You and Your Doctor, Partners in Good Health
• • •
The following information is provided by
The New York State Department of Health
If you think the only time you need to see a doctor is when you're sick, think again. Taking the time today to choose the right doctor, and build a relationship with him or her, is health "insurance" for tomorrow.
How to choose a doctor
Be as thorough in your search for a doctor as you would be if your life depended on it. It just might - someday. So, don't settle for a quick scan of the Yellow Pages. Instead, take your time; get sufficient information; have high expectations; and, know your rights as a patient.
Not all doctors are the same
The first step is to decide what type of doctor you need for your medical care. Unless you're sure that you have a particular medical problem, you probably want a general practitioner, family care physician or internist for adults, and a pediatrician for children. These doctors offer a wide range of services, unlike doctors who specialize and limit their practice to a single condition (e.g., dermatologist), group of disorders (e.g., neurologists), or procedures (e.g., surgeons).
Many doctors also become board-certified in a specialty. This means that, after completing specialty-oriented residency programs, they have passed formal examinations in their chosen fields of medicine. While no guarantee of excellence, board certification is one way the average consumer can be certain of a doctor's specialty.
If you do need specialized services, ask your family doctor to recommend a board-certified specialist. If you have chosen your doctor carefully, you will probably wish to accept his or her opinion.
Where to find your doctor
You can ask friends and relatives which doctors they use, and whether they are satisfied with their medical care. Or, you can check with your county medical society or health department for suggestions. Other sources of information are nearby medical schools and hospitals.
Once you have narrowed your selection to two or three possibilities, you should check their qualifications. Most public libraries have The American Medical Directory (arranged by states) and The Medical Directory of New York State, as well as The Directory of Medical Specialties. These list the qualifications of individual physicians - medical school background, training, board certification, hospital affiliations, teaching positions, and some professional associations.
Also, a doctor may not practice legally in any state in which he or she is not licensed. Before choosing a physician, always check with the New York State Education Department for information on the status of the physician's license.
That done, contact each doctor's office to check office hours, waiting room time, after-hours, and emergency coverage, and availability of telephone consultations and house calls. You'll also want to know, before scheduling an appointment, how much the doctor charges for routine visits and tests; whether payment in full is expected at the time medical services are rendered, or if you can arrange time payments; and, if the physician participates in your health insurance plan.
Compare each of the doctor's fee schedules with one another, and with your insurance coverage, to see which seems most reasonable. But, don't base our decision on fees alone.
HMO - Another health care option
You may want to consider becoming a member of a health maintenance organization (HMO). As a member, you pay a fixed monthly or annual membership fee which covers comprehensive health and hospital insurance and health care services. This set fee includes all preventive health visits, physical exams, visits for any symptoms or illnesses, hospitalization, surgery, and most required services other than dentistry or extended psychiatric care.
You may have a choice among the primary care doctors on the HMO's staff. An HMO will usually give you biographies, credentials, and other information needed to select your personal HMO doctor. If needed, visits to a specialist are arranged through our HMO doctor. And, the specialists are generally chosen from the HMO's staff.
If you are not satisfied with your HMO doctor, you can choose another from among those available on the HMO's staff. In some cases, you may obtain the benefits of an HMO and use the services of physicians in their private offices, providing the HMO is based on an "individual practice association" (IPA). Ask to see if this option is available at your HMO.
Your first visit
The first visit is the most important step in choosing a doctor. You should have high expectations of your doctor and his or her office staff. Your own judgment is the best indicator at this point, so during this visit:
- Check to see if the doctor's staff seems efficient,
and whether they treat you, and other patients, in a courteous and caring
manner This is important because you'll be working with the office staff when
scheduling appointments, completing insurance forms, making payments, etc.:
- Note how much time, if any, you are kept waiting
beyond your scheduled appointment:
- Ask the doctor questions, to see whether he or she
responds in terms you understand:
- Pay close attention to the doctor's attitude (rushed,
resentful, relaxed, interested, etc), to see how he or she makes you feel
(sorry you asked, good about yourself, appreciated, etc.): and
- Consider how much time the doctor spends with you and how thorough he or she is in taking your medical history and doing a physical exam.
Remember, you deserve
the best and shouldn't settle for less.
You and your doctor: Partners in health care
The more your doctor knows about you, the better he or she is able to help you get well when you're sick and stay well when you're healthy. It's as simple, and as hard, as that. Simple, because open and honest communication on your part and commitment and skill on the part of your doctor can make it happen. Hard, because a lot of things can get in the way.
As in any relationship, it takes time and mutual effort to make it work. Here's a checklist of what you and your doctor have a right to expect from each other:
What you should expect from your doctor
- Confidentiality
- Respect and willingness to listen
- Promptness at appointments
- Courteous, efficient office staff
- Reasonable fees, office hours
- Solid credentials (e.g., board certification)
- Sufficient time for you
- Information (complete and understandable
- Early intervention in illness
- Referrals (when medically indicated)
What your doctor should expect from you
- Prior medical records
- Open communication
- Understanding and cooperation
- Promptness at appointments
- Attention to medical advice
- Reasonable expectations
- Active participation (ask questions, report symptoms)
- Informed consent
- A healthy lifestyle
- Submission of insurance forms and payment of fees (as agreed upon)
Your doctor can help you to break unhealthy habits and do substitute better ones. But, you can't reasonably expect your doctor to keep you healthy if you choose, against medical advice, to smoke, drink or eat more than you should, never exercise, or use drugs.
When you've selected the right doctor for all the right reasons, it's up to you to become his or her partner in your own continuing, preventive health care.
You have rights and responsibilities
Your relationship with your doctor is a two-way street. You must be willing to be an active participant in your own care, and your doctor must be willing to recognize this partnership.
For the doctor, this means:
- Providing the best care possible
- Treating you with courtesy and respect
- Maintaining your medical records with complete confidentiality
- Obtaining your informed consent before initiating any medical tests or treatments, and
- Supporting your right to a second medical opinion.
Your responsibilities as a patient include:
- Obtaining your medical records. Write to your former physician, as soon as you choose a doctor,
to request the transfer of your records, including all laboratory and x-ray
reports. Your records cannot be transferred or released without your written
consent.
- Communicating. Tell your
doctor exactly how you're feeling - any symptoms you have, what drugs you take
on your own, etc. Your doctor needs as much information as possible to help
you.
- Not taking offense. When
your doctor asks if you think you're pregnant or how much alcohol you drink,
he or she is not prying. This is relevant, medical information.
- Being prepared. Jot down
you questions and concerns and bring them with you to the doctor's office. You
save time that way and you don't forget to mention them.
- Follow medical advice. Listen to your doctor and do what he or she prescribes regarding medicines,
therapies, or your lifestyle. But, also consider getting a second opinion if
you're uncertain, especially if it involves surgery; long-term, expensive or
inconvenient treatments; or, diagnosis of a serious, life-threatening or
chronic illness.
- Taking care of you. Don't
make your doctor's job harder than it has to be Do all you can to maintain
your good health, and to prevent problems from starting. Eat sensibly, use
alcohol in moderation, maintain ideal weight, don't smoke, get enough rest,
exercise, and take time to relax.
- Honoring your agreements. Be sure that you keep all appointments, calling well in advance when cancellation is necessary; treat the doctor and staff as courteously as you want them to treat you; and, follow the payment schedule that you and your doctor agreed upon.
The periodic physical: What should it include?
Your doctor's role is not only to treat illness, but to help you develop the healthy lifestyle that will keep you feeling your best. To do that, your doctor needs to know your complete medical history and current health status. At the first visit, his or her questions and physical examination should include:
- Personal habits (smoking,
drinking, eating, stress, and physical activity levels)
- Family background(cancer,
heart, kidney or lung diseases, and chronic disorders, such as diabetes)
- Prior health record(Immunization history, illnesses, injuries, surgeries,
hospitalizations)
- Work/home sites (exposure to toxic substances, allergies)
- "Normal" conditions (heart and respiratory rates, size and weight, bone structure, organ function, overall health status).
Once that's completed, your doctor and you can work out a schedule for subsequent examinations to keep your medical records up-to-date. The schedule may range from every few weeks or months (if you have a serious or chronic medical condition) to every few to five years (if you are young and healthy).
For most normally healthy men and women, at low risk of developing serious illnesses, the following should be included in periodic examinations:
- Pap smear. Every three years, after two consecutive negative annual exams, starting from age 20 or sooner, if sexually active. Pap smears may be discontinued after age 65. (For women only)
- Blood glucose levels. Annually, after age 40, when a family history of diabetes is present or when the patient is obese.
- Mammography. Should be done at least once between the ages of 35 and 40. When medically indicated, between ages 40 and 49; annually, after age 50. (For women only)
- Other x-rays. Should not be repeated more than once every three to five years, unless medically indicated.
- Blood in stool (stool guaiac test) annually, after age 50.
- Blood pressure.Every one to three years, up to age 50; annually, after age 50.
Understanding what your doctor tells you
One frequent, and unnecessary, barrier to a good doctor-patient relationship is the failure to communicate. If you ever find yourself uncertain of your doctor's instructions, unclear about any medical condition he or she has diagnosed, or course of treatment prescribed or prognosis, say so. Chances are that you'll never understand if you don't ask. Furthermore, your doctor won't know you don't know unless you speak up.
It's easier to talk with your doctor frankly, when you:
- Remember to jot down questions in advance of your doctor appointments, so that you don't forget them; and
- Know that your rights as a patient include the right to give informed consent.
Informed consent means that your doctor must fully explain in simple terms the advantages and disadvantages of any proposed procedure, including surgery, which poses a threat to your life or continuing good health. The doctor must also tell you why he or she feels the procedure or treatments are necessary and any risks that may result. Before you sing a written consent form, be sure that you fully understand what the doctor has said.
You may refuse to give your informed consent, or request a second medical opinion. In fact, you should consider seeking a second opinion whenever a serious, non-emergency medical problem is diagnosed or course of treatments is prescribed.
Remember; it's your time, money, and body.
What to do when you don't get what you expect
Following the guidelines presented here should help you to establish a satisfying, long-term relationship with a doctor who is a dedicated, ethical health professional. But, if you ever feel that your doctor has acted irresponsibly, or is guilty of medical misconduct, you should know that the New York State Health Department will investigate all reported instances of medical misconduct. If your doctor is a member of a local or regional chapter of the New York State Medical Society, you may also ask the society to investigate your complaint.
Some examples of medical misconduct include practicing medicine fraudulently, with gross incompetence or negligence, or while impaired by physical or psychological disabilities; refusing to support your right to obtain a second opinion; guaranteeing a cure will result from medical services; not referring you to a qualified specialist when warranted; and, suing his or her professional position to profit personally (e.g., demanding you have prescriptions filled at a specific pharmacy).
For further information, contact the nearest regional office of the State Health Department. A list is provided at the end of this article.
The choice is yours - make it a good one.
Keep in mind that most of the reasons why one doctor may be right for you, while another equally well-qualified doctor is not, depend on you - your individual health care needs, financial situation, time schedule and, most importantly, your personality.
NYS Health Department Regional Offices
Albany Region
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington Counties.
Sr. Medical Conduct Investigator
Albany Regional Office
New York State Department of Health
Building No. 7A - State Campus
Albany, NY 12226
(518) 457-7150
Rochester Region
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates Counties.
Sr. Medical Conduct Investigator
Rochester Regional Office
New York State Department of Health
42 South Washington Street
Rochester, NY 14608
(585) 423-8057
Buffalo Region
Alleghany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming Counties.
Sr. Medical Conduct Investigator
Buffalo Regional Office
New York State Department of Health
584 Delaware Avenue
Buffalo, NY 14202
(716) 847-4532
Syracuse Region
Broome, Cayuga, Chenango, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St Lawrence, Tioga and Tompkins Counties.
Sr. Medical Conduct Investigator
Syracuse Regional Office
New York State Department of Health
351 South Warren Street
Syracuse, NY 13202
(315) 428-4738
New York City Region
Bronx, Dutchess, Kings, Manhattan, Nassau, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Sullivan, Ulster and Westchester Counties.
Supervising Medical Conduct Investigator
New York City Regional Office
New York State Department of Health
8-10 East 40th Street
New York, NY 10016
(212) 696-2619
