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CloseHow to Make Informed Choices About Physicians
It has generally been assumed by many people that the longer a physician has been in practice, the more experience, knowledge, and skills he/she has accumulated and, therefore, the higher the quality of care they provide to their patients. Recent research conducted by a group of doctors from the Harvard Medical School, however, seems to strongly suggest that this premise may not be true. In an article published in February 2005 in the Annals of Internal Medicine (Volume 142, No. 4, pp. 260-303), the Harvard researchers seriously challenged the common assumption that the more clinical experience a physician has accumulated, the higher the level of medical care they provide to their patients.
In fact, surprisingly, the researchers found an inverse (opposite) relationship between the number of years that a physician has been in practice (i.e., experience) and the quality of care that the physician provides. In other words, the widely held belief that "practice makes perfect" does not necessarily apply to all physicians and should not be the sole criteria used by patients in their decision analysis for choosing a physician. The underlying message of this study is that the length of time a physician has been in practice does not necessarily equate to a high quality of medical care unless the doctor takes steps to keep abreast with new advances and changing patterns of clinical practice.
Here are some important issues you need to consider and carefully research before making an informed decision about choosing your doctor:
Board Certification - Board certified doctors are required to have extra training after medical school to become specialists in a particular field of medicine and are required to take continuing education courses in order to maintain their board certification status. Check with the American Board of Medical Specialists (ABMS) to determine if a specific physician you are considering is board certified in a particular medical specialty. To find out if a particular physician you are considering is board certified:
Visit your local public library and ask for a copy of the Official ABMS Directory of Board Certified Medical Specialists.
Search the ABMS web site at http://www.abms.org/login.asp.
Call the ABMS toll free at 1-866-275-2267.
Experience - As noted above, research from the Harvard Medical School strongly suggests that how long a physician has been in practice (i.e., experience) does not necessarily correlate with a high level of medical care. The most important issue, therefore, is not how long a doctor has been in practice but rather how much experience the physician has in treating your specific illness or medical condition. Some physicians who have been in practice for many decades may have only treated a small number of patients with the specific disorder, whereas, some younger physicians who have been in practice only a few years may have already treated hundreds of patients with the same disorder. Here are some suggestions for helping you find out about a particular physician's experience in treating your specific illness:
Call the physician's office and speak with a staff member such as a nurse or physician's assistant. Ask them for information about how many patients with your specific medical condition the physician treats during the course of a year. Ask how many patients with this condition the physician is currently treating. You will have to call several different physicians' offices in order to have a basis for comparing the numbers of patients.
Find out if the physician has published any articles about the condition in reputable medical journals by doing an author search online. You can conduct an online author search using PubMed at http://www.nlm.nih.gov. Simply click on the "PubMed" icon, select the "author" field from the "Limits" menu, enter the physician's name (last name followed by first initial), and then click on the "Go" button. The author search will retrieve all articles published by the particular physician you are considering.
Talk with your family physician and ask if he/she can provide you with any information about the particular physician's experience in treating patients with your specific illness or condition.
Contact disease organizations and support groups that specialize in helping patients with your specific disorder and ask if they can provide you with any information, including experience, about the physician you are considering.
Medical School Affiliation - Find out if the physician you are considering also has a joint faculty appointment at a medical school. In general, practicing community physicians with a joint academic appointment at a medical school are more likely to be in contact with leading medical experts and may be more up-to-date with the latest advances in research and treatments than community based physicians who are not affiliated with a medical school.
Hospital Affiliation - Find out about the hospitals that the doctor uses. In the event that you need to be treated at a hospital, is the hospital where the physician has admitting privileges nearby to your home or will you (and your family members) have to travel a considerable distance?
Hospital Accreditation - Find out if the hospital where the physician has admitting privileges is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). You can find information about a specific hospital's accreditation status by searching the JCAHO web site at http://www.jointcommission.org/. The JCAHO is an independent, not-for-profit organization that evaluates and accredits more than 15,000 health care organizations and programs in the United States. To receive and maintain JCAHO accreditation, a health care organization must undergo an on-site survey by a JCAHO survey team at least every three years and meet specific standards and performance measurements that affect the safety and quality of patient care.
Health Insurance Coverage - Find out if the physician is covered by your health insurance plan. If you belong to a managed care plan (HMO or PPO), you are usually restricted to using specific physicians who also belong to the Plan. If you decide to use a physician who is "outside the network," you will likely have to pay "out of pocket" for the services provided.