Ask Your Doctor Questions

To be sure that you are getting the best care possible for your hard-earned health care dollars, you need to ask your doctor a lot of questions.  Although most consumers give high marks to their own pysicians, according to a study conducted last year by the Rand Corporation, quality of care is lacking in the United States.  Analysis of 12 metropolitan areas by the health policy organization found that patients received an unsatisfactory level of care across all geographic lines.

The study found that it really doesn't matter where you live - you are getting the recommended care only about 50% of the time.

Faced with major medical decisions, many people just let their doctor decide, relying on the comforting notion that "the doctor knows best."  But that's not always true, even when science has provided clear guidance.  Some doctors can't keep up with the flood of studies that pour off the presses.  Others may brush of study results that conflict with their own training, experience, or preconceived ideas.  Still others simply forget to provide the necessary care.

These are some of the results they found in their study:

Condition	Percentage of recommended care received
Alcohol dependence	11
Hip fracture	23
Atrial fibrilation	25
Heartburn and ulcer	33
Sexually transmitted diseases	37
Pneumonia	39
Urinary tract infections	41
Headache	45
Diabetes	45
High cholesterol	49
Asthma	54
Colon cancer	54
Osteoarthritis	57
Depression	58
Stroke	59
Heart failure	64
Hypertension	65
Cornary heart disease	68
Low back pain	69
Prenatal care	73
Breast cancer	76
Cataract	79

What this means is that we are all facing increased responsibility for our own care.  We need to learn as much as possible about our own health conditions.

There are two main criteria you should focus on when evaluating physicians.

      1.  Look at whether the doctor keeps up with the latest medical research and incorporates it 
           into his or her practice.
      2.  Determine if the physician is willing to partner in a respectful relationship and willing to
           answer questions. 

Failure to being proactive and openly discuss these topics with current and prospective doctors could result in misplaced care resulting in additional physician visits and a drain on finances. 
There needs to be a physician-patient partnership.  You need to know about your own condition, be aware of the evidence and ask a lot questions.  Consider any special health conditions and ask about the doctor's experience with them.  Ask questions surrounding volume of patients, risk and recovery time from procedures.  The responsiveness from the doctor is just as important as the actual response.  Proposing appropriate questions and getting reciprocal answers can go a long way toward determining whether a particular doctor will be cost-effective in addressing unique health needs.

Some Questions to Ask:

1.  Why do I need this test?  (Is the doctor ordering three different radiology tests when only one is neccessary?).
2.  What is your experience with this kind of illness?
3.  How much will this cost me?

Online Resources

There are some viable resources to consult when selecting a doctor.

The American Medical Association web site (www.ama-assn.org/) includes information on specific procedures, licences and board certifications.  AMA offers basic professional information on practically every licensed physician in the country.  The site provides medical school, residency training, specialty and board information.

Consumers can consult their state medical boards online (www.fsmb.org/members.htm) to find information about individual doctors.

The Diabetes Physician Recognition Program (www.ncqa.org/dprp/) and Heart/Stroke Physician Recognition Program (www.ncqa.org/hsrp/) recognize high-quality care in these designations.

Health Grades (www.healthgrades.com) is a national site that provides quality reports for a fee through a search on individual physicians.  These reports consider board certification, education and disciplinary actions.

Other resources for researching a specific medical condition are:

www.webmd.com
WebMD Health is a leading provider of online information, educational services and communities for physicians and consumers.

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is recognized as the lead federal agency for protecting the health and safety of people - at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships.

http://www.consumerreports.org/main/health/home.jsp?bhfv=7&bhqs=1
Consumer Reports Medical Guide, which can be found at www.ConsumerReportsMedicalGuide.org, is designed to help consumers understand their illnesses and compare treatment options based on evaluations of quality and effectiveness.  The venerable consumer magazine is teaming up with the British Medical Journal Publishing Group to produce tools it hopes will become the "gold standard" of Web-based health information.

Patient Self Tests
Many firms now offer medical tests patients can order themselves; they pay their fee online and stop by a collection point to drop off their specimen.

HS Labs www.BloodWorksUSA.com for example, offers "Complete Blood Work Special Tests" for about $95.

Laboratory Services, Inc. www.DirectLabs.com offers a similar blood profile, based on more than 50 individual tests, for $89.

My Med Lab at www.mymedlab.com/ provides you with convenient, quality lab testing at a cost that is 50-80% LESS than the same testing would cost at your doctorýs office or local hospital.

At many pharmacies, parents can buy for about $50 an Ear Check Middle Ear Monitor that uses sonar to check for fluid behind the eardrum, which may indicate an ear infection.  One of the most common reasons kids see a doctor, ear infections account for 20 million office visits annaully in the US.  There is a lot of litterature out there that says in uncomplicated cases you don't need to treat an ear infection at all.  The most common treatment in the US has been to give the child antibiotic.  In many European countries ear infections are rarely treated with antibiotic.  The trend now is to give the child Tylenol for a few days to see if the infection goes away.  The quandry is that the baby who is in pain may not have a bacterial infection at all, but rather a virus.  And, anitbiotics, the quick fix of yesterday, work on bacteria, not on viruses.  Overuse of antibiotics in cases of viruses, in fact, has led to a surge in drug-resistant bacteria.

Likewise kids often develop sore throats that don't require a physician visit.  Families can buy a Quick Vue Strep Test for about $90, providing 25 tests.  The simple test differentiates strep infections, which require a physician visit, from viral infections, which do not.