FOOT PAIN & PODIATRY
ONLINE
THE TOP TEN REASONS TO CHOOSE A DOCTOR
PATIENTS BEWARE!! Over the last ten years the integrity of physicians and surgeons has been greatly affected by the economic changes of how physicians are paid. Many Physicians are no longer able to make independent decisions about medical treatment because they are employees of a medical group or an HMO. In many cases, the cheapest doctor, is the doctor hired by the HMO or medical group and any consideration as to credentials or training is secondary. In many medical groups and HMOs, the patient never sees a doctor but a physician assistant who can only treat minor medical problems and the doctor (who supposed to be supervising the physician assistant) is too busy treating other patients. There are exceptions in that the physician assistant is supervised correctly and provides a excellent level of care. However, the usual story with being treated in a medical group or HMO is that the medical problem does not receive definitive medical intervention until the medical problem has significantly worsened or intensified. As a patient, if you have decided to purchase a PPO like insurance plan that lets you go to a doctor of your own choice, it is important to use some type of guideline in determining the level of medical care that your will receive. The following list has been developed to assist patients in finding a good physician or surgeon.
1. TIME WITH THE PATIENT: The first question and the most important is how much time face to face does the doctor take with the patient on new and established office visits. The answer that you should hear is one hour for a new office visit and one-half hour for established office visits. For a patient to receive good medical care, the doctor must understand you health history and perform a physical examination and other medical tests to make a diagnosis. Five to ten minutes for a new and established office visit to achieve all of the requirements to make a diagnosis, explain the treatment plan and administer treatment is not possible unless shortcuts are taken by the doctor at the patient's peril. If you get five to ten minutes of the doctor's time, the doctor is not worth your time as a patient.
2. BED SIDE MANNER AND APPEARANCE: Is the doctor caring and friendly and professional in demeanor and appearance. Patients do not have to go to a doctor that is a cold fish and who looks like a slob. If the doctor takes short cuts with his bedside manner and appearance, as a patient, you can be assured that the doctor takes shortcuts with your medical care and when performing surgery.
3. PPO PREFERRED PROVIDER: Is the doctor or surgeon on your PPO insurance or is the doctor actually an out-of-network provider. There are many doctor's offices that will tell the potential patient that their office is a PPO provider but in fact the doctor is an out-of-network provider. As a patient , if you get fooled into going to a out-of-network provider, only after a patient receives the insurance claim will the patient discover that they are responsible for payment of the medical service and not the Insurance Company. This situation where doctors are treating out-of-network patients occurs frequently because most doctors are not Providers for PPO Insurance Plans but do not what to turn away business. As a patient, make sure the doctor is on your insurance plan or find a different doctor.
4. HMO CONTRACTS: Find a surgeon or doctor that does not have HMO contracts if you have a PPO insurance plan that lets you go to the doctor of your choice. In the case of a surgical specialist such as an Orthopedic and Podiatric Surgeon, who has an HMO capitated contract, typically the doctor receives in payment 16 cents per month per patient whether they treat the patient or not. In addition, these doctors with HMO capitated contracts must see many patients per day as part of their HMO contract agreement and every patient gets treated the same HMO way. For a doctor or surgeon with many HMO patients, it is extremely difficult to change gears and treat PPO patients differently than HMO patients. If the doctor has a HMOs, try finding another doctor.
5. NICE OFFICE STAFF: Is the office staff nice on the phone and helpful in verifying your insurance and in scheduling your appointment. If the office staff is nasty, the staff will continue to be nasty even when an emergency occurs and you need to speak with the doctor. Remember the doctor hired the nasty staff and usually it is to squeeze every dime out of the patient while the doctor plays stupid about who he or she hired. If the staff is nasty to you on the phone, find a office where you are treated as a patient who needs your pain relieved and not aggravated by the attitude of the office staff.
6. SMALL GROUP PRACTICE: The doctor should be in a small group practice of two to five doctors. Large group practices treat large numbers of patients and have less time for individuals. This fact is especially important if you need to reach the doctor about a medical problem and get a stand-in who has no concern for your problem like care provided by your treating doctor.
7. ONE LOCATION: The doctor should be in practice at one location or in very close proximity to a second location. The doctor should not have different locations spread out all over the region. If a problem occurs after treatment, you need to know your doctor is not 50 miles away at his or her other location.
8. BOARD CERTIFIED: The doctor should be board certified by a certifying board that has title of "American Board of __________" such as Podiatric Surgery. Because there are many mail-in certificates for board certification today, there are many fraudulent certifications stated in advertisements. As with most surgical specialties, certification by one of the American Boards insures that the public can rely on the fact the surgeon is well trained and qualified. In the case of Podiatric Surgeons , the doctor should be board certified by the American Board of Podiatric Surgery. In the case of foot doctor who is board certified by the American Board of Podiatric Surgery, the doctor must have been in practice for five years after residency training, had successfully completed many different types of foot and ankle surgeries and passed both oral and written examinations that encompass every aspect of foot surgery.
9. RESIDENCY TRAINING: Is the doctor residency trained in the area of specialization for your medical problem. As an example, there are only a few orthopedic doctors with training in hand surgery, but just about every Orthopedic Surgeon performs carpal tunnel releases. As an additional example, there are only a few Orthopedic Surgeons who have Fellowships in Foot Surgery, but just about every Orthopedic Surgeon will perform a bunion correction. Today, there are many doctors who hide behind their white coats pretending to be a Jack of All Joints or medical problems at the peril of the patient. As a patient, if you can choose your own doctor, make sure you are going to a true specialist for your medical problem in the area of the body that needs to be treated.
10. USA EDUCATED: As a patient, you should understand that there is a significant difference in education and training for foreign trained doctors compared to USA trained doctors and physicians. As a patient you should be aware that there has been an explosion of foreign trained doctors in HMOs in recent years because these doctors are willing to accept less pay and will follow the profit driven dictates of the HMO to restrict patient access from expensive tests and / or medicines. There are exceptional foreign trained doctors but generally only seek out USA trained doctors.
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