How to Pick the Perfect Specialist
A medical specialist is defined as a doctor who has completed advanced education and clinical training in a specific area of medicine (their specialty area). Most patients still allow their primary care physician (PCP) or trusted physician adviser to choose which specialist they will see by way of a referral. Prior to the Internet era, this was reasonable as word of mouth and the recommendation of an expert were really the only options. Now, there are copious sources that can aid you in choosing your next specialist. DoctorRated and other websites strive to provide this much needed data so that patients are informed about the doctor before arriving.
These days, primary care physicians will often ask the patient whom they want to see for a specific specialty. If and when the patient is unable to choose without a recommendation, the PCP will often make the choice for the patient. This is one of the reasons why choosing the perfect PCP (see my article) is so important. Now, however, patients do not have to rely on word of mouth and friend/family opinions to help make this choice.
The following article attempts to illustrate the qualities to look for and those to avoid when choosing a specialist. I want you to think about your choice of each specialist as one that is vital to your health and happiness- it may be the difference between life and death. Remember that specialists are diagnose serious medical illnesses and may admit you to the hospital when critically ill. As you can imagine, this can be a daunting decision and has many twists and turns. This article is intended to be an overview and will not be able to cover all potential dilemmas.
Look for these Gems
First, although physician demographics (age, gender, race, religion, etc) are important when deciding about your next specialist, I think that quality of specialist care is the most important factor when making this decision. Quality can come in many forms including knowledge, personality, communication, education, experience, and nonclinical factors. Quality can be measured in several different ways. Patient satisfaction questionnaires can give patient opinions about personality and office logistics. When doctors rate their peers, you should have the most comprehensive detail of a specialist's abilities.
I think that personality should be one of the most important qualities that you investigate when picking. It is widely known that not all doctors have great personalities, however I think it is important for you to find a compatible personality type in your prospective doctor. Once again, word of mouth and websites like DoctorRated are vital when deciding whether a doctor's personality is a good fit for you. Be reassured that if you see a specialist and find them not to be compatible with you, you have the right to switch to another specialist.
Second, a doctor's knowledge and ability to translate this knowledge for the patient is paramount as this is the way you will be educated and informed about your medical issues. A smart doctor is not just book smart, well read, and up-to-date on current studies and literature, he/she should also be able to harbor that knowledge and release it to the patient in a form that is understandable and logical. Too often, I hear patients tell me that they think their doctor is "very bright” or even "brilliant” but state that "[the doctor] talks over my head.” DoctorRated will be the best resource for determining which specialists will be able to translate his/her knowledge into a meaningful conversation with you.
Third, training and experience are the foundations that doctors use for making complex decisions about patients. When researching which specialist to choose, a patient must keep these two qualities in mind. Far too often, I hear friends discuss young doctors and discount them due to their lack of experience. Although this snub can be warranted, be aware that older doctors were trained in an era when technology was not as advanced necessitating that they keep up with newer literature and techniques. There is no better source for determining which doctors have the best training and experience than a website which asks doctors and their peers to rate this quality.
Specialists rely on PCPs to refer them patients and thus keep their practices full. The availability of a specialist both in his/her clinic and at the hospital can be very important. It never ceases to amaze me when I hear a specialist turn down a patient referral for no apparent reason. I often think about this when I am referring patients in the outpatient or inpatient setting as I am hesitant to develop a relationship with a referring doctor who is not always willing to see the extra patient and go the extra mile. I think this way due to the fact that there are times when a specialist is needed in an emergency and if that doctor is not always willing to be available for a non-urgent situation, how can I be sure that they will be so for an emergency situation.
One often-underestimated situation when considering which specialist to choose involves the ability of the specialist to communicate and work closely with your PCP. Your PCP is the gateway to your healthcare but also should be your healthcare "quarterback”. If the PCP does not communicate well with your specialist, you either need to find a new PCP/specialist or you need to be completely aware of the details of your healthcare.
Patients often do not give much thought to a specialist's partners when choosing which specialist to see. I say this because patients become acutely aware of a specialist's partners in a variety of situations. The first involves nighttime and weekend coverage- make sure that a specialist not only has coverage when not available but also ensure that the coverage is well trained and caring. Too often, specialists in small practices will take time off and not have a doctor to cover. Remember that
Finally, I think it is vital that you pre-determine you preferred hospital and emergency room. In so doing, you need to be aware of which hospital your prospective specialist prefers. If you were to choose a specialist who does not work at or with your preferred hospital, this can cause either a lack of communication or it will require you to choose a "temporary” specialist who will fill in for your doctor. Both situations will affect your health in a detrimental way.
Don't Get Bogged Down in the Details
I often hear patients describing their choice of specialists based on certain personal qualities or logistics of the office system. Wait times, office staff/environment, location/convenience, and friendship are often mentioned as important. I am going to explain below why these should not be at the top of the list when making your choice.
Friendship with a physician surely can be a benefit to the patient when it comes to obtaining access to the doctor and simplifying communication. However, I suspect that the benefits of these patient-physician relationships end here. More commonly, I see patients treated inaccurately and inappropriately over the phone or after a cursory office visit with a friend/physician because the friendship muddies the decision-making process. I do not think this is the case for all friend/physician relationships, however I point it out so that you ensure that this does not happen to you. Healthcare is like business and financial services in this way- be very careful when you go into business with a friend, let your friend manage your money, or choose your friend to be your doctor.
As with hospitals and ERs, patients will often pick a specialist because his/her office is convenient to work or home. Although location certainly can make seeing a doctor easier, I would not sacrifice quality for convenience.
A specialist's office staff undoubtedly can make or break the patient/doctor relationship. Rude or unfriendly office staff, nurses, doctors, and doctor's partners can make for a very troubled relationship. There is nothing worse than a doctor whose nurse does not return calls, follow up on tests, and/or inform patients about results. At the same time, the office environment including the waiting room, furniture, cleanliness, security/privacy, and parking all contribute to the overall patient experience. Although I do not feel that these factors trump doctor quality, they can sway a patient to change doctors if the patient feels that another physician offers similar quality without these hassles.
Extended wait times are not uncommon in certain specialist's offices. Most patients dislike waiting on their doctor and will change to another less "busy” doctor due to this. What they do not know is that "busy” doctors are usually busy because they either are more skilled, more personable, or more liked by their patients than their competitors in the area. Doctors who are not busy can be that way for a similar but opposite reason. I will put it another way- would you rather wait to see a highly qualified doctor who may save your life one day or go to a subpar doc who will get you in and out quickly? It just takes one life-threatening diagnosis to know that a couple of extra minutes once or twice a year is worth your time.
Although the above article cannot cover all details when choosing the perfect specialist, I have laid out a groundwork for you to make this decision easier. Not all of the advice will pertain to you so use it as you deem fit. The following is a list of the top 5 recommendations when choosing a specialist:
1. Your choice of specialist can be a life or death decision because certain specialists deal in serious medical illnesses.
2. Word of mouth and websites like DoctorRated are great resources in making your decision about specialist.
3. Personality, knowledge, training and experience, and communication skills (between PCP and specialists) are vital in choosing a perfect specialist.
4. Wait times, location/convenience, office staff/environment, patient/physician friendship should almost never be a major determinant of which specialist you choose.
5. Research your choices of specialist by asking your doctors/friends/family and review ratings on DoctorRated and other websites.