How to Be a Smarter Patient

We asked doctors on the front lines to tell us the real secrets for getting better medical care.
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Finding Dr. Right

I've survived breast cancer -- twice. And I'm a health journalist. My life and my living depend on asking doctors the right questions, so you'd think I would be a smart patient, right?

The truth is, I've done some dumb things. I've gone to appointments unprepared, left without knowing what I really needed to know, and had tests and procedures I probably could have skipped. I even put off one surgical decision till the very last minute, still debating options while the nurse was starting my IV. While my errors haven't caused any catastrophes, they could have. Medical mishaps occur every day -- but we don't want them to happen to you. That's why we asked members of the LHJ Medical Advisory Board to share their best insider advice to help you work the system like a pro and get the best care possible.

Finding Dr. Right

Most people spend more time researching a household appliance than shopping for a physician, but your health is worth the effort.

Tap Your Social Network

You can find a great doctor by asking an acquaintance with your exact same problem or someone who works with doctors every day. "With Facebook, everyone can have a doctor friend one step away. Use your connections to come up with names," suggests David Kriegel, MD, director of the Manhattan Center for Dermatology in New York City. Looking for a surgeon? Ask your friends if they know a local anesthesiologist, scrub nurse, or surgical resident, because they see what goes on in the OR every day and know who the most skilled specialists are. If you need an orthopedic doctor, talk to a physical therapist. And no one knows obstetricians like a labor and delivery nurse.

Erin Turner, 29, of Arlington, Virginia, found the perfect doctor thanks to Twitter when she learned that a specialist at the Mayo Clinic, Richard Berger, MD, was hosting an online chat about wrist pain. Turner described the pain she had lived with for five years and the treatments she'd had, and Dr. Berger recommended she get a second opinion. Turner researched his credentials and experience and decided she should see him. "Less than 24 hours after my initial appointment with Dr. Berger, I not only had a new diagnosis but had surgery to correct a torn ligament," she says.

Don't Be Afraid to Consider a New Doctor

It's important to build a relationship with a physician you see regularly, but don't fall into the trap of being too loyal. What kind of woman cheats on her favorite doc? A smart one. Even a specialist can't be an expert on everything within her specialty. "For example, it's hard for women to acknowledge that the obstetrician they love and trust may not be the best person for every gynecological problem," says Lauren Streicher, MD, assistant professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University. "One gynecologist might be an expert in PMS while another concentrates on menopause or hysterectomies. If a physician is interested in a specific problem, she'll read about it, see more patients with it, and get better at treating it."

If you have questions your doctor isn't able to answer or a problem that's not getting resolved, or you're at a certain life stage, such as trying to have a baby or going through perimenopause, go with the expert more specialized in your type of case. You can always switch to your former physician -- or not.

Dig a Little Deeper

To find a doctor who focuses on your specific problem, take your research to the next level. Check with a teaching hospital referral service. They usually list detailed information about each doctor's particular interests. Don't assume that the department head is your best bet; he may be at the top because of his administrative abilities, not his medical skills, says Robynne K. Chutkan, MD, the founder and medical director of the Digestive Center for Women in Washington, D.C.

While searching for a specialist, get suggestions from the local chapter of an advocacy group, like the National MS Society or the American Diabetes Society, or a professional organization such as the American Association of Gynecologic Laparoscopists. For serious or complicated problems, use Google Scholar or PubMed.gov to find doctors who publish papers on your condition. And patient-support groups often have great advice about local providers, treatments, common side effects, and how to cope.

Find a Surgical Specialist

Experience counts when treating any tricky condition but especially when it comes to surgery. One of the best questions you can ask a potential surgeon is, How many times have you done this particular procedure? "That doesn't mean that an orthopedic surgeon who does knees and shoulders and broken arms can't do a knee as well as someone who only works on knees," says Daniel Rousso, MD, past president of the American Academy of Facial Plastic and Reconstructive Surgery. "He may be an exceptional surgeon who can do it all. But the people who do mainly one procedure get the kinks worked out."

Keep It in Perspective

Of course, you don't always need -- or even want -- the most specialized expert you can find. There will be times when you need a physician with a broad, experienced view to balance the narrow focus of some specialists. For example, if you go to a breast surgeon after an abnormal mammogram, you may end up with a breast biopsy -- even though watchful waiting might be the best course of action, says Dr. Chutkan. Sometimes the best physician for the job is someone with a wider focus who can help you decide where to go for the next step and how to sort through conflicting advice.

Do a Background Check

Once you have a list of physicians, check their credentials. Go to the Federation of State Medical Boards (fsmb.org) to access information about licensing and complaint history. Resist the temptation to look at doctor-rating sites. Dr. Streicher and Dr. Chutkan both caution that some sites encourage doctors to become paid members, which then boosts their rankings, and others simply don't have enough consumer reviews to be reliable or objective. Finally, go to the American Board of Medical Specialties (abms.org) to be sure your top candidates are board-certified. Then make an appointment.

Continued on page 2:  Prep Tips

 

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