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Finding the Right Doctor and Why

Do you know who your doctor is? Should you? Have you considered that your healthcare provider, whether it is a primary care physician or a specialist treating you for a specific disease or performing surgery, is contracting with you, like any other contractor who provides a service. However, your healthcare provider, your doctor or nurse practitioner or whomever, is aiming to provide you with the best possible health care service instead of fixing the plumbing or a roof. And most of them do. I wrote a book called “A Comprehensive Guide to Finding the Right Doctor” because I believe we all need to be just as empowered when choosing a doctor as we are when we are choosing a plumber or other household fixes.

I want to share five steps with you on how to ethically learn about your healthcare provider. These five steps are things your hospitals and your insurance companies already know. Even though that’s true, you need to know that not all physicians or other healthcare providers have hospital privileges and not all of them accept insurance not in their names anyway, especially if they are the transient kind who may purposely work under the radar through a locum tenens or staffing agencies.

I’m sure you have all heard the news stories about healthcare providers intentionally harming their patients. So wouldn’t you like to know who is treating you, and why they are considered competent enough to treat you? Do you know who your doctor is?

Let’s look at what you can know about these professionals. But, keep in mind, the majority of these individuals are in this business because they genuinely seek to help others, and they maintain more than the required education, training, and experience to make sure they do no harm. But, there is that few, like in any other demographic or profession, that aren’t savory, aren’t trained, and do not have your best interest at heart.

So here’s what you can know? [if !supportLists]

  1. [if !supportLists]License

  2. Every state has a licensing board and you can go directly to their websites and verify or look-up a practitioner’s license. The verification will tell you things like whether the license is active, suspended, or restricted.

  3. Some states, like Georgia, post a profile that the physicians have to keep updated or get fined.

  4. The Georgia profile tells you their specialty and where they were educated and when and if they are board certified.

  5. That profile also lists any malpractice claims and most importantly, they will provide you with the documentation of any disciplinary actions.

  6. Board actions published by the state would include any disciplinary actions taken against your doctor and whether that resulted in any limitations, any restrictions, any fines, and acts of termination here or in another state.

  7. Georgia is pretty comprehensive in the information they post. Not all states provide that information so publicly.

  8. Education, Training, and Boards

  9. This one is 3-prong. Since the license is not issued until education and training is verified, you can feel pretty confident that if a doctor has graduated a residency program, he passed his competencies to get his license. However, for subspecialty, most hospitals and health plans require board certification in that particular subspecialty, but the licensing board does not verify that. But, you can at the Board Certification institution’s website like the American Board of Internal Medicine.

  10. Sanctions

  11. If you are really interested in researching more, you can check the federal websites like OIG and regional sites like Cahaba to see if they can accept Medicare or Medicaid funds, or whether they have opted-out voluntarily or committed fraud or a felony.

  12. Criminal Activity

  13. Google them. There are also numerous websites to perform a criminal background check, but I would only do that, if I were suspicious of their behavior. Hospitals check. Most insurance plans don’t perform criminal backgrounds, but that is changing.

  14. Quality

  15. Quality is not something you will easily access. But you can do a few things to get an idea of their competency. Ever heard of Health Grades? Check out Health for reviews. Check Angie’s List and Healthcare Again, Google them. Soon Medicare will be releasing information on their pay scales for specific treatments and diagnoses, so you will be able to compare costs of your care by physician.

Why do you need to know any of these things? Because getting to know more about your doctor will empower you and help you to be more accountable for your own health care. If you want to learn more about empowering yourself when choosing a provider, pick up a copy or download a copy of my book. If not, take another step by keeping track of your own medical records and download the Doctor Finders Tool. You won't regret it.

This point of view is held by author, Dilsa Saunders Bailey, and no one else should be held responsible for her opinions. For information about communicating with your healthcare provider, get a copy of "A Comprehensive Guide to Finding the Right Doctor." Or, get entertained by picking up the romantic suspense series, "The Sperling Chronicles."

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