How to Choose a Doctor

Having a child is a exhilarating experience. Dealing with the health system in this country however, evokes the exact opposite emotion. One of the most traumatic experiences we had to revisit with the birth of our child was to pick a doctor, a pediatrician, for him and a OB/GYN for my wife. For myself, it was never really an issue, as I rarely visited the doctor. With a pregnancy and a child however, the doctor is critical, as we are likely to see that person a lot more than our parents

So I got to thinking – how do you pick a doctor. What do I look for in a doctor…

1. Subject Matter Expertise
2. Availability (Phone and In-Person)
3. Personality

Let us look at each of these in some detail:

Subject Matter Expertise – The primary function of a doctor is to examine symptoms, come up with a diagnosis, and judiciously medicate in order to cure the patient. If they are not really good with their medical fundamentals, they will treat the wrong cause, and you will end up medicated in vain, and sick for longer than you have to be. Further, most medications have side effects, and using larger numbers of medications would mean you are exposing yourself to even more risk, than possibly the initial complaint in the first place. Expertise is a table stakes thing. One thing to note here is that medicine, unlike engineering, is an inexact science. Or at the very least, not completely understood science. So experience plays a large part in identifying a cause. So the keys to picking someone with the right subject matter expertise would be:

1. Prioritize the doctor that has the most years of relevant experience
2. Prioritize the ones that went to the best medical schools
3. Prioritize the ones that went to the best hospitals for residency and specializations
4. Prioritize the ones that believe in minimal medication

Without subject matter expertise, it does not matter if you a doctor that is always accessible and is very pleasant to do deal with – you are not looking for a friend, but an expert in medicine at the end of the day.

Availability (In-person and Phone) – The most important thing for a doctor outside of being a competent doctor is that they are available when you need them. It does not help much to have a doctor that is as good as Dr. House if they are never there when you need them. Some really good doctors have so many patients that they are never able to talk to you at all. You are talking mostly to their nurse – in which case, you should be applying your choice criteria to the nurse instead of the doctor! So pick a doctor that is able to make time to see you when you need to be seen. Medical needs rarely come scheduled and planned in advance. Some doctors are much better than others about reaching out to you on the phone either in response to a voicemail or just to followup on a visit. Ask questions and research their modus operandi before you make a long term commitment to see a particular doctor.

Personality - I cannot stress this enough. The two criteria above are clearly more important than this one, but going back to the fact that healing is one part faith and two parts science, a doctor that can win your faith, and give you the confidence that you can trust them is paramount to a successful healing relationship. Now all patients are really just cases for a doctor – after all, being a doctor is their job not their hobby. However, not all doctors make you feel like you are an appointment on their calendar. Some of them, on the other extreme of the spectrum, make you feel like a close friend, others like an friendly aunt or uncle. Just ability to win the trust of the patient will add the equivalent of a placebo effect in curing the patient. Given the above two criteria, try hard to find the ones that come across like friends rather than those that make sure you understand you are nothing more than an appointment on the calendar that they have to get through.

The most important thing about the personality criteria is to also gauge the the personality of the nurse. Since in most cases, you will be dealing with the nurse more than even the doctor, making sure that the nurse has a great personality is not just nice, but great!

So we can in fact create a Doctor Score by rating a doctor on each of the above criteria, and adding them up in a weighted manner. Given the relative importance on each I would give Expertise a weight of 50%, Availability a weight of 30% and Personality a weight of 20% (yeah, that high).

With this scoring mechanism, I aim to review most of the doctors that I come into contact with to help put my own experiences online for others to benefit from.