How Do You Find a Good Doctor?

This is from a post on my site Women4Hope....
Link Text ( http://women4hope.wordpress.com/2007/03/26/do-you-... )
Are You Happy With Your Doctor? — by Catherine Morgan

As patients, we all know that we are not always treated with the respect and dignity that we deserve. There is a site called RateMDs.com, and I recommend that EVERYONE (whether you are sick or not) go to this site and rate both your good and your bad doctors. It is very easy to do, and it is the only way that doctors will begin to realize that they can’t just treat us as numbers and dollars, we are human beings, and they work for us. And if they do a bad job, we are going to tell. It is also a good place to check and see if a doctor you are considering going to has a good rating or not.

I can not recommend this activity enough, the internet is a great tool for consumers, and a great way for patients to take their power back. So, go to RateMDs.com and give your good doctors the credit they deserve…..and “tattle” on all those bad doctors who have mistreated and been disrespectful to you. And then pass this information on to your friends and family.

Link Text ( http://www.ratemds.com/index.jsp )RateMDs.com

I was looking for the best place to post the following article on BlogHer. As my article ( which actually is an old one ) is a warning regarding several deep-rooted problems existing in women's medicine, maybe it has something to do with this topic - "How Do You Find a Good Doctor ?". At least, I hope so.
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The Traditional Tie of Gynecology to Obstetrics and Surgery: Deep-rooted conditioning coming from the past and devoid of scientific basis

Dr. Nelson Soucasaux, gynecologist

"... there are neither solid 'scientific' reasons nor logical ones that can justify the insistence on the need for the usual integrated practice of gynecology and obstetrics by the same professional."

"... what seems to exist behind this stubborn position that proclaims the gynecology-obstetrics 'fusion' as being essential is, above all, a situation of 'convenience' in the practice of women's medicine. In my opinion, it is a very well-planned professional strategy for getting more patients, hidden behind pseudo-scientific and pseudo-logical justifications."

"... in a similar way to what happens in many other areas of medicine, would it not be much more reasonable for gynecology to be an essentially clinical speciality, the surgical part of it remaining as another speciality, female pelvic surgery and breast surgery?"

(Nelson Soucasaux, "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology")( www.nelsonginecologia.med.br/novas.htm#new ( http://www.nelsonginecologia.med.br/novas.htm#new ) ), Imago Editora, Rio de Janeiro, 1990, pages 33 and 112. )

Before starting this article, I must make it clear that since I live and work in Rio de Janeiro, Brazil, I do not know exactly to which extent the criticisms contained in it are still valid for the present-day situation of women's medicine in other countries - though unfortunately the traditional tie between gynecology, obstetrics and gynecologic surgery has always been basically the same all over the world. (The origin of this traditional tie between the three specialities lies in serious mistakes that are part of the history of women's medicine.)

As I observed in my aforementioned book "Novas Perspectivas em Ginecologia", contrary to many people's suppositions, the "intrusion" of obstetricians and surgeons into gynecology has always been one of the more problematic aspects of women's medicine. Obviously the obstetrician's main interest is directed to pregnant women. This means that they look at women from the point of view of obstetrics (just as gynecologic surgeons look at women from the standpoint of surgery).

Nevertheless, as women's medicine, obstetrics is a speciality which by far transcends women, since it is also devoted to embryos and fetuses. (Consider the enormous development of fetal medicine, a new branch of obstetrics.) Obstetrics only takes care of women in very particular periods of their lives, periods in which women house inside their bodies beings other than women themselves and who equally are subject of the speciality. Here we already have one of the enormous differences between gynecology and obstetrics, since gynecology is exclusively devoted to women.

Considering that the great majority of modern women only want to become pregnant and have children in very few moments of their lives, it is easy to see that obstetrics is a speciality that only takes care of women in moments of exception. On the other hand and as opposed to obstetrics, gynecology takes care of women during most of their lives. In this way, as a consequence not only of the need for having more patients but also of the frequent "longing for omnipotence" existing in women's medicine, obstetricians never fail to also practice gynecology. In fact, this is a highly smart "professional strategy" for gaining and preserving the greatest number of patients as possible. Nevertheless, given the increasing complexity of modern medicine, this "strategy" inevitably implies a great loss in the quality of the medical assistance that is provided, since presently it is humanly impossible for the same physician to practice different medical specialities with the necessary competence and expertise (see Note 1, below).

In "Novas Perspectivas em Ginecologia" I made it quite clear that the enormous differences between gynecology and obstetrics concern mostly their respective clinical, physiological, pathological and therapeutic aspects, which are completely different - besides the obvious fact that, while gynecology takes care only of women, obstetrics takes care of women and fetuses. For all these reasons gynecology and obstetrics constitute, without any possibility of reasonable doubt, separate medical specialities. From the point of view of medical science, gynecology and obstetrics have much less in common than it is usually supposed, though, unfortunately, almost nobody wants to recognize this fact.

Regarding what happens at least here in Brazil, all the constantly repeated opposing arguments are totally devoid of scientific basis and what they actually intend is, above all, to protect the "tradition" and some professional and "corporate" interests that cannot be publicly mentioned. (As to the increasing domain of these "corporate" interests, what presently is going on in Brazil is truly a shame.)

Considering the enormous technical progress of present-day medicine, from the standpoint of medical knowledge and training it is humanly impossible for the same physician to simultaneously and satisfactorily practice two medical specialities so complex and different as gynecology and obstetrics. Thus, mostly for technical and cognitive reasons, my opinion has always been that only gynecologists should practice gynecology, and only obstetricians obstetrics.

Even so, the insistence on the integrated practice of both specialities by the same professional persists. To my point of view, this attitude is typically illusory and even "megalomaniac." And, to make things worse, at least here in Brazil, that attitude is being stimulated and even "established" by societies of gynecology and obstetrics that, with growing stubbornness and great political power, advocate the continuation of the scientifically irrational "fusion" of both specialities.

As most women regrettably are not aware of the problems resulting from this traditional "fusion" between gynecology and obstetrics, they naively consider the integrated practice of both specialities as "ideal" and "normal." This mistake is understandable on the part of the patients, but unforgivable on the part of the medical class.

By the way, sometimes we can even verify the existence of some "confusion" between gynecology and obstetrics on the part of people who are not from the medical area. This happens because most of the physicians who practice women's medicine introduce themselves as "gynecologists and obstetricians." Therefore their colleagues are those who collaborate the most for the maintenance of such "confusion," since they have the greatest interest in satisfying the naive and mistaken "aspirations" of most patients. It is obvious that, professionally, the "gyneco-obstetricians" take the maximal advantage of such position, while patients are frequently harmed without being aware of that. As a result of all of this and regarding professional competition, there is also a subtle process of "exclusion" of the gynecologists who do not practice obstetrics.

Note 1: Because of the present-day accumulation of technical medical knowledge, the possibility of each physician acquiring a complete mastery of his own speciality becomes more and more restricted. This happens because the medical specialities themselves are going through a continuous process of division into subspecialities. In this way, the traditional habit of the practice of gynecology, gynecologic surgery and obstetrics by the same physician becomes more and more impracticable and absurd because it actually implies the practice of three different specialities by the same professional. Considering the human limitations - not only cognitive, but also of training and continuous updating -, will it be possible for the same physician to practice these three areas with the necessary competence? (Here I am also criticizing the traditional view of gynecology as "surgical speciality," as a consequence of which almost all gynecologists are surgeons.)

Note 2: Regarding the aforementioned traditional view of gynecology as "surgical speciality," it is also devoid of scientific basis, since the clinical part of the speciality by far exceeds the surgical one. This is another distortion coming from the past and that, along the last decades, became entirely unjustifiable from the scientific point of view. Therefore, there are no reasons at all for the insistence on combining the practice of gynecology with the surgical activity.

Note 3: As to the already mentioned "longing for omnipotence" in women's medicine: it is clearly demonstrated by the fact that almost all physicians devoted to it insist on practicing gynecology, gynecologic surgery and obstetrics, that is, three different specialities simultaneously.
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Nelson Soucasaux is a gynecologist dedicated to clinical, preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1990, 1993. He has been working in his private office since 1975.

Website (English-Portuguese): www.nelsonginecologia.med.br ( http://www.nelsonginecologia.med.br )

Email: nelsons@nelsonginecologia.med.br

I had a primary physician that I was happy with for a while, but it was really in comparison with my previous experiences which weren't very good. She didn't seem to really appreciate my active participation in my own health care. I didn't like the OBGyn that she sent me too either. Between the two of them the scheduling and billing practices were not worth the hassle. Also, being too busy to listen to you just doesn't cut it. I've been dreading the switch and have been delaying my annual visit. What I really want is a doctor that practices integrative medicine.

Pamela
Well Soul ( http://well-soul.blogspot.com )
Finding My UU Soul ( http://blog.uusoul.com )

I love the feedback and knowing that I'm not the only one who has had these issues.

Time to start my search! (And pray that the appointment Michelle has this Thursday goes without a hitch.)

~Denise
Fast Times @ Homeschool High ( http://fasttimes.clubmom.com ) and Flamingo House Happenings ( http://www.flamingohouse.net</a )

The only thing I've found that works for doctors is to fire a bunch of them until you find a good one.

My old GYN was great, but her office staff was atrocious. I once had to take a bus to their office and shove a note under the door to get an appointment. But I hung on because I wasn't willing to fire them. The breaking point? I called and used their web form to let them know I had 2 positive home pregnancy tests and could I please have an appointment - and they NEVER called back! So fired. Should have done it long before.

The good doctors I have found have come across my radar either by work of mouth or pure dumb luck.
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Flooded Lizard Kingdom ( http://www.lizardkingdom.org )
Heroine Content ( http://www.heroinecontent.net )

It sounds as if you have a lot of sources for finding doctors. But just as important as finding the right expert is to make sure you get along with the doctor. The most important things to watch for are:

- Does he/she listen to you when you talk? Or does he just interrupt you with another question or not pay attention?
- Does he/she seem rushed and ready to run out the door immediately after examining you? Or does he tell you to get dressed and meet him in his office to talk afterward? And even if that doesn't happen, does he at least have a place for both of you to sit and discuss things in the exam room?
- Is he/she willing to listen to your own theories on what's wrong with you? Or does he have that "I'm the doctor" attitude and shut you up?
- Is he/she open to you getting a second opinion without making you feel guilty or ashamed?

These are probably the most important traits a doctor can have because if they don't listen to you they may miss an important symptom or clue as to what may be wrong with you. It's more than just being about rapport. It's about competence.

Hi Denise,

I have another website that may be helpful in your search for a new doctor. I work for a new company called Revolution Health, and we have a lot of great health information and health tools, but specifically we have a place to find doctors, hospitals and other care providers. The directory has over 700K doctors covering all different specialties. What’s also unique is that we have the ability to rate doctors so people can provide their own personal experiences to help you with your search.

You can find general medical information about a doctor, but also see specific opinions from other users that can help you find the doctor that’s right for you. Our ratings give you the ability to find out what others think about a doctor such as convenience, knowledge and skill, and shared decision making and communication. You can visit http://www.revolutionhealth.com/care-providers/ and check it out. We are a new website so we are continuing to grow our ratings, but I hope this helps you in your search.

Denise,

I use the same technique as finding any other professional: I ask everyone I know.

I'll tell them some of the specifics and ask who they might recommend.

It works the same for finding a painter who can paint a 2.5 story tall wall and ceiling (and patch the hole); or a physician who understands that they know the generalities of medicine, I know my body, and we will work as partners in my health care.

Remarkably it's worked well for the physicians. We'll see about the painter.

Debra
A Stitch In Time ( http://astitchintime.blogspot.com )
Deb's Daily Distractions ( http://debsdistractions.blogspot.com )

Coming from a medical family, we always saw doctors that my parents had worked with. Some of them were terrible. I had one PCP who didn't bother to let me know that my test results showed I indeed had a UTI. This was a good friend of my dad's from med school. Only after numerous phone calls from me (I was in college at the time) and one from my dad did she tell me that I needed to be on antibiotics. I ended up switching.

My new doctor is the best one I've ever had. To make a long story short, we had just moved to MA and I had the a really bad cough and was having a hard time breathing. I had to go to the ER but before my insurance would clear it they said I needed a PCP. I didn't have one so they assigned me one that was accepting new patients. A week after the ER I had a follow up visit with my new dr. She sat me down and told me there was a lot of BS in her practice. She believed that adults knew when they were sick and as such she left appointments available every day for that. If I was ever given a wait time of more than 2 weeks for a physical I was to leave a message for her to call me back and she would personally schedule me in. She eventually opened up her own private practice where she'll open her office for her patients if need be! She was a lawyer and went to medical school in her mid-40's. She absolutely great! If you live in MA, I would highly recommend her although I recently was told by someone that her practice is full at this time.

On the other hand, my son's ENT's office is a complete nightmare. They've double booked appointments on me etc. Last time we were there I called twice to make sure that he didn't need a hearing exam because the ENT had told me last time that for the next appointment he would need one. I was assured no hearing test was needed only to be told at the appointment by the ENT that my son had needed to have a hearing test done. 3.5 hours later we were able to leave. Nothing like being in a waiting room with a 3 year old and a newborn baby. Luckily my son only has a couple appointments left because I had been seriously thinking about asking for referral to another ENT who's an hour drive from me.
A. Elliot ( http://www.flexibleparenting.com )