An inside perspective of health care and life as a physician, from Pure Family Medicine
When I’m talking to friends and family and the topic of health care comes up, I often forget that what I know about the inner workings of a doctor’s office and the health system is not common knowledge. I recently advised my in-laws on what they should be looking for in their (new) primary care doctor when their previous physician missed a major test finding that landed one of them in the hospital. It can be overwhelming narrowing down your choice of doctor from all the options out there, so hopefully I can use my insider info to help guide you in this process. Without further ado, here are the tips you need to know to find the best family medicine doctor for you and your family.
This is how many people select their doctor, because they don’t realize the doctor listed on their insurance card is merely a suggestion. To be honest, I’m not sure how insurance companies decide which doctor to put on which patient’s card. Sometimes I imagine an insurance employee throwing darts at a map and wherever your dart sticks, that’s who you need to trust with your health. In fact, since opening my new practice (where I don’t bill insurance), I have had dozens of people call to schedule with me because my name is on their new insurance card…
If you have insurance, browse through your insurance network to get an idea of what your options are and use that as your initial guide, don’t settle for the name on your card. Or, consider not using insurance for your primary care, since some of the best care you can get will come from doctors who are not forced to play by the insurance companies’ rules.
Your primary care doctor will literally be involved in all aspects of your health (if they are good). Don’t settle for a restricted network that you are required to stick with. My family personally had insurance with a restricted network a while back, and I immediately regretted it when we couldn’t see the best specialists because they were out of network. We decided to just pay cash at these out of network specialists, but with limited networks like HMOs they won’t even accept orders or referrals from doctors not in their network. No thank you, we switched plans as soon as possible because we didn’t want the insurance companies in control of who we saw and the care we received.
Yes, many doctors will do this! If not, consider your first appointment an interview and take the time during your appointment to ask questions. If your doctor doesn’t have 5-10 minutes to spare to answer these questions when first meeting you, that’s your first red flag. Important things to ask include:
This should probably be #1. Ask people you trust who they are seeing, and if they feel they are well cared for. This doesn’t mean their doctor will automatically be a great fit for you, but it’s an excellent starting point. You can also look at online review sites, but whether you are looking for a doctor, or a bite to eat, take online reviews with a grain of salt. Another great source of recommendations is other medical professionals in your area that you may know and trust, chances are they know a ton about your potential physician of choice.
Everyone wants something different out of their care and out of their health care provider. Do you want someone you trust to direct you and tell you how to best care for yourself, or do you prefer a more collaborative approach where every recommendation is discussed in detail (this is my approach)? Do you want a more traditional approach or a more natural approach to your health care? Just like you have preferences for your care, each physician will naturally practice a certain way. Through recommendations and possibly your initial interview/visit, you should try to see if your health care philosophies mesh with your physician’s.
Although doctors are supposed to (by law) practice without any outside influences, the reality is that the quality of care they provide is heavily influenced by the policies set by the company they work for. Research the company, is it a locally owned private practice or a massive corporation? Dig beyond their mission statement and try and find what the practice is really about. Look at their staff and figure out if there are a lot of administrators or non-clinical staff (the more non-clinical staff, the more likely your doctor has to answer to non-medical administrators). You may love your doctor, but they may be forced to see 30 patients a day, or may be being pressured to refer to certain practices affiliated with their company. They may be suffering from moral injury (aka burnout) because they are unhappy with their current job. I am obviously biased towards doctors who are independent or in smaller practices, but there are plenty of awesome doctors with larger corporations, you just have to find which doctors are able to thrive in that system.
I started my practice because 10 minutes is just not enough time with patients, insurance companies should not be allowed to control how my patients are cared for, and I want to be there for my patients when they need me. There are a lot of doctors who feel the same way, and more and more are taking a stand to try and change our health care system. There are about 90 DPC practices in Colorado, and 1000 nationwide. All of these doctors have made the commitment to better patient care, and taken a huge risk by leaving stable jobs to fulfill that commitment. If you are looking for a great primary care doctor who will literally change the way you view the health care system, I encourage you to look up a Direct Primary Care practice in your area, and at least chat with the doctor to see if it makes sense for you.
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