How do I get names of clinicians to evaluate?

1.    If you are on a health plan, particularly if it is an HMO (reimbursement only within the plan) or a PPO (higher reimbursement within the plan, but generally some outside), start with the list of clinicians affiliated with your plan. Your plan’s website will generally allow you to check credentials (specialty, board certification, hospital affiliation.)

 

2.    Even if you aren’t in a specific plan, you can use plan websites to identify clinicians in your area, and then evaluate their credentials.

 

3.    Ask trusted friends for their recommendations.

 

4.    Check with well-known hospitals (for example, where you would want to be if you were to be hospitalized). Each hospital generally has a referral panel for their affiliated physicians. Teaching hospitals, particularly those that are major teaching hospitals associated with medical schools, generally have excellent affiliated physicians.

What should I consider when I have the names of possible clinicians?

•  What kind of health care provider do I want? Nurse practitioner, family practice, internal medicine, obstetrician-gynecologist? All these may be appropriate, depending on your particular medical history, needs, and finances.

 

•  Technical Competence – Is s/he Board Certified (or at least Board Eligible) in her/his specialty? Does s/he practice by herself, in a group, or in an HMO? Is s/he involved in teaching medicine in hospitals or in the office? Does s/he participate in Continuing Medical Education? How does s/he keep up with developments in her/his field? What precautions are used to insure that infections are not passed from patient to patient? Has an OSHA complaint ever been filed against the office?

 

•  Medical Emergencies – How can you reach the clinician or office after hours in case of a medical emergency? Is there an answering service? Who would see you if necessary? Where would that be?

 

•  Accessibility – What are the office hours? When will phone calls be returned? Are there evening or weekend appointments? Can you call with questions? Can you get advice about a minor complaint over the phone, or is an office visit required? Can you get to the office by public transportation? Is it wheelchair accessible? At what hospital(s) does the clinician have admitting privileges in case you need hospitalization? (Teaching hospitals are good.) Who covers when your clinician is ill or on vacation?

 

•  How helpful are the office staff?* Will they help you with billing issues and prior authorizations efficiently and pleasantly? What is it like to call the office on the phone?

 

•  Financial – What are the fees? Is there a sliding scale? What insurance plans are accepted? Does the office bill for you? Do you have to pay up front? Would s/he allow extended payment plans?

 

•  What treatment approaches do you want to include? For example, is the clinician comfortable with alternative and complementary therapies? (Use of herbs, mind-body techniques, acupuncture, chiropractic, bodywork, etc.) Would s/he provide them in that office, or refer you to someone else?

 

•  Finally, don’t be afraid to "interview" several clinicians to find someone with whom you are comfortable. Health care and wellness requires a partnership, and the two of you should work well together, with mutual trust. It is important to have your clinician communicate with you in a way that demonstrates respect, competence and caring.

 

 Preparing for Your Visit

 

•  Explain why you are making the appointment, and what you think you will need (for example a gynecological exam) so that the right amount of time can be scheduled. Find out if the doctor or practitioner will be doing any tests, and whether you can eat or not before coming.

 

•  Be sure to have the basic facts of your medical history: Major/chronic illnesses, any hospitalizations and surgeries (reason and dates), past or current pregnancies, and physical or other disabilities. Be sure to know what medications you may be allergic to, and what the symptoms of your allergy(ies) are.

 

•  Know the history of your specific complaint (s): When did it start? What have the various symptoms been? How did they begin/resolve? How you have tried to treat it? With what results? (Include lifestyle modifications and medications).

 

•  Be sure to inform your clinician of all prescription and/or over-the-counter medications you are taking (including vitamins, herbal or homeopathic preparations, pain relievers, contraceptives, antacids, laxatives, etc.)

 

•  Be prepared to discuss your menstrual history: When your periods began, how regular they are, how long they last, and the date of the first day of your last period. You also may be asked about your sexual history and sexual orientation. Do not make a Pap smear appointment when you think you might have your period.

 

•  Expect to be asked if you smoke cigarettes or drink alcohol, or use any other drugs. Questions will include how long, how much, and how frequently.

 

•  Have the facts of your family medical history. Know who has/has had cancer, hypertension, heart attacks, diabetes, kidney diseases, mental health problems, eating disorders, genetic disorders, high cholesterol, alcohol or other drug problems, etc. If you are adopted, do share any information you have about the medical history of your birth parents.

 

•  If you do not understand why your clinician is asking you a particular question, ask her/him to explain it to you.

 

•  Either bring your medical records with you, if significant, or sign a release for them to be sent to your new clinician.

 

•  Bring a written list of questions you want to ask! It’s too easy to forget.

 

•  Bring a pen and pad so that you can take notes on advice/instructions your clinician may give you. This information is easy to forget, too!

 

•  Be sure to ask questions about any diagnosis you may receive: Are there other names for this illness? About how long might it last. Is it anything else it might be? What kind of treatments are required? Any alternatives? Risks/benefits of each?

 

•  At repeat visits to your clinician, be sure to report any changes in your lifestyle (stopped or started smoking, become a vegetarian or vegan, etc.), medication allergies, or medications. This is information it is important for your clinician to have.

Barnard Seniors

A final note…

Don’t forget the importance of health insurance in enabling appropriate health care. See our just - for - seniors brochure which is being distributed to all Barnard seniors and will also be available online.

Barnard College Student Health Services

Http://www.barnard.columbia.edu/health

WE WISH YOU A HAPPY AND HEALTHY FUTURE!

Barnard Student Health Services Staff