Finding Excellent Doctors
Having rheumatoid arthritis forces us to seek out doctors in a variety of specialties and subspecialties. Part of being a “professional patient” is learning how to select quality doctors for our care. This can be a daunting task especially if you’ve been relatively healthy until receiving a diagnosis of RA. Below are some suggestions for finding excellent doctors.
- Recommendations/referrals from trusted doctors and other healthcare professionals. These professionals usually know the good doctors around town. Ask whom they would go see. I’ve also received good recommendations from physical therapists. Sometimes you have to be careful because they’ll first recommend a doctor from their own clinic because they’re trying to keep the business in house. This may be particularly true for physician-owned clinics. But good clinics also attract good doctors (see #6 below).
- Recommendations from friends. Ask around about other’s experiences. Personal recommendations are always helpful but it may be difficult if you don’t know someone with RA.
- Board certification. Don’t go to a doctor unless they’re board certified in the specialty in which they practice. Licensure to practice is mandatory by a state but board certification is voluntary. Each specialty has a governing board that oversees the certification process and it’s very rigorous. There are 24 governing boards in various specialty areas. Certification is good for 10 years. Rheumatologists are certified in internal medicine first and then in the subspecialty of rheumatology. The process for certification is quite rigorous and includes the following components: a. at the time of application, be previously certified in Internal Medicine; b. satisfactorily complete the requisite graduate medical education fellowship training; c. demonstrate clinical competence, procedural skills, and moral and ethical behavior in the clinical setting; d. hold a valid, unrestricted and unchallenged license to practice medicine; and e. pass the Rheumatology Certification Examination. The American College of Rheumatology (ACR) provides an online search tool for finding a rheumatologist in a particular region. The resultant list documents if the doctor is a fellow of the ACR meaning that they are board certified, are recommended by two other doctors, and are a dues paying member of the ACR. Members receive ongoing training and receive updates on the latest research and clinical practice techniques.
- Patient Reviews. With the advent of the Internet, online patient reviews are readily available. Simply searching a doctor’s name reveals multiple patient reviews. One popular tool is Rate My MD. One word of caution about these tools is that it’s likely more naysayers will take the time to complete a bad review than a happy patient will post a good review. But I’ve learned that if a doctor has a good reputation, they’ll be plenty of strong reviews. If you have a great experience with a doctor, take the time to complete a good review.
- Experience and training. Look to see where the doctor was trained. Was it at a reputable medical school? Think Harvard Medical School vs. the "Medical School of South Aruba". Where did they do their residency and fellowship training? How long have they been practicing? This can be a double edged sword…too inexperienced may mean less knowledge, too experienced may mean they’re out of touch with the latest ideas and techniques. These are generalizations and don’t always hold true. If you’re looking at a surgical procedure, ask the surgeon how many of those procedures have they done. I even had one surgeon send a patient to me to ask about my experience with a particular procedure in an effort to calm their fears about the outcome.
- Where do they work? I find that excellent doctors generally take the best jobs at the best clinics and hospitals. If you live in a smaller community, you may need to travel to a larger city to find higher quality care.
- Complete surveys of your experiences. Most clinics and hospitals will send you a survey asking you to rate your experience with a doctor, their staff, and the clinic. Take time to complete these surveys as the administrators carefully analyze this data in order to make improvements.
Remember, you can always get a second opinion on any diagnosis or recommended treatment/procedure and insurance will usually pay for this. If you don’t have a positive experience with a doctor or clinic, vote with your feet and go elsewhere.
I've had success using the techniques listed above. Sometimes it's trial and error but I'm currently very pleased with the quality of care received. I hope you find some excellent doctors!
When was your last flare?