Choosing a Physician

By Mark A. Kelley, MD |06/27/16

Choosing the right physician is an important step.

First, let’s review a few definitions. All doctors are trained in a specialty like internal medicine, pediatrics or surgery. We term these doctors “specialists”. Beyond their specialty, some doctors have advanced training in fields such as cardiology, plastic surgery, pediatric intensive care, etc. These doctors are “sub-specialists”.

Here are some things to consider when choosing a physician:

1. What kind of doctor are you looking for?

Primary Care – If you want a doctor who can treat most common illnesses, a primary care physician is a good choice. These physicians are specialists in internal medicine, family medicine or (for children) pediatrics. You want your doctor to be nearby if you are sick. Therefore, most people prefer that their primary care physician be convenient to their home. Usually that doctor also has staff privileges at your local hospital.

Sub-specialty Care – (like joint surgery, cardiology) – most hospitals have sub-specialists in both surgery and medical fields. Your primary care physician will know them in your community and you can also ask around as suggested above. Be aware that some sub-specialists will only see patients referred by another physician.

What Most People Do: Choosing a primary care physician is good first step. He/she will get to know you personally and understand your needs. Shopping around for a sub-specialist for every problem is unnecessary if you have a good primary care physician. That doctor can handle most common conditions and will also refer you to a subspecialty expert if necessary. For recommendations about specific doctors, it can be helpful to ask friends (particularly those in health care).

2. How can you judge the quality of the doctor?

Finding information about physicians is easy, thanks to the Internet.

Finding the Doctor’s Practice Site – You can perform an online search for the doctor by name and find their office location and other details. Be sure to add the doctor’s degree to their name (usually “M.D.” or “D.O.”)

Credentials – all doctors have the same credentials: medical school, specialty training (residency), medical license and, in most cases, specialty board certification. You can find this information from their hospital’s website, the doctor’s practice website or from national listings.

Public Quality Reporting – there are ratings of physicians’ quality that come from the federal government. These reports are still under development and most experts feel that they are not yet very precise.

“Best Doctors” Ratings – some commercial companies publish listings of the “best doctors” in a region or across the nation, often for a subscription fee. These ratings concentrate on sub-specialists and are usually based on physician polling. These sources can vary in quality and consistency. In addition, many excellent doctors are not listed in these directories.

Consumer Ratings – consumers are now rating doctors through websites such as “Yelp”. This new movement is gaining some traction with consumers. Most of the feedback is focused on the doctor’s bedside manner and how the practice is organized. This is helpful in judging the “user-friendliness” of the practice. However, these ratings may not be reliable in judging the clinical skill of the physicians.

The Physician’s Professional Experience – As with all professions, experience matters in medicine. However, there are other issues to consider. A new physician may be more available and also more up-to-date in the latest medical advances. A senior physician who practices only part-time may not have as much experience as a younger colleague who practices full-time. Regardless of age, physicians who perform surgeries and other procedures must perform them regularly to maintain their skills.

What Most People Do: The most trusted source of information about a doctor still comes from a physician or a relative/friend. However, many folks will also check on the physician’s background from the online sources above. When you select a physician, ask the him/her about their experience, particularly in performing procedures. One rule of thumb: a practicing physician is usually good at what they are do now—not what they did years ago.

3. How can I see an expert at a famous medical center?

Most large medical centers are teaching hospitals with multiple missions: providing medical care, educating future physicians, and performing medical research.
Often, these hospitals are owned or affiliated with a university. This allows them to recruit experts in complex and challenging medical conditions.

Seeing such an expert may not be difficult. Many centers are open to self-referred patients although some still require a referral from your doctor. A good approach is to look at the hospital’s website and find the “How to Make and Appointment” section.

What Most people Do: – The process is easier if you use your own physician to recommend and orchestrate the referral. Sub-specialists at large centers are more likely to expedite physician referrals from physicians. With your permission your doctor will send your records to the medical center expert and help coordinate your care.

4. How do I know the doctor accepts my insurance?

Doctors accept most insurance plans but you should check the details. If you are looking for doctors who accept your insurance, contact your insurance company–either by phone or on their website. Most companies list their participating doctors on their website or in a printed directory

Once you select a physician, it is best to verify the insurance information by calling the doctor’s office. You do not want any surprises when you arrive at your appointment.

As noted in a previous blog, check to see if you insurance includes a “narrow network”. This means that you must see doctors within that network. If you get treated “out-of-network” you may have to pay extra charges out-of-pocket.

Some of these networks have a limited number of doctors and hospitals you can use. Others are “wider”, with more options. Your insurance company can provide this information.

20 thoughts on “Choosing a Physician”

  1. Erika Brady says:

    I am looking for a doctor that can help to take care of my family and our basic needs. It sounds like a primary care physician is going to be the best option. Choosing one that is relatively close in location is important to me. Thanks for the points on what makes someone a quality doctor. I will take all of those into account as well for when I am choosing my physician.

    1. HealthWeb Navigator says:

      Hi Erika,

      We’re glad that you enjoyed our article on choosing a physician. If you are looking for more information on choosing a physician we have a section here on HealthWeb Navigator for reviewed websites that help patients find physicians or compare them.

  2. Olivia Nelson says:

    I agree with your comment on how you can find out if a doctor has good credentials by checking their website. I would imagine that finding out if a physician is experienced or not would be a really important step towards finding someone who is right for you. I am looking for a doctor of internal medicine to see for some health problems so I’ll have to remember to check their credentials first.

    1. HealthWeb Navigator says:

      Hi Olivia,

      We appreciate your feedback. Luckily, there are many tools available online for consumers when researching potential healthcare providers. Some of these websites even offer education and specialty profiles for physicians. Though our database is growing every day, you can explore some of the websites we’ve already reviewed on HealthWeb Navigator that help patients choose a physician.

  3. john Mahoney says:

    My brother has been sick a lot lately and it might be contagious, I should look for a doctor just in case. It is a good idea to check that the doctor you choose can work with your insurance, this is something that I haven’t usually done before going to a doctor. You also need to make sure you pay attention to what your symptoms are so that the doctor can provide you with the best care possible.

    1. HealthWeb Navigator says:

      Hi John,

      We’re sorry to hear about your brother’s illness. We agree with you that it’s a good idea to check beforehand whether or not a provider accepts your specific insurance. Consumers can find this information by calling the provider directly or checking websites that compare physicians. Several of these websites can be found on HealthWeb Navigator under the Choosing a Physician category.

  4. Cindy Tesler says:

    Thanks for pointing out that you should find a primary care doctor if you want a doctor that can treat most common illnesses. You also mention that your primary care doctor also has staff privileges at your local hospital. I think it’s a good idea to choose a primary care doctor that you feel comfortable around hat also has great availability hours.

    1. HealthWeb Navigator says:

      Hi Cindy,

      Thank you for your important reminder. Sometimes, due to the lack of personal research, patients can overlook the importance of a primary care doctor’s availability and personality. We hope that consumers will use the resources listed on HealthWeb Navigator to find the doctor that works best for them.

  5. Dave Anderson says:

    I just moved and I am looking for a good primary care physician. Like you said a primary care physician is a good person to be seeing because they deal with so many different types of illnesses that can happen to a person. I agree that the best way to find if a doctor is right for you is through ratings by your peers and online.

    1. HealthWeb Navigator says:

      Hi Dave,

      Thanks for adding your voice to the conversation. We hope that you can use some of the websites listed on HealthWeb Navigator to find the best primary care physician for you. Good luck with your search!

  6. Maggie Allen says:

    It’s good to know that I should be looking for either an “M.D.” or “D.O.” on the doctor’s degree. To be honest, I don’t even know what those abbreviations mean! I should probably research them and see if either one has an advantage over the other. After all, it’s better to be safe rather than sorry when choosing a doctor.

    1. HealthWeb Navigator says:

      Hi Maggie,

      Education, credentials, and areas of expertise are all extremely important when choosing among physicians. You can ask a physician directly about their background or research them online (if information is available). Good luck with your search!

  7. I agree with the article that the most trusted source of information about a doctor comes from someone you trust and know like a relative or friend. I’ve heard that it’s best to still do your own research about a doctor by looking up credentials, seeing ratings, and even visiting their office and chatting with the staff. I know I’d feel much more comfortable seeing a physician that I feel I’ve thoroughly vetted prior to my appointment.

    1. HealthWeb Navigator says:

      Hi John!

      We totally agree. We recommend that patients try as many types of research as they can before choosing a physician, including web research, conversations, and in-person visits.

  8. That makes sense that you can learn a lot about a doctor’s bedside manner from a user review site. People are very sensitive to customer service. I know I work well with people who communicate well, so I’ll have to look for a medical provider like that

    1. HealthWeb Navigator says:

      Let us know how the search goes!

  9. Frank Delaware says:

    Thank you for all this great information about choosing a physician. One thing that really stood out to me is that you say to look online and see how you would make appointments with them. It would be nice to know that you will be able to get in there without needing to do anything extra.

    1. HealthWeb Navigator says:

      Glad we could help!

  10. Frank Delaware says:

    My wife and I just moved to a new city, and we were curious about how you would choose the right physician. I really like that you say to find information online about the doctor that you are looking up. It would be nice to know that you are going to know where they went to school, and how they received their knowledge.

  11. Gloria Durst says:

    I agree that a good physician has good credentials. It would be good to find someone who is qualified and experienced. My brother is looking for a physician to help look after his family, so he’ll have to find someone with credentials.

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