Thursday, October 4, 2007

How to choose your doctor

I am sure most of you have faced this problem at one time or the other. For many of you who have the benefit or otherwise of a regulated health service where the decision is made for you and you really have no choice but to go to particular doctor. There are others who are living in a free market economy with the government run health services being what they are [like in India] have no choice but to select a personal physician in the immediate neighborhood. How does one go about doing it? I asked several persons some time ago and also some of my new patients why they chose me. The replies narrated here, I hope will make interesting reading.

Many said they asked their friends for a referral. The friend who recommended, if knowledgeable as to the doctor’s ability would have done you a service. God forbid, if he is one of those who believed in the dictum that there is a treatment for every itch and stitch in your body, then you would get referral to a doctor who is fond of medication and you will end of getting treatment for any and every complaint of yours and may be get investigated from head to foot.

The other common source of recommendation is the neighborhood chemist, the mister know all of medicine. This man can make or break you with his advice. If he likes a doctor because he gets a lot of prescriptions from him, it is likely that you are dealing with the type of doctor mentioned above. Sometimes he can be quite perceptive and may recommend the right type. But most businessmen chemists have no idea as to judge the merits of a doctor.

Another source is your previous doctor. This occasionally works. But here too, the recommendation is based on personal friendship rather than the knowledge of one’s professional efficiency. I know of a well known orthopedic surgeon of the city who recommended a very mediocre physician to his own cousin!

The other rare method is when you are going for a walk, you see the doctor’s board and you decide to pay him a visit. This may or may not work.

Thus as you can see, none of these are foolproof. Most patients, however after a period of trial and error, get the type of physician of their liking sooner or later, but the example of how two of my patients chose me is interesting.

She was a middle aged woman who dropped in with complaints of aches and pains and also to get her blood pressure checked. After the examination and consultation, she made a strange request, ‘Doctor, will you please check my pulse.’ I thought she wanted me to count her pulse properly which I had not done because while taking her blood pressure I had an idea of her pulse rate too. But I felt it to be a reasonable request and I had nothing to loose but a few extra minutes. So I proceeded to count her pulse. Normally the radial artery is located on the outer front aspect of the wrist and easily felt. But in this patient I couldn’t get the pulse. I groped around for a few minutes and felt the other wrist with the same result. No pulse! I then went up and felt the brachial artery where the blood pressure is taken. Presto! The bounding pulse was felt! I counted the pulse and made sure that the blood supply to her hands was alright. I told the lady that both her radial arteries are placed under the tendons and could not be felt and warned her to tell her next doctor this fact. She smiled and said, ‘there is going to be no next doctor, you are my doctor’. She had gone to three doctors before she came to me and all the three had failed in this test! She knew of her anomalous arteries and has been using this as a test to test the efficiency or otherwise of the doctor. According to her this is a foolproof test and those who passed this test have turned up to be good doctors! Though a bit put off by this way of choosing I could see some merit in her method.

The other person’s explanation was straight forward. He followed his doctor father’s advice. ‘Go to a doctor whose patients waiting area is never very full or never fully empty. The person whose waiting area is overflowing will not have time to examine you properly and the other fellow who has no patients is obviously no good’. Fortunately he found my clinic fulfilling these two criteria on the day he sought my help!

Some aches are private and silent
Some open and obvious
Some need to be told and shared
But all must be endured


Anonymous said...

Interesting. They say people come to your life for a reason. Doctor for certain. I am happy I chose a doctor while golfing. Not for his golfing abilities( very good) but for his nature and attitude which gets exhibited in full when you play golf.
Appreciate your writing skills and style.

Dr K Lakshman said...

particularly nice piece, Doc. Congrats.
How true, too!!
The process of choosing a 'specialist' is even more intriguing. But, one thing is certain - patients always have some logic for choosing a doctor - whether doctors agree with that logic or not!!

leelahp said...

I liked the story of the woman with no apparent pulse. I agree finding a doctor that matches one’s disposition can be a challenge. I am now shopping for a dentist, with little luck. I find that they are always trying to prescribe the “high-end” treatment and almost refuse to give a simple cleaning.