Choosing a doctor can be a life-or-death decision, but most people spend more time planning their next vacation than researching the credentials of their physician.
Although most doctors are qualified and do their job to the best of their abilities, nearly 3,000 doctors in the U.S. are disciplined each year by state medical boards for offenses such as negligence, incompetence, sexual misconduct, and breaking criminal laws.
Years ago, word of mouth was the only way to get information about a doctor's track record. Now, information ranging from disciplinary actions and malpractice suits to medical training and specialty certification is just a click away on the Internet.
But what information do you really need to know? And where should you go to get it? WebMD has the prescription for finding the doctor that's right for you.
What Do You Need to Know About Your Doctor?
When finding a new doctor or checking up on your own, there are a few basic pieces of information you should know:
- Is he or she licensed to practice medicine in the state where you live?
- What type of medical training did he or she receive (medical school, residency, internships, and fellowships)?
- Is he or she board certified in the specialty you desire (internal medicine, oncology, etc.)?
- Does he or she accept your type of medical insurance for payment?
"These are standard things that suggest that there is a minimal level of competency," says Michael Grodin, MD, professor and director of medical ethics at the Boston University School of Public Health.
Although it may be tempting to use where a doctor went to medical school as a measure of quality, Grodin warns against falling for the prestige factor.
"The fact is that there are people who graduated from Harvard Medical School who are brilliant scientists who I wouldn't want to touch my daughter," says Grodin. "On the other hand, there are people who graduated from lesser medical schools, at least by name, who are superb clinicians."
He says medical schools, unlike other types of graduate schools, are professional schools where everyone learns basically the same thing, and students must past standardized tests in order to move on.
However, John C. Nelson, MD, MPH, president of the American Medical Association, says those standards apply only to all accredited medical schools in the U.S.
"If the physician does not come from one of those schools, we have questions," says Nelson.
Graduates of foreign medical schools must pass a certification test to enter a residency or fellowship program in the U.S. and pass a United States Medical Licensing Exam in order to practice in the U.S.
Where to Get More Information
This type of basic information about doctors is readily available from many public sources, and experts say you shouldn't have to pay a web site or other source in order to get it. Several commercial Internet sites charge a fee for providing a background check on doctors.
Hospitals, insurance providers, major medical organizations (including the American Medical Association), and WebMD provide free physician directories with information about doctors, such as office locations and hours, medical training, and accepted insurance plans. Most doctors' offices will also provide this information upon request.
Sources for more detailed information about a doctor's training, licensing, specialty certification, and professional record include:
- State medical boards: Contacting your state's medical board by phone or on the web provides information about whether the health-care provider has a valid license to practice in that state. The site www.docboard.org provides free access to a database of 18 member state medical and osteopathic boards as well as links to non-member state medical and osteopathic board web sites. Several states, including California, New York, Florida, Massachusetts, Rhode Island, Virginia, and Connecticut, have physician profile laws that require physicians to provide disclosure on public web sites about disciplinary actions and outcomes of malpractice suits filed against them. Some physician profile sites also provide information on prior felony convictions.
- Medical specialty boards: The American Board of Medical Specialties represents the 24 recognized medical specialty boards in the U.S. Its web site, www.abms.org, requires users to log in, but it provides free information on physicians' specialty and subspecialty board certifications. However, no certification or renewal dates are provided. Additional information is available by contacting the web site of the individual specialty board, such as the American Board of Internal Medicine www.abim.org.
- County Clerk's Offices: Information on malpractice and other criminal suits filed against physicians can be found online by visiting the web site or office of the county clerk's office in which the physician practices.
- Medical Societies: National, state, and county medical societies often provide physician finder or referral services. Information provided varies.
Putting Information in Perspective
Although the Internet has made it easier to get more information about doctors, experts say it hasn't done a good job of putting that information into perspective.
"It's a mixed bag," says Grodin. "The general idea that patients should want and should get more information about their doctors is good, but I have some concerns."
"The real issue I have is how you interpret the information," Grodin tells WebMD.
For example, some people may balk at a doctor who has a long list of medical malpractice suits filed against him. But Grodin says that for some specialties, such as obstetrics and gynecology, it's not uncommon for 50% to 60% of the doctors to have a history of malpractice suits due to the nature of their practice.
"It's not clear how to interpret the fact that there was a malpractice suit. Just the fact that there was a suit doesn't mean it was successful," says Grodin.
Grodin also points out that a malpractice suit that was settled out of court also doesn't necessarily imply any wrongdoing on the doctor's behalf. Many insurance companies require doctors to sign off that even if they are not negligent, they give the insurance company the right to settle because it's often cheaper than pursuing a court case.
Nelson, who is also a practicing obstetrician-gynecologist in Salt Lake City, agrees and says just the fact that someone was disciplined or sued doesn't necessarily mean anything.
"If you're an obstetrician or a neurosurgeon, chances are you've been sued," Nelson tells WebMD. "Even if you've had a judgment against you, there is no correlation between whether there was really negligence or whether you had a payout. On the other hand, if a person has 20 or 30 lawsuits, maybe you need to know why."
If you have questions about the doctor's record regarding disciplinary action or malpractice suits, Nelson says you shouldn't hesitate to ask the doctor directly.
Grodin says talking to doctors you already know and trust can also be a valuable source of information and guidance.
"Along with getting information from the Web, you want to get information from doctors who are in the know because they can interpret that information," says Grodin.
Making a Choice
After you've found a doctor who looks good on paper, it's time to set up an appointment to meet and interview him or her while you're well.
Nelson says many physicians offer free initial consultations for new patients. He recommends taking advantage of this opportunity and bringing a list of questions to ask, including:
- WhatÂ are the doctor's special areas of practice? Is he or she involved in research?
- What is the doctor's philosophy about medicine? For example, if alternative medicine is important to you, ask about his or her position on that, and if you're considering a new ob-gyn, you may want to know his or her position on abortion.
- How does the doctor view the doctor-patient relationship? Is it a partnership or does he or she expect you to follow orders?
- How does the office operate? Who's on staff and will be involved in your care?
- Who covers if the physician is not on call or available for an emergency?
- Does the doctor provide home phone or beeper numbers to patients? If not, who is available to answer questions?
- What hospitals can the doctor admit patients to? If he or she does not have admitting privileges, how will hospitalizations be handled?
"I think the patient needs to have the courage to make sure they ask the questions they want to ask, and if the doctor is not forthcoming in answering those questions or is reluctant, they ought to find a different doctor," says Nelson.
Another red flag that should raise concerns is if the doctor oversteps the bounds of his specialty or certification, such as a gynecologist who also dabbles in plastic surgery.
Nelson says it's also important that the doctor answer questions in a way you can understand. That means avoiding confusing medical terminology and checking to see if you're following along.
Above all, experts say communication is the key element in finding the right doctor for you and building a good relationship.
"A lot of medicine relates to communication issues that are independent of the technical knowledge that the doctor has," says Grodin. "If you can't communicate with your doctor, and you don't have a relationship, you're going to have problems regardless of how much they know."