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Choose Well

Six important tips to help you pick the right medical specialist.



YOUR DOCTOR IS in a hurry. As always. So when she tells you she’s referring you to Dr. Good over at UCSF, it’s tempting to say thanks and get your clothes back on. After all, you are in a hurry too.

Not so fast.

Patient advocates, as well as families with too much experience navigating medical treatment, advise asking your primary care physician for two to three specialist options, and then going home to research those options before booking an appointment.

Jill is a mom who spent years seeking treatment for her daughter’s multiple congenital issues and is now being treated for breast cancer herself. It’s not that she doesn’t trust primary care physicians (PCPs) to recommend good specialists, but she rarely takes their word for it.

“Your doctor sees many patients and may not know what’s most important to you,” she says. Heading into a mastectomy, some patients might be most concerned about the doctor’s skill in minimizing scars, while others care more about a doctor’s bedside manner or cutting-edge techniques.

Choosing a specialist is a multistep process — and if you get to the last step and don’t feel right about your choice, don’t hesitate to start over.

“This is important stuff,” Jill says.

1. Ask questions before you leave the PCP office.

Ask your PCP why she chose the specialists she wants to refer you to.

Then ask this question, recommends Kathy King, chief executive officer of Marin Healthcare Navigation: “Who would you go to? Whom would you send your mother, father, child to?”

“This usually elicits a genuine response,” King says.

If your doctor doesn’t recommend a specialist, or if you’re dissatisfied with the ones she provides, search for names through specialty-specific and disease-specific organizations, such as the ALS Foundation, King suggests.

2. Verify that the specialist accepts your insurance.

Your doctor might have told you the specialists he recommends accept your insurance. You still need to double-check with your insurance provider and the billing department for the specialist’s practice.

“Contracts change all the time,” King says.

3. Gather word of mouth.

Ask friends, family and neighbors if they’ve visited this specialist and what their experience was like, King advises.

Jill favors word of mouth from within the medical community.

“My daughter is seen by a neurosurgeon and orthopedic surgeon. I trust them both and asked their opinions when I was searching for a breast surgeon,” she says.

Nurses and other staff are also good people to ask.

4. Get the basic facts from the practice website or by calling the staff.

“Consider the logistics,” King says.

Is the doctor’s practice a two-hour drive from you? Find out if the doctor has a satellite office in Marin, as many do, King recommends. It’s also important to find out whether the doctor’s affiliated hospitals are near you and accept your insurance.

If the first available appointment is two months out, that could spell logistical problems as well.

In that first phone call, King says, you can “get a feel for how busy the practice is and get a feel for how the staff treats you.”

5. Conduct online research.

At the very least, verify that the doctor is board certified in his field, and rule out red flags such as disciplinary actions or multiple malpractice suits. You can go directly to the Medical Board of California for this information, but sites such as Healthgrades collect this and other information in one place.

You can find patient reviews of doctors on Yelp as well as Angie’s List and other sites. While King glances through reviews to get a feel for how patients like the doctor, she wouldn’t use them to make a final decision because they are too subjective.

Jill even delves into scientific journals online, to see what kind of research her specialist may be doing, and looks up hospital complication rates.

6. Treat your first appointment like a job interview.

Be observant from the moment you step into the waiting room, King advises.

“If it’s disorganized, if the staff is less than respectful or courteous, in many cases that’s a sign of an underlying issue,” she says.

Once in the examination room, pull out your list of prepared questions. Jill always asks how many times the doctor has performed the procedure, and what the success rate has been.

Just as important as the answers the specialist provides is the way she receives them.

“I would listen to my gut,” King says. “It is critical when you ask your questions that you feel heard.”

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