Question: “I've come to understand that not all doctors are created equal. What are some things I can do to pick a good general physician for myself?”

Answer: This is a very important question, but not an easy one to answer for many reasons.

   

There is some good news and some bad news for you in your quest:

• The good news is that all medical doctors in the US must meet rigid qualifying criteria to be able to practice.
• The bad news is, as you said, not all doctors are created equal. As in any profession, there are some people who are better at their job than others.
• So how do you separate the wheat from the chaff? Unfortunately, I do not have a magic formula; however, I do have some thoughts that may help.
• There are some things that you can work out before you see a physician but other things will have to wait until you actually step foot in the doctors office.

Before you step foot in the office:

Medical insurance:

• Many health insurance plans will require that you choose a primary care physician from their approved list of providers. Start with this list and save yourself some time.

Minimal requirements:

• I would recommend that your physician has at least met the basic residency requirements of an ACGME certified medical specialty and is board certified.

Ask around:

• Ask other people you know about their PCP. If a trusted friend likes their doctor, then that is definitely something to explore. Be sure to ask them why they like their doctor because their reasoning may not apply to your needs. This admittedly is not a perfect solution; what some people perceive as good is not necessarily going to work for you, but this is a great start.
• If you like your current doctor, but can’t see them anymore for geographic or insurance reasons, then ask your doctor if they can recommend a referral.

Background search:

• Some people believe that the prestige of a physicians medical training will reflect the quality of the doctor. The rational being that the better the medical school/internship/residency/fellowship, the better the doctor that is produced.
• Another perspective is that high level medical training programs will select for the best candidates.
• It is hard to prove if this is a legitimate argument and I don’t think that this method has ever been tested to be a valid strategy for selecting the best physician. In addition, I have known some great physicians from little known medical programs. I have also heard stories of subpar physicians form the most prestigious medical institutions.

Seek a specifically trained physician for a specific situation:

• Some primary care physicians are more experienced in some medical situations than others and will therefore be in a position to provide better care for that specific circumstance.
• As we all know, the more someone (anyone) does something the better they will be at that task. Some of these are obvious; you don’t go to your kid's pediatrician to have your gallbladder removed, and you shouldn’t go the ER for a routine mole check. Etc.
• To this end, consider that some doctors may have additional training in a medical field specific to your needs. This additional training may not always be designated with a certificate of merit or fellowship but may just be an area of particular physician interest.
• If you are an athlete/weekend warrior, then a doctor with additional training in Sports Medicine might be a big plus.
• If you are older, then additional training in Geriatrics will help.
• If you are often sick or have an immune disease then you would be lucky to find a PCP with additional Infectious Disease training.
• Additional Women’s Health training can provide a physician with insight into problems that a general trained physician may not have experience with.

Physician age:

• Some people think that an older doctor will be a better doctor because they have more experience.
• However, others believe that a younger doctor will be better equipped because they have more experience with the latest medical advances.
• I don’t think there is a good answer here. The quality of a doctor in my opinion can’t be determined by their age.

Look around: 

• There are several online physician rating sights out there. However, I wonder who is writing the opinion on the websites or if anyone is policing the entries. I am skeptical about the usefulness of these sights.

Logistics:

• Beyond a doctor’s medical talents, you will need one that works for you schedule.  Consider:
• Office location
• Office hours
• Emergency availability
• How long does it take to get an appointment
• Average wait during appointments
• Number of patients booked per hour
• Is the doctor affiliated with a local hospital? If you prefer a specific hospital, is your doctor associated with it?

After you step foot in the medical office:

Physician personality:

• Some people will think their doctor is the best because they are nice. While, I would expect all doctors to be personable, I would not say that this automatically equates to good medical care. None the less, you definitely want a physician that:
• Listens to you, doesn’t interrupt you, and seems to be paying attention.
• Does not make you feel rushed.
• Is willing to listen to your theories on what's going on and is open to you getting a second opinion without making you feel guilty or ashamed.
• Perhaps most importantly, I would caution against an arrogant physician. Ego can and has clouded judgment. I have seen many unfortunate cases where a self-righteous physician has not allowed themselves to see significant medical issues because someone else proposed an alternative diagnosis or treatment.
• In my opinion, a great physician is one who does everything they can to be at the top of their field and at the same time is open to alternative explanations/care.
• The paternalistic (doctor tells patient) model of medicine needs to change to a more productive partnership between patient and physician.

Medical office:

• Beware if the office/exam rooms are not clean. Cleanliness is a necessity in medicine and may be a reflection of the quality of care in general.
• The doctor’s office and nursing staff should be courteous and respectful of your privacy.

The bottom line, if something doesn’t feel right, don’t hesitate to move on or get a second opinion.