Tuesday, January 29, 2013

How to find a primary care physician in America

Step 1. Go to websites like Healthgrades or RateMDs and check out the ratings of doctors in your area

Step 2. Read through the reviews, try to decipher which ones are bogus. Decide that the doctors that score well must at least be doing a good internet reputation management system, and hey, isn't that a sign that they care?

Step 3. Read through some of the profiles and figure out that the ratings are based on junk like 'he's a really nice guy' and 'he spends time with me', and if you're lucky maybe one review complaining about a specific misdiagnosis. This lets you identify some doctors that suck, leaving you with the 'all 5 star possibly bogus reviews' guys.

Step 4. Figure out that in fact the far more useful information is the quality of the medical school they went to and the quality of the hospital they interned at. There is, of course, no way to filter by this information.

Step 5. Settle on some guy that looks good based on your really half-assed search criteria of 'went to a medical school I've heard of' and 'well-rated on both websites'. Call up to make an appointment, get told he's not taking new patients.

Step 6-12. Go down the eligibility list repeating this procedure for successively less desirable doctors. Begin to realise that most of the best doctors are closed to new patients, and that the accuracy of the 'Accepting New Patients' checkbox on the website is no more than 50%. In a few lucky cases, you'll get a doctor who is accepting new patients, but the earliest appointment for a new patient is in 6 weeks time. This is less helpful if you happen to be in need of medical care, you know, now.

Step 13. Call up one of the reception desks at a place you'd previously been refused and ask when the earliest new patient appointment is if you don't care who the doctor is. Realise from the receptionist's reply that the vast number of places do not apparently have appointment management software that can actually answer that question easily, even for the doctors within their own practice.

Step 14. Using a repetition of the procedure in step 13, reach a receptionist who actually doesn't even bother to check the calendar but instead refers you to a doctor in another practice. A quick search reveals that the internet knows virtually nothing about this person or the quality of her care, except that the dates on her profile make it clear that she's only recently moved to this state, and hence doesn't have many patients.

Step 15. Make an appointment with Sally Random, MD, for two days time.

Step 16. Start thinking whether you want to make a 6 weeks time appointment with one of the better doctors for a general checkup or some junk just to get on the 'current patients' list. Decide to put it off until you find out just how bad Sally Random, MD, actually is.

Step 17. Finally figure out why everyone just goes to emergency rooms or urgent care places for medical treatment, or, in the case of my friend, only calls up specialists directly, since they actually have appointments available.

Update: Step 18. Double check on Sally Random, find out her medical degree is from some place in the Caribbean. Decide this is unacceptable, start going through the list of doctors in the medical group you're examining and just reference their medical school with lists of rankings of medical schools. Hate life.

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