Searching for information on good doctors and particular diseases and conditions
The New York Times recently published an excellent article helping to direct readers to better information on doctors, institutions and particular diseases and conditions. The article was authored by Pauline Chen, M.D., and titled "In Search of a Good Doctor". Among her suggestions:
1. To evaluate local institutions, go to www.hospitalcompare.hhs.gov, where you can compare a number of quality indicators, some of which may be pertinent to your anticipated surgery or treatment.
2. Your primary doctor (assuming he or she is a good one) is your primary ally in securing good specialist care. If you don't trust your primary care doctor, or he or she sent you to a poor specialist, maybe you need to start over!
3. Identify high quality medical groups or practices: it may be easier to find information on a medical group than it is to find information on a particular doctor.
4. Pay attention to the doctor's credentials, including Board Certification, which requires a full residency at an accredited institution, plus passing written and oral examinations and documentation of experience in a defined set of clinical problems and technical procedures. By the way, there is no such thing, technically, as a "board eligible" specialist: That simply means the doctor has been in practice and done the other work necessary to sit for the exam; either he flunked it the first time or he hasn't made the time to sit for the exam. Either way, it is not a formal specialty status.
5. Many specialties have a national professional society, and some of those will share credentials of members. Of course, no professional society will tell you if a member is incompetent, however, it may well provide documentation with regard to the particular sub-specialty of the doctor and demonstrate for you where he or she spends most of her professinal time. Also, it may document further training the specialist has received. Some common examples of national professional societies include the American Academy of Pediatrics (www.aap.org); the American Society of Anesthesiologists (www.asahq.org); the American College of Physicians (www.acponline.org); Society of General Internal Medicine (www.sgim.org); American Society of Clinical Oncology (www.asco.org); American Academy of Family Physicians (www.asfp.org); American College of Surgeons (www.facs.org); and American College of Obstetricians and Gynecologists (www.acog.org).
6. In addition to normal specialization, find out if your doctor is a Fellow in his or her specialty. This normally requires both board certification and a higher level of actual clinical experience. Doctor who are fellows usually use the initials F.A.C.S. or F.A.C.P. after their name.
7. Be alert to the length of time in practice as well as the area of emphasis within the doctor's practice. Virtually every study that has been conducted has confirmed that the risks of a procedure are reduced if it is performed by a practitioner who performs it hundreds of times per year. Similarly, the location of the procedure makes a difference in complication rates: institutions which perform several hundred of any given procedure per year employ thoroughly trained staff in all of the support positions, and probably have an experienced "second string".
8. Go to the "Foundation for Informed Medical Decision Making" a non-profit that is dedicated to helping patients make good choices. The website is www.informedmedicaldecisions.org and it is endorsed by the Society of General Internal Medicine.
9. Visit specialty sites, such as www.familydoctor.org, which may contain valuable information relative to a particular disease or condition, particularly common problems.
10. Find patient advocacy groups and chat rooms for particular conditions and diseases. Be wary, as with all information on the internet, however, of the quality of information from any site--particularly if the site is not professionally-sponsored.
11. Check the medical library association guide to medical information: www.mlanet.org/resources/userguide.html. The MLA also has a "Top Ten" guide to most useful consumer health websites.
12. Check with the State Board of Medicine to learn what you can about a physician's or other health care provider's licensing or specialty status and disciplinary record. Frankly, Michigan's disciplinary and investigatory branch was gutted by Governor Engler and is of little value.
13. You can confirm a doctor's board certification status through the American Board of Medical Specialties. (www.abms.org/)
14. The Agency for Healthcare Research and Quality (www.talkingquality.gov/compendium/index.html) has compiled health care "report cards" on many institutions (including nursing homes), practices, and individuals.
15. Go to Medline Plus for information on various health topics. This site is supported by both the National Library of Medicine and the National Institutes of Health. The site is www.medlineplus.gov.
16. With regard to communicable diseases, see the website of the Centers for Disease Control, www.cdc.gov.
17. Other sites with reliable information: The American College of Physicians Foundation (www.foundation.acponline.org); the National Cancer Institute (www.cancer.gov); the American Cancer Society (www.cancer.org); the American Society of Clinical Oncology (www.cancer.net); and for veterans: www.myhealth.va.gov.