July 16, 2019

The patient's guide to choosing (or firing) a doctor, according to NPR

Daily Briefing

    Editor's note: This popular story from the Daily Briefing's archives was republished on March 2, 2020.

    Having a primary care doctor is important, but searching for one can be a daunting task, Mara Gordon, a physician, writes for NPR's "Shots." Here's how Gordon advises patients start the search, and what she says they should be looking for.

    What drives consumer loyalty to a primary care doctor?

    How patients can find the right provider

    Gordon writes that a good place for patients to start their search is by determining which providers participate in their health insurer's network. For patients without insurance, Gordon notes that a number of community health centers will see uninsured patients either at no cost or for a sliding-scale fee.

    Gordon also advises patients that their primary care provider doesn't have to be a physician; a nurse practitioner or physician assistant may be able to play that role instead.

    Kimberly Manning, a primary care doctor and associate professor at Emory University, said it's also important for patients to determine what kind of patient they are, and let that guide their doctor choices.

    For example, a young and healthy patient may prioritize convenience when selecting a primary care provider, while someone with a significant medical condition should prioritize finding a provider who can easily share their EHR with appropriate specialists, Gordon writes.

    "As a practicing physician, I know how much better it is for us to take care of patients when we can all see the [EHR] of what's been going on," Manning said, adding, "It just allows for continuity."

    Once a patient has identified potential primary care providers, they can call around to a variety of offices and make preliminary appointments with different providers. Gordon advises patients to use those appointments to identify their best fit.

    The 'most important factor' in selecting the right provider

    Gordon writes that the "most important factor" in choosing a primary care provider "is that you feel comfortable" with them. Gordon recommends looking for a provider "who makes eye contact and who listens without interrupting."

    In fact, finding a doctor whom a patient connects with emotionally could be good for their health, Gordon writes. "Going to a doctor or nurse who is empathetic can actually help you stay on top of taking your medications and getting the preventive tests you need," according to Gordon.

    Sana Goldberg, a nurse and author of "How To Be A Patient," said patients should "[f]ind somebody who is curious, who asks questions that let you know that you're being heard."

    Gordon writes that people of color may want to choose a minority provider, as research has shown doing so may correlate with better care. One study, for example, found that black patients who had black doctors were more likely to get recommended preventive care services.

    In addition, patients who don't speak English as their first language may want to call around to different providers until they find one who speaks their native language, Gordon writes.

    What about 'firing' a doctor?

    Patients shouldn't hesitate to give their providers feedback, Gordon writes. "We promise: Your doctor really does want to hear from you about what she could be doing better."

    If you have a problem that needs to be addressed, it's good to start with "personal language about how your doctor makes you feel," and to keep your feedback specific, Gordon writes. For example, you could say, "It makes me feel dismissed when you look at the computer more than me," or, "I am having a hard time understanding the plan. Can you use less medical terminology?" Gordon writes.

    But for patients who have tried to talk with their provider and still feel like they're not connecting, Goldberg writes that it might be time to move on. "If you feel like you've made an effort and you're not heard, you're not listened to, it's always OK to find somebody else," she writes.

    And when you go to a new provider, be sure to tell them why you left your former provider so you can get started on the right foot, Gordon writes. "It may be frustrating to start your search again, but it's worth it to find a doctor who really gets you," she writes, adding, "Your health depends on it" (Gordon, "Shots," NPR, 7/8).

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