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untonugganI spend a lot of time looking for a doctor I feel I can work with before I actually make an appointment. I am lucky in that I have a PPO in addition to Medicare, and I have the educational background that lets me know how to do all of this shit. It is a pain in the butt, no joke, and it is not always successful. I don't do all of this for every doctor, and I hope it isn't just super overwhelmoing. However, if you are stuck in WHY AM I ONLY FINDING ASSHOLES limbo, here are some of the things I try in order to find a good doctor for me:
Ask a doctor I already like working with: it sometimes helps if it's more specific than "this specialty", but "this gender" or "someone who listens well to patients" or "this geographic region" or "takes my insurance". if the doctor really didn't work out, I try to let the referring doctor know (and know why). same goes for if they were great, or if I could only see a partner in the practice due to wait times and that person worked/did not.
Ask around my spoonie friends: this works better if you know spoonies in your geographic region, or you know spoonies who know spoonies in your geographic region. but from here you can learn useful info like "this doctor is great but just know their receptionist is super abrupt on the phone" or "they have a very Nerd bedside manner but they are all about science and great diagnoses"
Angie's list: (note: this is fee based, and the medical one is extra; I am lucky in that we have a family plan). I always double check this and use it not as my only source. (tbh, i never use anything as my only source.) but I find it's more accurate than Yelp reviews, which are often populated by people with an axe to grind or what I suspect are accounts created by the doctor's staff for the purpose of writing glowing reviews. anyway, not all dr's are on Angie's List, but the reviews are pretty good when they are. some of the negative ones are telling too: if someone's upset that a doctor is always late, for example, but they have a really good appointment because the doctor spends a lot of time with them, that's actually a really *good* sign for me.
Professional websites: If I'm seeing a particular type of specialist, I might check out their specialty or sub-specialty website. PsychologyToday has a pretty decent therapist and psychologist finder that lets you search by type of therapy someone specializes in, geographic region, and what insurance they accept (so EMDR + my insurance + avoiding the ones that offer CBT is one thing I look for usually these days).
Patient websites: If I am looking for a doctor for a particular condition, I might have luck with the organization for that condition. Often this is a crapshoot, however, as the organization itself will not recommend particular doctors for legal reasons so it's a "use at your own risk" list of doctors people have recommended on forums. Sometimes they're good, but sometimes the doctors are so specialized that they can have tunnel vision (I treat POTS, therefore *all* of your symptoms in your entire body including your psych symptoms are related to POTS, for example.) Also, some super-specialists have no competition in the region so they just take zero insurance or don't accept new patients. If you only go this route, it can feel really discouraging.
Finding the right keywords: Sometimes you need to find the right search terms. For example, I'm currently looking for a new optometrist for my more unique eye issues to replace the other guy I don't like. I looked on his website to see what he lists as his specialties, so I can search for other doctors with the same specialties. In another case, my psychiatrist who treats me for Premenstrual Dysphoric Disorder specializes in "women's mental health" which is apparently the search term d'jour (like the aisle in the pharmacy is marked "women's hygiene" or whatever not "get your tampons here").
PubMed: PubMed is the NIH database of medical publications. If I really want to research a particular doctor, I will try to see if they've published anything and what they have published. Alternately, if I am looking for a doctor on something super rare, I might see if someone in my area is doing research on it and might be interested in doing SCIENCE on me. (The risk for the second one is tunnel vision again, but the nice thing about looking at prior research is you can evaluate how good it is if you have the know-how.)
clinicaltrials.gov: Clinicaltrials.gov is a database of open/ongoing/recent clinical trials in the US. It's organized by the NIH, but they are not all run by the NIH. I am basically ineligible for any clinical trial because I have too many variables to be a good test subject. You might not be, and it can be a way to get a free evaluation or health care, though I am wary of pharmaceutical trials. However, it's also a way to see who is researching what in your area. Is someone super interested in [insert disease here] near you? They are probably up on the latest research and it's Their Special Nerd Thing, so they will probably not see you as just another 15 minute appointment to get through. Also, if they're full up/don't take your insurance, their receptionist probably knows other people who do the same thing, and if you ask nicely they might share the list.
Open Payments: All doctors in the US who accept Medicare must submit any industry payments they receive to Open Payments. This includes lunches from pharmaceutical reps, speaking fees, hotel stays at conferences, etc. I find I'm not as bothered if someone gets free lunches from pharmaceutical reps occasionally. However, if a doctor is super recommending a particular treatment and they also get money from the makers of that treatment, I am more likely to get a second opinion. I usually don't start with this one, but look it up if a doctor is pressing a more "cutting edge" procedure that is spendy or whatnot. Note: the search feature can be tricky, for example if the doctor's first name is listed as their initial and you search for their name they won't show up, so you might have to fiddle with it. AND if they don't accept Medicare, they don't have to report. So, just things to note.
Conference speaker lists: I usually only go this far if I'm desperately trying to find someone in a particularly obscure sub-sub-specialty. However, sometimes if you look at a conference for a super-rare disorder, you luck out and find that a good speaker actually practices medicine in your area. If you are super lucky, you can both read/see their speech online *and* they also have appointments available in the next six months.
Local hospital doctor lists: who knows, maybe their search feature will actually be useful and give me the name of someone good! more useful if I'm seeking someone general, but not a bad place to start. also sometimes the scary scary phone hotline person is actually helpful, although if they ask you to repeat the spelling of the specialty repeatedly, it is probably not worth your time. if you can reach the receptionist at the department you need help in, you may have better luck because they actually know the doctors.
Yelp: I will sometimes look at it as a tertiary source, but I take everything here with a hefty dose of skepticism.
My insurance company preferred provider list: Before going, I double-check that the doctor is on here if possible. If I have scoured heaven and earth and there is Only This One Doctor in a 100 mile radius who treats this thing, I ask for help from my parents to see if I can at least pay for a consultation. YMMV with this second approach. Without insurance? Seeing specialists is definitely shit-tastic, and on an HMO or NHS or another country than the US is obviously completely different.
Keeping track of my shit list: I do have a list of People to Never See Again, also culled from friends with horror stories. It's good to remember who's on the list so as not to waste time.
tl;dr I use a combo of word of mouth, finding out who's researching the thing, and double checking someone's background on the internet (aka "what's your internet resume?") I don't do all of this for every appointment; usually I do more if I've had a run of terribad experiences in a specialty or it's a super-rare thing I'm trying to find a doctor for.
(note: dw pingback to this is okay, but please ask before linking it out to the wider internets)
Ask a doctor I already like working with: it sometimes helps if it's more specific than "this specialty", but "this gender" or "someone who listens well to patients" or "this geographic region" or "takes my insurance". if the doctor really didn't work out, I try to let the referring doctor know (and know why). same goes for if they were great, or if I could only see a partner in the practice due to wait times and that person worked/did not.
Ask around my spoonie friends: this works better if you know spoonies in your geographic region, or you know spoonies who know spoonies in your geographic region. but from here you can learn useful info like "this doctor is great but just know their receptionist is super abrupt on the phone" or "they have a very Nerd bedside manner but they are all about science and great diagnoses"
Angie's list: (note: this is fee based, and the medical one is extra; I am lucky in that we have a family plan). I always double check this and use it not as my only source. (tbh, i never use anything as my only source.) but I find it's more accurate than Yelp reviews, which are often populated by people with an axe to grind or what I suspect are accounts created by the doctor's staff for the purpose of writing glowing reviews. anyway, not all dr's are on Angie's List, but the reviews are pretty good when they are. some of the negative ones are telling too: if someone's upset that a doctor is always late, for example, but they have a really good appointment because the doctor spends a lot of time with them, that's actually a really *good* sign for me.
Professional websites: If I'm seeing a particular type of specialist, I might check out their specialty or sub-specialty website. PsychologyToday has a pretty decent therapist and psychologist finder that lets you search by type of therapy someone specializes in, geographic region, and what insurance they accept (so EMDR + my insurance + avoiding the ones that offer CBT is one thing I look for usually these days).
Patient websites: If I am looking for a doctor for a particular condition, I might have luck with the organization for that condition. Often this is a crapshoot, however, as the organization itself will not recommend particular doctors for legal reasons so it's a "use at your own risk" list of doctors people have recommended on forums. Sometimes they're good, but sometimes the doctors are so specialized that they can have tunnel vision (I treat POTS, therefore *all* of your symptoms in your entire body including your psych symptoms are related to POTS, for example.) Also, some super-specialists have no competition in the region so they just take zero insurance or don't accept new patients. If you only go this route, it can feel really discouraging.
Finding the right keywords: Sometimes you need to find the right search terms. For example, I'm currently looking for a new optometrist for my more unique eye issues to replace the other guy I don't like. I looked on his website to see what he lists as his specialties, so I can search for other doctors with the same specialties. In another case, my psychiatrist who treats me for Premenstrual Dysphoric Disorder specializes in "women's mental health" which is apparently the search term d'jour (like the aisle in the pharmacy is marked "women's hygiene" or whatever not "get your tampons here").
PubMed: PubMed is the NIH database of medical publications. If I really want to research a particular doctor, I will try to see if they've published anything and what they have published. Alternately, if I am looking for a doctor on something super rare, I might see if someone in my area is doing research on it and might be interested in doing SCIENCE on me. (The risk for the second one is tunnel vision again, but the nice thing about looking at prior research is you can evaluate how good it is if you have the know-how.)
clinicaltrials.gov: Clinicaltrials.gov is a database of open/ongoing/recent clinical trials in the US. It's organized by the NIH, but they are not all run by the NIH. I am basically ineligible for any clinical trial because I have too many variables to be a good test subject. You might not be, and it can be a way to get a free evaluation or health care, though I am wary of pharmaceutical trials. However, it's also a way to see who is researching what in your area. Is someone super interested in [insert disease here] near you? They are probably up on the latest research and it's Their Special Nerd Thing, so they will probably not see you as just another 15 minute appointment to get through. Also, if they're full up/don't take your insurance, their receptionist probably knows other people who do the same thing, and if you ask nicely they might share the list.
Open Payments: All doctors in the US who accept Medicare must submit any industry payments they receive to Open Payments. This includes lunches from pharmaceutical reps, speaking fees, hotel stays at conferences, etc. I find I'm not as bothered if someone gets free lunches from pharmaceutical reps occasionally. However, if a doctor is super recommending a particular treatment and they also get money from the makers of that treatment, I am more likely to get a second opinion. I usually don't start with this one, but look it up if a doctor is pressing a more "cutting edge" procedure that is spendy or whatnot. Note: the search feature can be tricky, for example if the doctor's first name is listed as their initial and you search for their name they won't show up, so you might have to fiddle with it. AND if they don't accept Medicare, they don't have to report. So, just things to note.
Conference speaker lists: I usually only go this far if I'm desperately trying to find someone in a particularly obscure sub-sub-specialty. However, sometimes if you look at a conference for a super-rare disorder, you luck out and find that a good speaker actually practices medicine in your area. If you are super lucky, you can both read/see their speech online *and* they also have appointments available in the next six months.
Local hospital doctor lists: who knows, maybe their search feature will actually be useful and give me the name of someone good! more useful if I'm seeking someone general, but not a bad place to start. also sometimes the scary scary phone hotline person is actually helpful, although if they ask you to repeat the spelling of the specialty repeatedly, it is probably not worth your time. if you can reach the receptionist at the department you need help in, you may have better luck because they actually know the doctors.
Yelp: I will sometimes look at it as a tertiary source, but I take everything here with a hefty dose of skepticism.
My insurance company preferred provider list: Before going, I double-check that the doctor is on here if possible. If I have scoured heaven and earth and there is Only This One Doctor in a 100 mile radius who treats this thing, I ask for help from my parents to see if I can at least pay for a consultation. YMMV with this second approach. Without insurance? Seeing specialists is definitely shit-tastic, and on an HMO or NHS or another country than the US is obviously completely different.
Keeping track of my shit list: I do have a list of People to Never See Again, also culled from friends with horror stories. It's good to remember who's on the list so as not to waste time.
tl;dr I use a combo of word of mouth, finding out who's researching the thing, and double checking someone's background on the internet (aka "what's your internet resume?") I don't do all of this for every appointment; usually I do more if I've had a run of terribad experiences in a specialty or it's a super-rare thing I'm trying to find a doctor for.
(note: dw pingback to this is okay, but please ask before linking it out to the wider internets)
no subject
Date: 2016-01-22 04:00 pm (UTC)Another thing that helps
Date: 2016-01-22 04:33 pm (UTC)What I mean about receptionists is that finding my doctors I did this:
Me: [calls urology] Um, hi, I need to see a urologist about a kidney thing I guess.
Receptionist: Oh, then you want Dr. ____, he's the one who really likes kidney stuff.
Me: [thinking: wait aren't all urologists the same...? Oookay then...]
Same thing happened when I called the lung clinic about seeing an asthma specialist. I assumed all lung clinic doctors would be fine, but nope, receptionist says "Yes, Dr. ____ is our asthma specialist, the others do other lung issues."
no subject
Date: 2016-01-24 02:50 am (UTC)