In the past, many people saw the same doctor for years—sometimes for most of their lives. Today, people are much more mobile, making a long-standing patient-doctor relationship more difficult. People move to new locations, accept new jobs, and change healthcare coverage. Any of these situations may require a change of doctors. Some health plans restrict your choice of doctors to those who participate in their plans. Seeing a specialist may entail getting a referral from your primary care doctor. Choosing a new doctor takes more than just a word-of-mouth recommendation from a friend. You need to think carefully about what you are looking for when changing doctors.
The area of medicine in which a doctor specializes is an important consideration. If you have a particular medical problem, such as heart disease, you will probably want to see a cardiologist (a doctor who specializes in diseases of the heart). If you are generally healthy, an internist (a doctor who specializes in the care of adults) or a family physician is probably the best choice. You may also prefer a male doctor over a female doctor. Some people choose a doctor based on the hospital to which he or she admits patients. The location of the doctor's office also is a factor. It should be easy to reach from your home or workplace, especially if you rely on public transportation.
Once you have narrowed your choices, find out more about the doctors you are considering. Important information includes where they trained, how long they have been practicing, and their specialty area and whether they have been certified by the board in that specialty.
To become board-certified, a doctor must have had at least 7 years of medical training and must pass a comprehensive examination in his or her specialty (such as plastic surgery or otolaryngology). To find out if a physician is board-certified, call the American Board of Medical Specialties (ABMS) at 800-776-2378, or, if you have access to the Internet, visit the ABMS Web site (www.abms.org). Also, the American Medical Association's online Doctor Finder (www.ama-assn.org)
provides helpful information such as medical training, specialty, and board 95
certification for more than 650,000 physicians in the United States. The least Preventive reliable source of information about doctors is probably paid advertising. Healthcare
After you have compiled a list of doctors, you will need to check their credentials. There are several good sources of information about doctors. Three reference books—Directory of Medical Specialists, Compendium of Certified Medical Specialists, and The Official ABMS Directory of Board Certified Medical Specialists—that list board-certified physicians by location are available at your local public library. You also can call your local hospital or the offices of the doctors you are considering to find out the following information:
• Training. Where did the doctor attend medical school? Has he or she completed a residency? If so, where?
• Board certification. Make sure that your physician has been certified by an appropriate certifying board, such as the American Board of Internal Medicine, the American Board of Surgery, or the American Board of Dermatology.
• Hospital privileges. To treat patients at a given hospital, a doctor must gain official approval of his or her peers at that hospital. At which hospital in your community does the physician have staff privileges? Contact the hospital to verify this information.
• Experience. For example, if the doctor is a surgeon, how many times has he or she performed the type of surgery you are planning to have? When was the most recent time? The surgeon you select should be up to date on the surgery you are considering.
• Professional society membership. Perhaps the most important organization to which a physician can belong is his or her specialty society—the group that represents the medical specialty practiced by the doctor. Specialty societies certify their members and require that they participate in continuing medical education and adhere to a strict code of ethics.
Once you have made your choice, your next step is to develop a good working relationship with your doctor. A good relationship depends on effective communication between you and your doctor. Before you see your doctor for a scheduled visit, think about what you are going to say. Write down important questions you have or symptoms you want to tell the doctor about so you won't forget them. When describing your symptoms, be specific; explain when they started and what you experience when the symptoms occur. Write down the names of all the medications you are taking, including over-the-counter drugs and vitamin or mineral supplements. Remember to bring your notes with you.
Don't hold back any information when the doctor asks you questions about your diet, alcohol or other drug use, smoking, or sexual activity. These factors can affect your health, and the doctor needs to know about them to get a full understanding of your condition and treat your problems appropriately. If you
96 feel embarrassed about talking over sensitive subjects, it's all right to tell your
Staying doctor about your discomfort. Rest assured that all of your conversations with
Your doctor needs to communicate well with you by fully answering all of your questions and explaining medical terms and procedures in language you can understand. He or she also needs to treat you with respect and keep waiting times to a minimum. If you feel that you are not getting all the information you need to follow your doctor's instructions or that your appointment times are too rushed to address all of your medical concerns, try to talk to your doctor about the problem before switching to another doctor. Keeping an established relationship is much easier and more valuable than starting all over again.
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