Here's advice on how to pick a doctor - from a doctor

By Peter R. Kowey

A cardiologist outlines the best approach to finding a doctor, and the questions to ask yourself when you do

Finding the best doctor to care for your and your family is critically important - and sometimes complicated.

Identifying a doctor to take care of you or someone in your family is a daunting task.

There are so many issues to consider, as well as severe limitations imposed by our broken healthcare system, which means that the odds of finding someone you like and trust are stacked against you. It is certainly possible to end up in the right office, but getting there means you must avoid the mistakes that so many people I know and love have made.

Here are the 10 most important "don'ts" when you're looking for a new doctor:

1. Don't rely on the media. If a doctor advertises anywhere, they are likely looking for patients. Or worse, they may be on the TV or radio to endorse a remedy from which they stand to make a profit. Legitimately good doctors are deluged with referrals and turn away new patients. Also, ignore magazine listings like "Top Docs." These are usually popularity contests, and those whose photographs are included have paid for that distinction. Facebook recommendations from your "friends" are worthless if not dangerous. And if a physician advertises on a billboard, you can bet they are no better than the smarmy personal-injury lawyer on the next sign who makes a living chasing ambulances.

2. Don't fragment your care. Try to keep all your caregivers in one hospital system so they can communicate with each other and are able to see you when you're in the hospital. This may not be possible if you need treatment for a rare or unusual problem, but for most of what you need, you should be able to find satisfactory clinicians in your system.

3. Don't start a long-term relationship with a doctor who moves around a lot or is nearing retirement. Moving on to a new doctor is highly traumatic and fraught with problems related to continuity of care.

4. Don't pick a doctor based solely on location. I call the inclination to stay close to home "amusement park syndrome," because people will drive long distances to go on roller-coasters but refuse to drive to another city to see a superior physician. This is especially important if you have a complicated case and you need a second opinion from an expert in the field.

5. Don't be afraid to pick the brain of someone you trust. If you know a person in the health professions, especially if they are experienced and honest, chances are they can identify a good practitioner in the specialty you need, or they can reach out to a colleague for a recommendation. Word-of-mouth referrals from knowledgeable people are the way good doctors build their practices.

6. Don't consultant-hop. Find a good primary-care doctor who can be your quarterback and carefully orchestrate your care. If you can afford a concierge doctor, you should consider signing up.

7. Don't hesitate to be cared for by physician associates like nurse practitioners and physician assistants. Practices that have these individuals are likely to provide the best and most timely care. The key element is making sure that a physician supervises your visits and is available in person when needed by you or the associate.

8. Don't confuse gray hair with expertise. Yes, an experienced physician is a treasure, but sometimes older doctors don't have time to keep up with advances in their field. Young doctors have more up-to-date knowledge, are more tech-savvy and will be around to take care of you longer. The key is finding someone willing to spend time examining you, answering your questions and providing good advice, no matter their age.

9. Don't let health insurers limit your choices. Make sure that the plan you sign up for has a large panel of primary-care physicians and specialists to choose from. Similarly, look for a practice that has a contract with multiple insurance plans, so that if your coverage changes, you'll be less likely to have to find a new doctor.

10. Don't expect every doctor to be a thought leader, or to know how to cure every disease you or your family members might have. Unrealistic expectations lead to disappointment and doctor-hopping. Knowing something about your doctor's educational background is a good idea. The smarter the person, the better the places they are likely to have trained. But not everyone goes to Harvard Medical School, and doing a residency at a large academic institution doesn't always translate into being an exemplary physician. Again, advice about a good doctor usually comes from a healthcare worker you trust.

Once you've made your choice, there are a few questions you can ask yourself and your significant other that will help you understand if you have landed a good doctor:

-- Were you able to access the doctor when you needed them, even indirectly via their staff?

-- Did they see you close to your appointment time, or did you have to wait for hours?

-- Did the doctor sit down and talk to you, or did they spend the visit clacking away on a computer?

-- Did they preserve your hope of getting better, or were they a doomsayer?

-- Did they list several possibilities for treatment, or did they limit your options to a procedure that they just happen to perform?

-- Were they clearly motivated to do whatever is necessary to get you back on your feet? Were they willing to call a consultant they trusted to address questions beyond their expertise?

-- Did they facilitate the suggestions the consultant made by ordering the recommended tests and treatments?

-- When you left the office or the doctor walked out of your hospital room, did you feel better?

Just like baseball players, not all doctors hit at the .300 level. They have different skill levels, and a physician's ability to relate to people is also variable. Finding the best doctor to care for you and your family is a critically important and sometimes complicated task. Take it seriously and do it well, because your life literally depends on it.

Peter R. Kowey is a professor of medicine and clinical pharmacology at Thomas Jefferson University's Sidney Kimmel Medical College and the William Wikoff Smith chair of cardiovascular research. He is an internationally recognized expert in heart-rhythm disorders, has helped develop innovative therapies for cardiac arrhythmias, and has authored over 450 scientific publications and trained hundreds of cardiology fellows. His latest book is "Failure to Treat: How a Broken Healthcare System Puts Patients and Practitioners at Risk."

Read Peter Kowey's other commentaries:

-- Medicare Advantage is facing a reality check - and seniors are the ones who will pay for it

-- Getting a doctor's appointment will become even harder as a perfect storm hits the U.S. healthcare system

-Peter R. Kowey

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06-04-26 0744ET