My friend Michelle called recently. She was diagnosed with a rare and potentially debilitating disorder a few years ago and has developed serious complications. Michelle isn't happy with the care she is receiving from her doctor, a specialist who trained with an expert in the field. Apparently, this expert has been consulting on Michelle's case without actually seeing her and is recommending that she take a drug that suppresses the immune system and is known to have serious side effects.
Michelle has had a pretty rough time and is wary of the medical community. She is trying to find a new doctor, one who, as she says, “isn’t on the drug industry payroll” and she has asked for my help.
I’ve worked in the healthcare field for more than 25 years developing educational programs for physicians and patients that are sponsored by the pharmaceutical industry. Like it or not, in our current system of healthcare, pharmaceutical industry fills an important need, i.e., helping physicians and other providers keep up to date on new treatments and, in some cases, improving access to low-cost or free drugs. That some companies—and physicians—have engaged in unethical behavior is a matter of record. I am not an apologist for the industry. I will say though that my views—which have been colored by years of working with principled executives, researchers, sales representatives, and physicians dedicated to improving patient care—are more gray than black and white. But that’s my opinion.
Michelle has read the negative reports—as have you, no doubt—and she is smart to follow her instincts and look further if she suspects that a physician’s close ties with industry may be influencing his treatment recommendations. As a sole factor for evaluating a physician’s expertise, however, it falls short.
Because Michelle’s disease is very rare, I started by researching her condition—using google.com—to see if her complications were a result of her illness or if she needed to see a specialist in another area of medicine. I found they were caused by her illness, and then started searching for physicians who are experts in treating it. I used the following search terms:
- Leading experts in treating [name of disease]
- Current treatment guidelines on [name of disease] and [name of disease and specific symptoms]
- Background on the guidelines authors and where they practice
- Patient advocacy groups for [name of disease]
I looked for the most current information while paying careful attention to financial sponsorship of the sites.
When I came across a center devoted to the condition at a major medical center in NYC, I searched for information about the physician team members and found one on a 2009 Best Doctors list as well as cited by another patient in a disease-related Internet community who had good things to say about him—a good beginning. I sent the information to Michelle with links to:
- The full list of the specialists on the Best Doctors list
- Treatment guidelines so that she would have the background necessary to put together a list of questions for the doctor and make informed decisions about her care
- Two discussion groups on patient advocacy sites with participants who were dealing with the same disease and issues
If Michelle decides to visit the center, or seeks care elsewhere, she will be better able to assess whether or not the physicians’ treatment recommendations and style are a good fit with her needs, values, and preferences—in other words, if they are the best team for her.
You may have noticed that I didn’t use any of the sites that charge for information. I’ve found that there is lots of free information on the Internet if you are focused and persistent. Also, take care when evaluating other patients’ comments about their experience with doctors. Whether these comments are positive or negative, they are personal opinion and not to be taken as evidence of a doctor’s experience and skill.
Early next week…how quality in healthcare is measured and more suggestions you can use to find the best doctor for you.
In the meantime, think about your own doctor and ask yourself if he or she:
- Is highly rated and respected by other healthcare providers for providing quality care?
- Has the training and background to best meet your needs, e.g., advanced study in a specialized area of medicine and has completed additional studies and passed an examination (board certification)?
- Encourages you to ask questions?
- Listens to you?
- Explains things clearly?
- Includes you in making decisions about your care?
- Treats you with respect?
- Strikes a balance between serious consideration of your health problem and a positive and optimistic attitude?
Source: Adapted from Choosing Quality Healthcare by Agency for Healthcare Research and Quality
If you answered no to any of the questions above, it may be time to find someone new.
Resources
- Agency for Healthcare Research and Quality publication Your Guide to Choosing Quality Healthcare is available at no cost by calling 1-800-358-9295 or by visiting their website at www.ahrq.org
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