Scalpel’s Edge

How to find a quality family doctor

// February 19th, 2009 // No Comments » // Health

This article is part of a patient education series that I previously published elsewhere. Explanation is here. If you have already read this article, please accept my apologies.

With a quality GP you can “play” the healthcare system

A good primary care doctor, or general practitioner is the key to “playing” the health care system. They can be your passport to skipping queues, finding the best specialist, getting timely appointments, getting the best after hours care, and attention to the things you worry about.

I have written more about the need for a good GP previously. Now I would like to give explain one way to find the right doctor.

How to find your new family doctor

It is in our control to find a better doctor. There are very few people that are limited to only one family doctor in their town. Most of us have the luxury of 3 or 5 or 15. However, we get stuck going to a doctor we aren’t happy with. This is silly – patients are the consumers.

You wouldn’t go to a bad restaurant every week, so don’t continue going to a bad or even average doctor.

Recognizing that you are the consumer is vital – you are not limited to one provider, and you have no obligation to continue to use a service that you are not happy with.

I always knew these principles in theory, but it took having a family to realise their importance. I had been seeing a doctor for many years, one that I was “putting up with”. I had not been happy with the referrals she made and was not thrilled with her manner, but it was good enough. But when my daughter was born, I realised I needed someone better. My daughter was too precious to entrust to half-rate, “good enough” medical care. So I started looking around all the doctors in my area, and after a few visits, found someone I was really happy with, who continues to care for my family today.

I feel really happy with that decision – it is one of the most important things I ever did to care for my family.

Here is one process for finding a good doctor:

1. Look at your relationship with your current doctor

Are you happy? Do you feel you can trust them, and talk to them about embarrassing problems. Can you get an appointment when you need one? Do you have good conversations. Do you like them as a person, and respect their knowledge? Do they know you and your family and what is important to you? Would you trust them to make decisions about what medication to give you, or what treatment to offer, if they couldn’t discuss it with you?

If you answer YES to all of these questions, congratulations, you have the doctor that is right for you. If you answered NO to some questions, then it may be fixable. Trusting your doctor to make your decisions is the basic test of whether they are right for you. Normally good doctors consult with their patients, but as they can’t possibly explain all the variables, then they will have to abbreviate and select and recommend based on what they know of you. Maybe you need to have a conversation about your priorities, so that thy understand you better.

2. Figure out what you need from your doctor.

Is the gender of your doctor important to you? Do you have to be able to get an appointment at the last minute, or is after hours service more important? Is it more important to have a free service, or are you willing to pay out of pocket to go to the right doctor? Should the practice be close to home or work? Do you need a doctor who is right for all your family, or are you willing to go somewhere else to find someone that suits you personally?

3. Try someone new.

It doesn’t really matter who you try, but feel free to try as many doctors as you like. You have an opportunity every time you get sick. You can try recommendations from friends or family, or you can just work you way around the different practices. It is ok to try someone out. You are not obligated to continue seeing the same person. Remember, you are the consumer, and they are providing the service. You will probably have to fill in new forms at every place you go to, but that doesn’t oblige you to keep going.

4. When you find someone you like, tell them all your secrets

The best way to form a relationship with someone is to share your trust. Doctors need to know all the background to your health to help you make decisions in the future. Let them know about all the little things about your health, and your relationship will develop so that you can trust them when you need to.

5. If you get disatisfied again, repeat this process

Most importantly, never give up. Your needs change over time, as mine did when I had kids. If you retire, you will probably be less demanding about after hours appointments. If you develop a chronic illness, you may prefer a different style of practitioner.

In today’s “ehealth” environment, we are not stuck with the same doctor for life, so claim your right to upgrade. Find the right doctor, and start to take more control of your healthcare.

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Healthcare is not a battle

// January 30th, 2009 // 4 Comments » // Health

This article is part of a patient education series that I previously published elsewhere. Explanation is here. If you have already read this article, please accept my apologies.

I’m sick of the fighting

Healthcare doesn’t have to be oppositional. In fact, a doctor and patient should be acting as partners to reach a common goal. Although I am sure it will be unpopular, I have to say some of this is about patients behaving like a customer.

Some doctors have issues with patients who stand up for themselves, demand to be understood, or who ask lots of questions. However, your health is more important than any consumer product you might buy. If you would jump up and down to get your entitlements when your iPod breaks, you should be doing it about your health. But a better analogy is your prized vintage car. You choose a trusted mechanic, and you make sure you understand what is going on. You take control. If you feel in control of your health, your relationship with your doctor will benefit.

It’s all about the relationship

Problems in healthcare occur when the patient or doctor (or both) don’t understand what is going on.

Being a patient is sometimes difficult, humbling and embarrassing. However, dealing with doctors can be easier, if you are a smart consumer. You can improve your healthcare, and get more out of your experience, by using smart strategies.

There is a lot of information available on the internet on “How to Be a Good Patient”. The articles seem eerily similar - health-care providers giving patient’s tips on how to behave in an appropriate manner. This advice seems, to me, more about the provider than the patient, “Behave like this and I will find you easier to deal with and therefore have more energy to sort out your problem.”

But the answer is more simple. Create a relationship with your health. Work to understand what is going on. Find a useful doctor, who you can trust. Even when you are healthy, this can help smooth out the bumps of illness. For example, if you lost a prescription, you’re working uphill to get it replaced by a doctor on holiday, but it is much easier with someone who has met you before.

What about the doctors?

In my experience, doctors sabotage healthcare relationships, too. Usually, it is not intentional, but tiredness, unrelated stress, frustrating patients and staff conflict can make us into poor communicators. A short consultation seems even shorter, and less satisfying with a grumpy doc. It’s a trite comparison, but I behave this way with my kids when I am stressed and tired, as well. I know what I should be doing and saying, but I just can’t manage it.

What’s the solution?

I am no expert on this. I don’t have great answers. But I think part of the process is recognising the difference between the doctors/patients we should and want to be, and the way we actually are. Once we find real relationships in healthcare, then it becomes easier to cut through the daily static. Once we make connections, we can approach success.

Why is a good primary care doctor important?

// January 16th, 2009 // 1 Comment » // Health

This article is part of a patient education series that I previously published elsewhere. Explanation is here. If you have already read this article, please accept my apologies.

Everyone needs a general practitioner or primary care physician, and most have trouble finding the one that is right for them. Many patients I speak to “make do” with their primary care doctor, and that is a huge mistake.

Why is the “right” general practitioner important

Your body will travel through life with you and you will be together right at the end.

It will break down and you will get ill multiple times. How well you keep it maintained is vital. If you have a poorly maintained body, you will either have a shorter life, or a more uncomfortable one. Maintenance is all about having a good relationship with a primary care doctor. It won’t make you never get sick, but you will be more likely to recover faster, be more productive and be more able to enjoy your life.

It sounds a bit washy, so here is a real life example.

A friend of mine, who we will call Sarah, got ill with pneumonia. She had a great general practitioner who she saw promptly. Sarah was treated well and continued to get better. She trusted her doctor, and didn’t want to let him down, so she went for her follow-up appointment, even though she was feeling much better. The general practitioner used that appointment to review the illness and figured out that the type of pneumonia was a bit odd for someone of Sarah’s age and general health. So he did some more tests, which showed up a very early uncommon blood cancer. That was able to be treated before causing any other symptoms (except this unusual infection). So Sarah is not cured, but is still happy and functions well, many years longer than she was expected to.

Having the right doctor means:

• You will be more likely to go to the doctor when you are feeling a bit under the weather.
• Your doctor will be able to pick up on earlier symptoms, and diagnose things faster.
• Faster diagnosis means faster recovery. Faster return to work. All those good things.
• You will be more likely to attend for results and follow-up, which is important to look after your long term health.
  
• When you visit at other times, your doctor will be able to look at all of your health, not just the bit that hurts the most.

• Your doctor will be better at referring you to specialist care (if appropriate) as they will know you better, and be able to pick when you are particularly sick, and what specialist would best suit your personality.
• You will be more confident in the decisions they make.
• You will be more confident in asking questions, and know more abut what is going on, and therefore be more in control.
  
• You will become more involved in making your own health decisions.

• You will get better preventative care (of diabetes or hypertension, obesity or heart disease for example) because you will attend over a longer period of time.
• Attending more regularly means a better relationship - you will both get along better. More pleasant way to spend the day.

All of this things will make you a better maintained person. You and your body-mechanic need to have a close relationship, and there needs to be trust for one another. Things won’t get missed, and if you are sick, it will be a much less traumatic experience.