medical school, specialty and sub-specialty board certifications, and training sites of other doctors.  In fact, doctors who have trained with another top professional will generally brag about it.

Check out hospital privileges!  If you can, select the best hospital in your area and then check whether your doctor of choice has admitting privileges there.  If he/she does, chances are that they have been through screening procedures to obtain those privileges -- questions that you would not ask.  Also, the hospital team includes radiologists, pathologists, and anesthesiologists -- all doctors -- who will support your doctor of choice.

Volume does count!  Doctors always ask their own doctors how many annual procedures they perform in their specialty.  They want a medical team that is time-tested and have done a specific procedure many times.  Do you want to have bypass surgery by a beginner or an experienced pro?

Be detail conscious!  How are you treated by your doctor and his staff each time you make a visit?  How much of an exam is performed each time?  Does he/she explain what is being done, the results, and the implications thereof?  Does he/she listen to you and respond to your checklist -- you should always have a list of questions in hand -- or does he/she interrupt you in an attempt to move on with the visit?  Refer to our January 13 and January 20 columns for more suggestions.  You will also want to check out the cleanliness of the facility and the friendliness of the staff -- these are often good indicators of the efficiency and effectiveness of the doctor's office and the care delivered therein.

Request your medical records!  You are legally entitled to your personal medical records including progress notes, test results, and correspondence with specialists.  While the original records may be the property of either the medical group or the hospital, good doctors believe that the information should be made available to the patient.  You may or may not have to pay for copies of requested medical records -- you may also run into HIPAA (Health Insurance Portability & Accountability Act) privacy barriers.

Bring a list of questions!  A good doctor will encourage his/her patients to come prepared for the visit -- it assures the patient that all questions are addressed and it saves the doctor time.  It is essential that you come with a list of questions and concerns that the doctor can address during the visit.  If the doctor objects to the questions or tries to rush you, I would look for another doctor -- just like I would seek a second opinion if that doctor's treatment suggestions seem too radical.  In fact, you may wish to have a family member along with you just in case you need an advocate.

Learn the best time to schedule visits!  It should be obvious that early morning appointments are more likely to take place on time with a minimum of waiting.  Everyone is more alert and less hassled than what you might encounter later in the day -- both doctors and staff.  You may also want to avoid elective procedures or surgery during late summer and early fall if at all possible -- that is typically when inexperienced medical students start their residencies.  Also, hospitals tend to be chaotic during the summer vacation months when staff shortages typically occur.  This also applies to the holiday times of the year.

Get to know the support team!  Doctors get to know the receptionists in their doctor's offices.  You too can benefit from being nice to your doctor's office staff -- get to know them, have the appropriate paper work in order when you come, bring them occasional treats.  It is often amazing how you can get worked into a tight schedule when they know you and like you. 

Ask a nurse for their opinion!  Nurses typically see, or hear about, many doctors in the course of their daily activity.  They often know which doctors provide the best care for their patients -- and which do not.  Nurses who take care of sick patients in a hospital are often the best sources since they see various doctors and have contact with other nurses. 

To whom would a doctor refer his mother?  Although a rather personal question, it dramatically demonstrates exactly how many doctors find their own doctors.  To whom would they entrust the care of their own family members?  In large medical groups, there may be various pressures to refer to a colleague within the group -- but in selected situations, these same doctors will go outside their group to obtain the best care for the specific procedure or treatment that is indicated.

The above suggestions have been "doctor tested" and are also "time tested."  To learn more about doctors and hospitals, you may want to try these resources:

If you would like to share your spousal caregiving experiences with other readers of this column, please e-mail me at ASKBill@caregivershome.com.  You can also ask any questions that concern you -- but remember, I can only share my personal experiences with you and can not provide any advice that would require specific licensure.

WORDS TO CARE BY. . .

"Healing is a matter of time,

but it is sometimes a matter of opportunity."

Hippocrates (460-377 BC) 


Bill Andrew identifies himself as a former “nutritionally-empowered Alzheimer’s caregiver” who attributes the slow-down in progression of Alzheimer’s disease in his wife, Carol – and the growth of his own personal emotional, mental, physical, and spiritual capability and strength to provide quality 24/7 care for her in their own home – to the targeted nutritional supplements they both took on a daily basis. Carol went to her Heavenly reward on June 9, 2008 – Bill continues on to advocate for family caregivers. Contact Bill with your caregiving questions and comments via email at ASKBill@caregivershome.com.

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