Submitted by Dr. Yan Liu Baum, MD, from Kaiser Permanente
My father is a surgeon and I was exposed to medicine a long time ago. In my childhood, I vividly remember when my dad was on call, he was often picked up by an ambulance from our house for emergency surgery (there was no private care back then in China). I also remember the happy faces of my father’s patients after they recovered. Thus I was inspired to become a physician.
I had been working as physician until five months ago. Suddenly I was very sick due to a high risk pregnancy with lots of complications at the age of 47. I became so sick and went to see the doctor myself almost every day as the pregnancy approached delivery.
Being in this new role as a patient, I have always wondered how to find a good doctor and clinic (since medicine requires a team). But what is a good doctor? “A person you can trust to help you achieve the health goal,” was the simplest answer. How do we find such a person?
For the first time since graduating from medical school 20 years ago, I was a very sick patient. The switched roles made me review the process of looking for good doctor as a patient. Experience, quality and accessibility are the three key things towards to look for good doctors.
Patient Experience – How do we as patients experience the relationship with our physicians?
A good relationship with your doctor can improve outcomes. A good doctor can make the most of the brief time they have to listen to you, earn your trust, and then give practical advice in a way that results in you actually taking action.
A good physician must have a combination of technical and interpersonal skill to be able to forge a good working relationship with patients. It is ideal that the doctor and patient have an ongoing, positive relationship of earned trust. A trusted relationship makes it easier to have the crucial and sometimes awkward conversations that are needed to first let the doctor know what is really going on, and then to persuade the patient to take the action they need to improve their health. For example, your physician needs to be able to motivate you to take care of your body, whether that means changing what you eat or drink to “lesser evils” or healthier options, to manage diabetes, weight, or blood pressure, or simply to get more and better sleep.
As patients we can play an important part in the relationship. An engaged patient who looks into their own health concerns – asks questions, looks up drug side effects and is not passive – may seem at first glance to be something doctors don’t want (“Dr. Google,” covered in my next column). But engaged patients are interested and more motivated to make changes, to take action to work with their health care team to improve their own health – and that is a mutual goal.
Quality, meaning look for a doctor and supporting team that gets good results.
In addition to the positive relationship with your physician, can your physician provide the best health outcome? Countless websites will rate physicians or show online reviews, but few are fair and balanced. One good indicator is quality research done and published by the federal government for the Medicare quality ratings or by the Washington Health Alliance Community Checkup. Kaiser Permanente consistently ranks high for providing great care particularly in blood pressure control and diabetes management. You can research providers based on common ratings.
If patients have high blood pressure or blood sugar (diabetes), they may want a doctor that is known for actually getting patient blood pressure/blood sugar under control. Both of these common goals are achieved with a combination of medicines, and behavioral/lifestyle changes (like not eating too much of the wrong foods), which are spurred by the physician’s persuasion and the patient’s action. This again points back to the two items mentioned previously – trust plus the technical skill to give the right advice that will get results.
Once your PCP and you together start getting measurable results in useful areas – like reducing blood pressure or blood sugars – it can become a self-reinforcing loop, where it gets easier to take follow on steps to further improve patient health and the way you feel.
Ask your potential PCP, what is your area of interest? And what is your approach to motivating patients to make improvements?
Accessibility is the third piece of the puzzle, as no matter how good your health care team, unless you have ready access to them, they cannot help you. Access can take a variety of forms these days, such as access via the phone and internet. Kaiser Permanente is proud of our, online visits, care chat, a consulting nurse phone line, and comprehensive smart phone app. However, there is still no substitute for a face-to-face assessment by a skilled physician. Much of medicine can be routine, but almost every week I see a patient face-to-face where something quite complicated and serious becomes apparent only due to the physical interaction. Often what comes up at these exams is critical and requires immediate action to help the patient.
At Kaiser Permanente we work hard – even on weekends – to make ourselves available to help you. We are your health care team and collectively can offer the experience, quality, and accessibility to help you and your family stay healthy. As you choose a physician, make sure you’ll be able to access them with an appointment or other interaction (online or phone) when you need them.
After recent experience as a patient, and a tricky but successful delivery, I am so grateful for the skill and dedication of my physicians. I hope my experience can help more patients find their path to good physicians to help them and their families maintain and improve their health.