Sunday, February 16, 2020

How to Choose Your Primary Care Physician

How-does-one-select-the right-physician-as-patient ?

This is not an easy thing to do..However, there is a plan which can help you decide.  If you are well established in the community you may or may not have your own physician and you can ask a friend or a fellow employee who their physician is and if they like them?  If it is for a general physical examination when you are well some experts feel the annual physical examination is almost useless.  There are recommendations for screening tests, such as mammograms, EKG, stress testing. Your family history also is important for diseases that can now be suspected with genetic testing. Breast cancer is one where a gene BCRA can be found. History is very important. Heart disease has no specific genetic markers, but testing for lipid disorders helps and can reveal increased risk factors. Other diseases are recommended for colon cancer (colonoscopy).

Here are 10 tips on how to choose the right primary care doctor for you.

1. Ask around.

The first step to finding a great doctor: Talk to your family and friends about their great doctors. A recommendation from someone you trust is a great way to identify a highly-skilled, helpful physician. But remember: Every person is different. Just because a doctor was perfect for your neighbor or your best friend doesn’t mean that he or she is right for you.

2. Map it out.

Since you’ll be visiting your primary care doctor for everyday health needs, it’s important that he or she be located somewhere convenient to you. You won’t want to travel very far when you’re not feeling good. And if your doctor’s office is conveniently located, you’ll be more inclined to keep appointments for physicals and other preventive care when you’re healthy. If you’re enrolled in a Medicare Advantage plan, check if it offers transportation benefits, which can come in handy if you need help getting to and from your doctor appointments.

3. Make sure you’ve got coverage.

Once you’ve identified some possible candidates, check whether they work with your health plan. If you have traditional Medicare, call the doctor’s office and ask if he or she accepts Medicare patients. If you have a Medicare Advantage plan, call your insurance provider or check your plan’s website to see if the doctor is in your plan’s network. Most plans charge more if you see a doctor outside the network, and some won’t cover out-of-network care at all, so it’s important to take this step before scheduling an appointment.

4. Do a quality check.

Chances are you wouldn’t hire someone to make repairs in your home without doing a little research into the quality of their work. So why would you choose a doctor without doing the same?

If you have a Medicare Advantage plan, check with your insurance company to see if they have any information about the quality ratings of specific primary care doctors in your network. You can also use the Physician Compare tool on Medicare.gov to see if your doctor has participated in any activities that indicate he or she provides high-quality care.

Finally, check to see whether your doctor is board-certified through the Certification Matters site, which the American Board of Medical Specialties maintains. Board-certified primary care doctors have not only met the licensing requirements of their states, but also passed comprehensive exams in internal medicine. Doctors also have to keep up with the latest developments in their fields to maintain their certification, so you can be sure they’re giving you up-to-date advice.

5. Place a cold call.

Castillo advises that patients call a potential doctor’s office for a first impression of the practice.

“You can tell a lot by the phone etiquette of the office staff,” Castillo said. “Ask if they’re taking new patients and see how they answer. If they say, ‘The next appointment is in 90 days, have a great day,’ that’s a lot different than saying, ‘He’s really busy, and we always make time for existing patients, so it might take us some time to fit a new patient in.’”

6. Ask about logistics…and consider scheduling an in-person meeting.

Castillo recommends asking questions during that initial call that provide a sense of how the office runs. How does the office handle prescription refills? How do they let you know about test results? Can you email your doctor or schedule appointments online? Will the office call to remind you if you’re overdue for an annual screening or a flu shot?

When Castillo was in practice, some patients would ask for quick in-person conversations before making an appointment. Not all doctors will be able to accommodate such requests, but it doesn’t hurt to ask.

7. Keep your needs in mind.

Every person has unique health needs, and those needs change as people age. Castillo suggests asking your doctor about his or her specialties or areas of interest.

“Some primary care doctors are really good at sports medicine, but if you’re not a serious athlete in your senior years, that may not be helpful to you,” Castillo said. “Some doctors, on the other hand, may have a special interest in diabetes care or have a large population of diabetics in their practice. Those are things to ask when you call.”

And if you have multiple complex medical issues, you may benefit from seeing a geriatrician, Castillo said. Geriatricians specialize in the care of older patients.

8. Look at the bigger picture.

At the first visit, it’s important to make sure your doctor’s philosophy of care lines up with your own. Consider asking these questions: Why did the doctor decide to go into primary care? What is his or her favorite thing about being a doctor? What does he or she wish more patients would do after they leave his or her office? If your doctor’s outlook on patient care meshes nicely with your preferences, you’ll be more likely to follow his or her recommendations in between appointments. So take this information into consideration when deciding whether to stick with a doctor following your first appointment.

9. Avoid culture shock.

Every culture has its own customs, ideas, and taboos about medical care, so find a doctor who not only speaks your language but is sensitive to your cultural and religious convictions.

“In some cultures, it’s very easy to joke around, and in other cultures, that is just not the way you do things,” Castillo said. “It’s important that your doctor is culturally aware.”

10. Trust your gut.

Your primary care doctor is going to be a problem-solver and an important advocate for your health. It’s critical that you trust him or her and feel comfortable asking questions.

The American Academy of Family Physicians recommends that after your first appointment, you ask yourself the following questions:

• Do you feel at ease with this doctor?

• Did you have enough time to ask questions?

• Did he or she answer all your questions?

• Did he or she explain things in a way you understood?

If something seems off, trust your instincts and look for a new doctor, Castillo advised.

“You should be comfortable with your primary care doctor,” Castillo said. “It’s really about what you expect and need. It’s OK to say, ‘This person is not the right fit for me.’”

Plans are insured through UnitedHealthcare Insurance Company or one of

There are four categories to evaluate in a primary care physician (Family doc, or GP)

Accessibility
Affability
Affordability
Advocacy

What to do

You can also ask the doctor what journals he reads and how often. If he questions why you want to know...tell him it is important to you to know he continues his medical education. Medicine is a profession that requires continuing medical education. Trust your gut reaction.  How do you react emotionally to a doctor?  Does he listen more than he talks? Or does he have a fast answer?  Good doctors pause and ask more questions.
If you are fortunate enough to live near a School of Medicine, check with them. Physicians in a university setting are well-vetted and work closely with specialists. The U.S. News publishes a list of best hospitals for specific diseases. The hospitals do not pay to be on this list.

What not to do

Avoid 'Best Doctors in America"
Avoid doctors who advertise on TV, Radio, Newspapers and even the Internet.
Avoid 'health screening' fairs". 

Listen to the Podcast from Peter Attia M.D.  If you like it subscribe to it.




























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