Friday, February 22, 2013

Not all doctors are equally good

The Doctor, by Sir Luke Fildes (1891)
Patients spend a lot of time and energy in finding the right doctor, Patients know that this is a critical decision , and that finding the right doctor can make a world of a difference to the final outcome of their treatment. Most patients assume that all doctors are technically qualified and equally competent – but this is not true ! Some doctors will have superior technical skills; some are great at marketing themselves; some are entrepreneurial and are proficient at raising money; some can build great teams; while others will have a stellar bedside manner.

It can be hard for the patient to figure out what makes one doctor better than another – after all, they have all graduated from medical school and are qualified and certified. Some naively believe that doctors who work in a five-star hospital must be better, but this is not true. Not all doctors are equal – and not will be surgically gifted .

How much time and  energy you need to spend in finding a doctor depends to a large extent upon what kind of medical problem you have; where you live; whether it’s an emergency; and how much you can afford to pay. . If you have a common garden-variety run-of-the-mill problem , pretty much any doctor will do – after all, most problems are self-limited and get better on their own, often inspite of the doctor ! There’s no need to hunt for a world authority if you have a simple pneumonia, for example.

However, if have a complex or rare problem , it does make sense to invest a lot of time and energy in finding out what your options are. It's very hard for patients to judge the technical competence of the doctor , which is why most patients have to depend on surrogate markers of medical ability. This is often the bedside manner of the doctor ; how empathetic he is ; whether he speaks nicely to you ; and is willing to spend time with you , explaining what you need to know. While the best doctors will have both an excellent bedside manner as well as superior technical skills, it's also true that there will be some great surgeons with superlative technical skills who are rude or brusque; while there will be some doctors who may have a great bedside manner , but are technically incompetent. How is the poor patient meant to figure out ?

This is extremely challenging , which is why patients shop around and get a second opinion from doctors; doctor  friends, family members who are doctors, and nurses . Thanks to the internet, it’s much easier to hunt for the right doctor ! Sitting at home, you can find out a lot about the doctor. What are his qualifications ? Where did he train ? What do other patients think about him ? While this is obviously not foolproof method , it does give you a lot of background information before you start digging deeper, so you can prepare a comprehensive list of prospects you need to contact. For example, you can look for who’s publishing research articles about your disease , by doing a search at PubMed, which is an index of all the medical journal articles in the world. This will give you a good idea of where in the world the researchers at the cutting edge of the field are.

It’s a little known secret that all doctors have special interests, and are especially good at treating patients with a particular problem. Try to find out a doctor who has a special interest in your particular problem  - he will treat you with much more love and care !

You also need to trust your intuition - the chemistry between you and your doctor should be right , and your philosophies should match. This is the only way of creating a win-win situation , where you are happy and have peace of mind that you got the best possible medical.

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