Choosing your physician


Choosing a physician can be a little like selecting a new car or stereo system. You ask friends or family for recommendations, then shop around for the best deal. Of course, it's not the quality of music at stake here, but your very health and well-being.

Still, shopping around is considered the best way to find thright doctor for you.

"People should approach health care as consumers, to foster a mutual responsibility model of care, not the former model of dependency or a parent-child relationship," says Dr. Frank Claudy, chief of the Department of Family Practice at Maryland General Hospital.

"On the other hand, everyone's different, and some patients want to be told what to do."

Many people start by asking family members and friends for names of doctors they like, or in the case of a specialist, ask their primary care physician for a referral.

The choice of physicians narrows significantly for those enrolled in HMOs (Health Maintenance Organizations) or PPOs (Preferred Provider Organizations). But many HMO and PPO physicians have private practices as well, so the doctor your neighbor recommends may well be on the list. Also, your co-workers may have a few suggestions, especially if you are insured through your employer.

You might also try a referral system, such as those offered by city and county medical associations. But not all physicians will be in the referral system because it is the physician's option whether or not to be included.

"Hospital-based referral systems can also be good sources of information," says Neilson Andrews, executive director of the Baltimore County Medical Association. "But [hospital] referral services tend to recommend only 'big admitters,' physicians who are very loyal to that hospital."

Once you have a few likely names, make your way to the telephone -- not to set up an appointment, but to check the physicians' credentials.

One of the quickest ways may be to call the doctor's office and ask for a copy of his curriculum vitae, or resume. But some people may feel uncomfortable with this approach.

"Start with your city or county medical society," says BetsNewman of Medical-Chirurgical Faculty of Maryland, the state's medical association. "In addition to the referral services, the societies have data bases of all the physicians who are licensed and practicing in Maryland."

"Board-certified" or "diplomate" are buzz words that should occur in your search. Both terms simply mean that the physician has completed the required training and examinations to practice in that specialty.

A cardiologist, for example, is board-certified in two areas. He has completed three years of training and passed the examinations for internal medicine, and then he has completed another three years of cardiology training and the necessary examinations.

While a doctor must be licensed to practice in Maryland, meaning he graduated from an accredited medical school and passed the state exams, he does not need to be board-certified, says Bernadette Lane, executive director of the Baltimore City Medical Society.

Another information source is the American Board of Medical Specialties (ABMS) Compendium of Certified Medical Specialists, which usually is available at the local library or medical society. The compendium gives a professional brief, including specialty, education and membership in professional organizations, of all board-certified doctors in the United States.

This year, the ABMS began a new service in consumer Yellow Pages that lists physicians in an area by specialty.

"The Specialty Section lists doctors who pay to be in the section, so not all board-certified physicians in an area will be listed," says David Langsley, M.D., executive vice president of the ABMS. (This should be available in the coming edition of the Yellow Pages for the Baltimore area.)

For information on any specialist, whether or not listed in the specialty section of the Yellow Pages, call the ABMS at (800) 776-CERT (2378).

Once you've selected a specialist, you may need a referral from your family doctor before you get an appointment.

"A referral from another physician may be important," says Dr. Claudy. "Many practices are closed [not accepting new patients] or close to being closed because there is a shortage of primary care physicians in Maryland, especially in Baltimore City."

Next, check out the doctor's hospital affiliations, either through physicians referral services or by calling the doctor's office. Don't wait until you need to go to the hospital to find out that your doctor doesn't have privileges at the hospital of your choice.

Doctors apply for hospital privileges, so if yours isn't affiliated with a certain hospital, it's not necessarily of concern. He may choose not to practice there.

While you are checking out hospital affiliations, make sure the hospitals of your choice are accredited by the Joint Commission of the Accreditation of Hospitals. The JCAH, a national organization, makes periodic reviews of hospitals to ensure competent hospital operations.

Finally, call the Maryland Board of Physician Quality AssuranceIn addition to providing routine information, the Board can tell you about the doctor's practice record.

"Any formal disciplinary actions that the physician has received is a matter of public information," says Paul Roeger, director of Physician Licensure Programs.

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