Tuesday, September 11, 2007


Medical Adventures (B)

Looking for the Right Doctor

The key point to remember is that, like in any profession, the gap between the best and the worst practitioners is very wide. Not all of them keep up with advances in medicine. Here is another quote by Osler: "The average non-reading doctor might play a good game of golf or of bridge, but professionally he (is) a lost soul." This was said in 1909 and it is quite valid today. In addition, you have to consider compatibility of personalities between the doctor and the patient. Here are some suggestions:

(1) Be an educated consumer. Educate yourself as much as possible about human physiology and health issues so that can think better of your needs. But do not delude yourself that you can be your own healer. For one think, you are not objective.

(2) Look for doctors who are willing to listen and stay away from those who are in a hurry or seem to feel insulted when the patient proposes a diagnosis. Certainly, stay away from dogmatic and arrogant doctors.

(3) Be sure to ask for a second opinion for anything extreme. Either when a major treatment is proposed or when your doctors says "there is nothing wrong." Of course you have to be prepared to hear conflicting opinions, that is why (1) is important.

(4) If you have something very serious, such as cancer, go to a major medical center (in the case of cancer, Sloan-Kettering in New York and Anderson in Houston are examples of the kind of center I mean). At the very least try to select a doctor who is on the faculty of a major medical school. Physicians at such places are far more likely to be up to date with the literature and the newest developments in their field. They are also more likely to be genuinely interested in their profession and not consider it just as means of earning a living. I should add that in my own experience I have found the highly regarded specialists more humble and willing to listen than many ordinary physicians.

(5) Plan ahead. The best doctors tend to be heavily booked and it may take several months before you can get a new patient appointment (some of them may see patients only one day a week because they do surgery or research or teach the rest of the time). Decide what are your risk factors, find who is the best specialist in the area and make an appointment with him/her even if you do not have an immediate need.

(6) In addition to the specialists find a doctor who takes a broad view to medicine to be your primary care provider. You want a of doctor who takes a systems approach to medicine and places emphasis on nutrition and the treatment of the whole person. I was planning to use the term holistic medicine to describe such a practice but, unfortunately, the term is loosely used and it is often confused with alternative medicine and other unorthodox practices. The fact that mainstream medical practice maybe wrong on an issue does not make other views on the issue automatically right. When we deal with hard problems there may several wrong solutions.

There are various list of "Best Doctors" but not all of them are reliable. Probably, the most reliable indicator of the quality of a physician's training is the hospital where he/she was a resident. But you have to find that information first and then you have to find out the reputation of the hospital. A good indicator for surgeons is the number of operations they perform each year.

(To be continued)

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