Choosing the right doctor for you and your loved ones can be a daunting task, especially when most of us simply don’t have the time or resources to navigate the labyrinth that is the American medical system. Patient location can also exacerbate this challenge, narrowing options and access to quality medical care. So how can patients be sure that they or their children are being matched to the best doctor?
We spoke with doctors from Grand Rounds, a service that is equal parts personal medical concierge and patient advocate, which does everything from records management and appointment scheduling to matching patients with the best, most geographically appropriate doctor for an in-person visit. They also offer a second opinion service for patients to seek highly-qualified experts to review their diagnosis and treatment plan, and consult on their options. Grand Rounds is best known for offering their services to the employees of companies such as Comcast, SC Johnson, Wal-Mart, News Corp. and Jamba Juice. They gave us insight as to how to choose the best doctor for your family and explained why the first available doctor isn’t always the best.
"98 percent of the time, the soonest available doctor fails to rate in the top 10 percent of their specialty."
Choosing the Right Doctor for your Little One
Dr. Sohini Stone is the Medical Director of Quality of Continuous Improvement at Grand Rounds. Even more important, she’s the mother of two kids.
Dr. Stone suggests that families looking for a pediatrician opt for one that is both in network and in the neighborhood. As most parents know, sick kids don’t travel well. The health of your child often depends on a number of critical support services ranging from immunizations to screenings. With this in mind, it’s important to ensure that your doctor’s office has built-in relationships with other clinics to guarantee comprehensive pediatric-friendly care. However, access to these services depends heavily on regional location and rural offices are less likely to have all of them in-house.
Although it may appear to be counter-intuitive, Dr. Stone insists that being friends with your child’s pediatrician shouldn’t be a deal breaker. Nevertheless, there should be a baseline level of comfort between parents and the doctor. You have the right to meet with the pediatrician before your first visit to gauge compatibility. If it doesn’t feel right, move on until you’ve found a workable match. Dr. Stone also stresses the importance of after-hours access to your pediatrician. At the very minimum you ought to be able to speak with a pediatric-trained nurse after hours.
As with any doctor, it is important to know your pediatrician’s background when deciding whether they will be treating your children. Parents should insist on working with a doctor that is either board-certified or board-eligible. When it comes down to it, families would be better served choosing a board-certified family medicine doctor who focuses on children compared to a non-board-certified pediatrician. If you have an adolescent with a complex medical history, Dr. Stone also suggests working exclusively with an adolescent specialist if possible.
According to Dr. Stone, most parents are justifiably anxious when it comes to prescription medication for young children. For instance, parents should be wary of any pediatrician insistent on prescribing medication for children under five who have been diagnosed with ADHD. They ought to also get a second opinion any time their children are prescribed psychiatric medications. As a parent, it’s always okay to ask for a second opinion.
When attending to a sick child, parents often turn to the internet for information and advice. However, Dr. Stone urges parents to exercise caution when doing so, as abundant online misinformation can put children at risk when parents follow bunk advice. This is especially common in regard to dietary and nutritional advice found online.
Finding the Best Doctor for Patients on Dialysis
According to Centers for Disease Control and Prevention, 29 million Americans suffer from diabetes and one in every three American adults has high blood pressure. In the most severe cases, these conditions can lead to end-stage renal disease (ESRD), which marks the last stage of chronic kidney disease. One of the primary functions of the kidneys is to clean the body’s blood, so patients with ESRD rely on dialysis - a machine which takes over that blood-filtering process – to survive.
Two types of dialysis treatments dominate American medicine. The first, Hemodialysis, requires patients to undergo exhausting dialysis sessions in a clinic three times a week. Hemodialysis also has a high mortality rate. According to UCSF’s Schools of Pharmacy and Medicine, only 35 percent of Hemodialysis patients live beyond the first five years of treatment. The second method, Periton Dialysis, gives patients the ability to administer the treatment themselves, at home. This results in better control of blood pressure, greater comfort and a higher overall quality of life.
Here’s the kicker – according to Dr. Nisha Patel, a Nephrologist with Grand Rounds, only 7 percent of patients are on Periton Dialysis. She adds that 75 percent of patients qualify for this type of dialysis but simply aren’t aware that it’s an option. One of the life-changing benefits that companies like Grand Rounds offers is the ability to intercept these patients and give them the opportunity to get a second medical opinion about their dialysis options.
What Women Should Look for In a Doctor
Dr. Patricia Shay is a board-certified Gynecologist who spent several years in private practice before joining the Grand Rounds team. She specializes in surgical gynecology.
When looking for a new OBGYN, Dr. Shay lists several factors that are, in her professional opinion, non-negotiable. First, patients must feel comfortable about being open and sharing information with their doctor. Second, OBGYNs should be board-certified or board-eligible, which means they have at least two years of practice under their belts. She states that if patients don’t feel that their needs are being met, they need to look elsewhere. In addition, it should be clear to prospective patients how a practice handles patient communication when it comes to different OBGYN activities. This includes processes and procedures for communicating diagnoses, normal or abnormal.
Abnormal test results can be a great cause of stress in the best of cases. Under these circumstances, Dr. Shay recommends that patients ask their doctor about the cause, treatment, worst-case scenario, urgency level and prevalence of similar diagnoses. In addition, patients should gauge the OBGYN’s level of comfort in treating the issue.
Dr. Shay stresses two things that pregnant patients ought to look for when choosing an OBGYN. Primarily, they should determine whether they will be seen exclusively by one doctor or different partners at the clinic. In addition, patients may want to ask about which hospitals are affiliated with the clinic if they have a strong preference as to where they want to deliver their babies.
According to Dr. Shay, vaginal delivery is the safest option and should be recommended whenever possible. An article by LiveScience about the pros and cons of both methods reports that a woman who has had a C-section typically stays in the hospital longer, is at risk for more physical complications following delivery, is at an increased risk of blood loss during the procedure, is less likely to begin early breastfeeding and has a longer recovery time compared to those giving vaginal birth.
When choosing OBGYNs, women should visit doctors who prioritize routine preventative care. Pap smears, for example, can detect early symptoms of cervical cancer, often preventing patients from having full-blown cancer in the future. Similarly, vaccines can protect women against developing HPV which, according to the Mayo Clinic, is the most common sexually transmitted infection.
Determining whether surgery is appropriate can be a harrowing process for women. Dr. Shay stresses that OBGYNs should thoroughly analyze the symptoms and history of the patient before recommending any operation. Patients ought to be well-informed about benefits and risks, as well as alternative treatment options.
Every doctor that we spoke with, including Dr. Shay, agreed on the benefits of getting a second opinion. In the female patient population this may be especially critical for those who have gynecologic cancers, patients considering surgery, and patients with chronic conditions who have tried multiple therapies. Dr. Shay has seen examples of second opinions changing the course of the treatment for many patients, particularly for international and rural patients.
What Men Need to Know When Choosing a Doctor
Dr. Todd A. Thames, Staff Physician at Grand Rounds, has over twenty-five years of experience in the medical field and is acutely aware of what men should look for, and avoid, when choosing a physician. Dr. Thames faults misinformation online and largely through advertising, coupled with the high volume demands in medical practice, for the oversimplification of complicated medical issues, which he says ultimately influences how many doctors choose to treat male patients. Those especially impacted by this trend are men diagnosed with prostate cancer and erectile dysfunction as well as those seeking advice on hormone therapy. Men should first and foremost find a doctor that is willing to take the time to examine the subtleties of these issues and to help their patients comprehensively understand the medical evidence, risks inherent in treatment as well as over-treatment, and their available options. Whether the result of a physician’s well-meaning attempt to address patient needs or a byproduct of “retail health” misinformation, Dr. Thames believes that over-treatment is a serious concern for all men.
Beyond addressing traditional issues causing physical pain or discomfort, today’s physician should also be treating their patients holistically. This means that doctors must understand the psychology of men and prioritize its role in every patient’s comprehensive treatment plan. For instance, doctors should emphasize the importance of seeking and finding meaning throughout every stage of their patients’ lives, which is vital to maintaining cognitive, emotional and physical health. Particularly in retirement, men who invest in healthy personal and social relationships, perform meaningful work (e.g. volunteering, coaching or mentoring), participate in faith communities and actively engage in cognitively demanding activities show fewer signs of depression, enjoy improved physical and cardiovascular health, have healthier marriages, and have improved sex lives, which is often an important concern for them. This is an ongoing conversation that high-quality providers will engage in with patients at every opportunity. If male patients are noticing that their physician is overlooking these issues or replacing these conversations with prescriptions for medication, it’s time to look for a new physician.
Dr. Thames also stresses that a quality doctor closely tracks the diet and lifestyle of their patients, which are fundamental to good health and are far too often ignored in modern medicine. Specifically, comprehensive treatment plans should focus on moderating alcohol, reducing low-quality calories and prioritizing high-quality, nutrient-dense foods, maintaining optimal body weight and body composition (muscle-mass-to-fat ratio), exercising properly (both cardio and muscle building through strength training) and sleeping adequately, all of which are paramount to maintaining good physical and mental health. Addressing these factors has proven to be even more effective than medication in many cases, including for men experiencing nonorganic erectile dysfunction.
By taking the time to explain and emphasize these core tenets, quality doctors lay the foundation for greater productive longevity and better emotional, relational and physical health for their patients. On the flipside, when physicians overlook or ignore these issues in favor of "simple" solutions such as prescriptions for Viagra or testosterone (classic “retail health” cure-alls), the outcomes can be significantly worse. In contrast to the "simplify the problem, prescribe for the solution" approach that often mars modern health care, high-quality providers look beyond the hype and the false promises of quick fixes, and help men understand and make the changes needed to truly affect and improve their health.
An Available Doctor Isn’t Always the Best Doctor
With many doctors now offering online appointment scheduling, it’s easy to see why busy patients will oftentimes schedule an appointment with the soonest available doctor rather than wait for a slot to open days, weeks or even months later with a more trusted or established physician. The problem, according to Nate Freese, Director of Analytics at Grand Rounds, is that the best physicians are rarely the easiest to schedule.
Freese goes on to say that 98 percent of the time, the soonest available doctor fails to rate in the top 10 percent of their specialty. In an effort to address this disparity, Grand Rounds designed a quality algorithm to help patients find top physicians. Sometimes, urgent or complicated situations arise and Grand Rounds’ staff physicians and care coordinators bring the human element to the equation. As Freese says, “The algorithm ensures that you receive excellent care; our medical team ensures that you receive the right care.”
One thing to keep in mind if your selected or preferred doctor is booked, says Dr. Shay, is that offices often have emergency slots available when patients experience a problem that requires immediate attention. If patients don’t feel like they’re able to get the care that they need when they need it, Grand Rounds can help find other providers who are vetted, experienced and who will accept their insurance.
These recommendations, along with cutting-edge services such as those provided by Grand Rounds, can be enormously beneficial in ensuring that you and your loved ones have been matched with the best available medical professionals, even if they are not the first available option.