Robert Krughoff is the president of Consumers' Checkbook, the non-profit consumers' organization that put this list of approximately twenty thousand doctors along with some other important advice together. He visits The Saturday Early Show to talk about it.
This book is intended to improve consumers' odds of getting an excellent doctor, says Krughoff. However, there are certainly many excellent doctors who are not in the book, he notes. "The objective is to help consumers choose high quality doctors and unfortunately without this guide it's hard for consumers to know which are the best to choose from," he says.
"We have 34 different specialties in the book, ranging from anesthesiologist, to family practitioners to obstetrics to rheumatologist to vascular surgeons. We have identified top doctors in all 50 of the metropolitan statistical areas and mostly areas that are geographically close to those areas," says Krughoff. He adds that they have identified more than 20,000 doctors out of about 700,000 doctors in the U.S.
These doctors were essentially selected by their peers through a survey that Consumer Checkbook conducted. More than 260,000 doctors were surveyed. Krughoff says that this number includes all of the actively practicing doctors in the more than 50 largest metropolitan in the country and areas nearby. "We weren't just going to universities and asking them to tell us everyone who is affiliated with the university," he says. "Not that they aren't good. We wanted to reach out further in the community."
In the survey, each of the doctors in each of the 34 specialty fields were asked to name one or two physicians that they would consider most desirable to care of a loved one. Krughoff explains that some may have only mentioned a handful because they only had knowledge of a few specialty fields. Others may have felt comfortable naming 15 fields. He says they received almost 20,000 questionnaires back. "We added all into a large data base and we matched up doctors mentioned by various doctors," he says.
After entering the responses in a large data base, the researchers looked for physicians who were mentioned at least 3 times by other doctors and in many fields, in many metropolitan areas, the cut off may have been that the doctor had to be mentioned 5 or 10 times. "In San Francisco allergists had to have at least 7 mentions and for cardiac surgeons in that city they had to have at least 10 mentions. For internal medicine physicians, just 3 mentions. We also tell the consumer, how many doctors recommended these doctors." Krughoff says that they also checked to see if there were records of disciplinary action. If there were, they didn't get on the list.
Here are some ways that Krughoff in accordance with the guide recommends how we can choose a good doctor.
Referrals from friends "They can find out if the doctor takes enough time to talk to you," says Krughoff. "Is he accessible by phone if you have a question? Does he seem to be thorough? Does he remember what treatments and tests he or she has given you in the past? Does he seem to be familiar with your case? Does the doctor follow-up when you are referred to a specialist? Does he coordinate your care?"
Board certified "There's really no reason for them not to be. It means you've taken advance training and in some cases, three years or seven years after medical school. In addition to that, you had to pass a difficult exam. You don't have to be board certified to be in the book, but the doctors who other doctors recommended were much more likely to be board certified" Krughoff explains.
Hospital teaching responsibilities Krughoff says, "It shows respect from colleagues and shows that he's up on things. You don't have to be a full time teacher to have teaching responsibility. Many doctors may spend a few times a week teaching new doctors at hospitals. Many good hospitals have residency programs, which are advanced training programs for doctors. Those newly minted doctors get taught by someone and it's often doctors who practice in the middle of the week. Or, they may have a student in their office. This doesn't mean only choose doctors who have teaching responsibilities, but it's a good sign."
Hospital affiliation "You want to know where you are going to be admitted," says Krughoff. "It's good news to you if a doctor admits patients to good hospitals and he or she is more likely to know specialists there. When you are choosing a cardiologist, cardiac surgeon or general surgeon, you certainly want to make sure they are affiliated with a good hospital."
Graduation date from medical school "You may be interested in how long the doctor has been in practice," says Krughoff. "You may prefer someone who is fresh in training and will be available to you for many years to come or someone who is more seasoned and has seen a little of everything." Though many consumers choices of picking a doctor is limited by their health insurance plan, these things to look for are good to remember.
Here is a list of reasonable expectations that patients can have about the service the doctor provides:
- Responds quickly "Will he call you back the same day if you have a medical question and in a few minutes if it's an emergency and arranges to see you in a day or two?" Krughoff says. "Does he give you helpful medical advice by phone, even when it's not an emergency and doesn't just say 'come in.'"
- The doctor is thorough and competent Krughoff says that consumers can certainly make some judgments about this by determining if he or she takes a thorough medical history. Does the doctor keep accurate records of prescriptions and which medication worked and didn't work in the past? Is the doctor familiar with your case and able to give you a good explanation of what's wrong.
- Communicate well with you This means that the doctor listens to you and explains things well, such as what's wrong, what's being done about it and what are your options. This gets the patient involved in the decision-making. He or she listens to you and makes you feel comfortable about asking questions.
- Doesn't keep you waiting more than 15 minutes past your appointment time Krughoff says that they know this isn't an unreasonable expectation based on the surveys that have been done where patients indicate how long they have to wait.
- Gives helpful advice on how to stay healthy Krughoff says that a lot of doctors are still in a non-prevention mode. You want a doctor who will give you suggestions on exercise and diet.
- Seems to care about you It's important for you to feel that your doctor cares about you. One indication is that your doctor spends enough time with you.
When it's time to switch doctors
If you are not satisfied, your doctor retires, or you move and need a new one. The guide advices that it's not wise to continually switch from doctor to doctor. It's important to establish a relationship with one that you like and trust.
Everyone can't go to the top doctor in the country and how far you may travel to see one of the best may depend on how serious the condition is and how many choices of physicians nearby who can handle it. Insurance coverage will also determine how many options a patient has.