Wednesday, March 28, 2007

Choosing Your Doctor

Excerpt from "Choosing Your Doctor" as seen in Sick Girl Speaks!

Compatibility with your doctor is an issue of great importance. Whether you see him or her once a year or once a week, it is important to have some of the same philosophies and approaches to your health care.

Personality is important, and that is obviously something completely unique in every situation.

There are a few generalizations I can make about doctors, however, that are worth considering when you are deciding if you and your doc are a good match. At the very least, it is imperative to know that when it comes to your main physician, you do have choices.

Individual vs. Team

Both of these options have clear pro’s and con’s. Being treated by and individual allows more room for consistency and personal interaction. For the most part, I find this to be ideal. However, example 2 is one dramatic experience that can outline the flaw in this system of care.

The upside of the team approach is that there are many doctors working with you who are able to put their heads together to find the course of care best for you. There is less burnout and there is always someone to cover for a sick or otherwise unavailable doctor.

The down side of the team approach is the revolving door. Each time I go to clinic at my Carolina Hospital I seem to have a different doctor. There is less consistency of care and less of a personal rapport. Sometimes, the team does not agree on the next step and this can cause a gridlock that will postpone your treatment for days, maybe even weeks.

Conservative vs. “Laid Back”

By conservative, I do not mean politically. There are some doctors who will not take a chance with your health in any way. That means, if you come in with a fever, they will send you for blood work, a CAT scan and urinalysis before they are satisfied that you only have a passing virus. The “laid back” doctor, however, will assume it’s nothing before they assume it’s anything. They will send you home and let you “wait it out” before they will order tests or prescribe meds. Both have pros and cons, but it’s important to know which approach you prefer before choosing a doctor.

Old vs. Young

At the risk of being “ageist”, I have found there are differences in the two. They both have very distinct benefits and it’s up to you to decide which one seems more important.

An older doctor obviously has more experience. This translates to the patient as less guess work and unnecessary tests. I have often gone into see an older doctor with unusual symptoms and they know right away what is wrong with me. Why? Because they’ve seen it first hand millions of times.

A younger doctor may have to do a little more research to figure out the cause of your problems, but the advantage to a younger doctor is that they are more often up on all the latest drugs and technologies. Medicine changes rapidly, and it’s difficult to keep up. A younger doctor is more likely to know about a new procedure or treatment that can be a smoother road for you than the roads of yesteryear.

Male vs. Female

The difference between male and female doctors is very much what you might expect. Women tend to be better at the whole beside manner thing. I have no evidence to prove that they are better or worse doctors than men, but I do sometimes worry that their emotionality can lead to a quicker burn out.

Current Philosophy

In many areas of medicine, there is a drive to use the latest and greatest theories to enhance or prolong life. What is interesting is that no two centers seem to have the same idea of what that “latest and greatest” may be.

When I was waiting for my first set of donor lungs I moved to California. I was very sick but I figured I could wait somewhere new, different and warm (as opposed to the third floor bedroom at my parents’ townhouse). I transferred my care to a California University Medical Center and was very happy with my team of doctors. I was still considered a patient of Carolina University, however, and so was not bound by the philosophies of California. At that time, all California CF lung transplant patients were required to undergo sinus surgery before the transplant. The theory behind this was that the sinuses had infection and that infection would eventually infect the new lungs and therefore it was best to clean them out. My doctor at home was in complete disagreement with this idea. He felt strongly that many patients would die getting the sinus surgery and was far to much of a risk to take. This kind of disagreement with procedures is not at all uncommon. Medical theories and practices change with the wind and when you are choosing your doctor, you may also be choosing a certain protocol. Be sure to do your research and discover for yourself if this is a protocol you agree with.


David Claud said...

Very interesting post. As your post indicates, the words physicians use are very important. When a physician uses a choice of words or a tone of voice that lacks empathy, this can often increase the patients' anxiety about their health issue substantially.

As mentioned in a recently published book (I forget the title, it's about knowing what your doctor is thinking), it's important to realize that doctors are people too, all with different personalities, and that no one doctor will be best for all patients.

Thanks for the post.

Femail doc said...

What an interesting blog; thank you for sharing your experiences.

I've thought a lot about the age of doctors. Being middle-aged, I've decided that a middle-aged MD is the best choice; lots of life and practice experience, but still interested and energetic enough to keep up.

I read an interesting study recently though on surgeons who use robotic techniques. Those who were proficient at video games, logging lots of hours twiddling the controls of same, had fewer complications in their surgeries. Presumably they that are enthusiastic video game users are young. So maybe young works best in precision surgeons!

Looking forward to being a regular reader here!

Femail Doc