Saturday, September 08, 2012

Calling Doctor Love


She is an excellent doctor.
Doctors' appointments are on my mind a LOT lately. I am at the delightful stage of pregnancy where I have to go in every week, though thankfully the perinatologist said I didn't have to go back there after this week's ultrasound. I had extra ultrasounds because: I'm old, we have some family history of heart defects and T was running low on amniotic fluid at the end of my last pregnancy. Good times. But apparently I'm hydrating well (thanks Starbucks!) so that part is not a concern.

I now have to rotate my prenatal appointments with the other OBs in the practice, in case I go into labor off-hours and one of the on-call doctors has to deliver Baby X'. I've got my fingers crossed that X' will hang in there until her scheduled C-section appointment (3 weeks and 2 days, yo!) but you know babies, always on their own schedule.

The OB rotation makes me realize how hard it is to find a doctor I really "click" with. I've seen a lot of doctors over the years, but the last few years of my prenatal appointments and all of T's different appointments have really made me realize that it's worth it to "shop around" and find the right person for the job.

My usual MO to find a doctor is to go to our insurance plan's website and look up someone in the specialty I need, within a few miles of our house. I tend to pick female doctors, especially if there's a chance they'll need to see me naked.

But as you might imagine, that's not a foolproof way to find the right doctor. It's just a way to start the real process, which for me is trial and error. Those sites that rate doctors are not at all helpful to me. I don't care where they went to school or what Joe Blow thinks of them. Here are the things I *do* care about:

Bedside manner - are they always in a hurry? good at listening? dismissive of my concerns? (I have a degree in molecular bio, so I'm not completely clueless, nor do I have the "doctor always knows best" thing going on.)

Availability - Do I have to wait forever to see the doc after my scheduled appointment time? Can I get an appointment at short notice if I need it? if not, is there someone else in the practice who can take me?

Office Support - do they have weird scheduling glitches like losing appointments? Are there a lot of insurance or billing mishaps I need to sort out?  Am I on hold forever and a day when calling?

Diagnostic Ability - this is the hardest one for me (and probably for doctors too!).  I want someone who is cautious, logical and willing to dig around to find an answer or solution.  But not someone who's super alarming and tells me right away what the worst case scenario is (I have Dr. Google for that!).  I also need someone who's willing to accept that the current treatment isn't working and that we might need to change it up, or try something stronger.

That last criterion is usually where I figure out I'm dissatisfied, unless there are horrible scheduling or billing issues, in which case, I don't stick around long enough to find out how the diagnoses go.

The primary care doctor I had for the first 7 years here was one I just picked at random from the directory.  She was nice, easy to get an appointment with even on short notice, and had competent office staff.  But she never could get a handle on the weird lingering sinus infections or 4 week + coughs I'd get *every year*.  We'd go through the same thing - first visit, "it's just viral and will go away on its own".  Second visit a week later, antibiotics that didn't work.  Third visit after another week, stronger antibiotics that might work, and if I was lucky an inhaler to fix the issue.  Usually she'd take an X-ray of my chest at this point too, which I wasn't crazy about, but really just wanted to get rid of the ick because it had been 6+ weeks by then.  I just muddled through this each year because I was healthy otherwise, and switching docs was too much work.

When a shiny new medical center opened near us and I had a bad cold, I took the opportunity to try a new doc and never looked back.  Dr. L is a bit younger than I am, but very methodical.  The office is completely computerized and records from other practices appear like magic once I give consent.  Prescriptions are sent electronically so all I have to do is drive to Target and pick them up.  Test results appear online and I can *email* my doc with questions.  No more X-rays and Dr. L tends to prescribe stronger stuff earlier and also give me FAR more effective OTC options.

But my OB, Dr. A, is freakin' awesome.  She was the 4th doctor I saw after getting sick in Ireland, and the only one who prescribed anything worth a damn.  Literally within a day of taking the medication, I felt BETTER.  I lament all that lost vacation opportunity but I guess it just means we're going back to Ireland again someday. 

In general, she is a great listener, has lots of solutions like getting the right chair to alleviate pain and wearing wrist braces for tendonitis, is straight up about which OTC meds I can take (and isn't in the overly cautious "don't take anything, please suffer for your baby" school of thought), and runs tests to check out any concerns, even if it's a long shot. 

Now for some people this might not work - they don't want lots of blood draws, the tests alarm them, and they don't want prescriptions or OTC meds if they can help it.  But for me?  It's the perfect balance of being proactive without being alarmist. 

At the end of my pregnancy with T, I got an ultrasound to check on her fluid levels, and the doc there told me "this baby needs to be delivered in the NEXT FEW DAYS" and of course this was the one appointment I went to alone. I was only at 37 weeks and came out of there all OMG dude, really??

When I went back to see Dr. A the next day (after freaking out that I couldn't get a same-day appointment), she was very reassuring, and said, that yes, T was running low on fluid and it wasn't an ideal situation, but really, she only needed to come out within the next week and here, let's schedule a time that works for everyone.  *SO* much better for frazzled first-time parents.

Dr. A did a bang-up job on that C-section.  I was able to walk up and down stairs and carry the baby 2 days after the surgery, and by 3 weeks, was feeling great.  Or, as great as one can feel with broken sleep, anyway.

So I've got my fingers crossed that Baby X' will hang in there until our scheduled appointment with Dr. A.

What about you?  Got any techniques to find a great doctor?  I'd love to hear them!

9 comments:

  1. I have found THE best doctor but she's not for me. mike and the kids have Dr L and she is absolutely freaking fantastic! Can she be my doctor? Apparently not. I COULD have had her as my doctor when I was pregnant with the twins and on Medicaid. Now, I'm happily married, insured and I can't join the program. She is a wonderful doctor, a mother with 4 kids so she's down with the mommy thing. She's even said that she would love to be my doctor. Uuuurrgghhh!! This country pisses me off with the insurance crap!

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  2. I have to say that I've been very happy at (wait for it) Group Health. The whole family has the same doctor, which gives me a cool "big picture" vibe. Dr. D isn't an alarmist and totally gives me scientist props (the only reason she let us get allergy testing for the 18-month-old Charlie was that she knew I had data she could trust). The billing is not a worry and appointments are a breeze. Now we're rearranging our insurance coverage so we can keep her. We just lucked out, though - I picked her from the brochure almos at random.

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    1. That's cool that you'll be able to keep her! I've actually heard pretty good things about Group Health. If they still had their Redmond medical center it would be more of a contender for us but the closest one is downtown Bellevue, I think, now. And that would mean changing EVERYTHING, though who knows what insurance changes are coming for MS in 2013?

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  3. I like a doctor who doesn't just prescribe medicine as a cure for symptoms but looks more holistically for the cause of the issue and gives me suggestions about lifestyle changes to avoid future illness/pain. I have a DO who is great and I love my OB. Non-alarmist is key.

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    1. I'm curious about the difference between a DO and an ND? We have lots of NDs around here (crunchy Seattle) but I haven't tried one yet as we've been reasonably successful with our MD choices. But I'm definitely open to it after figuring out HOW MUCH what I eat plays into how I feel.

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  4. You know I love reading about a world I know nothing about. I never would have imagined all that goes into having kids. You're awesome for doing this.

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    1. Lol, I'm sure we overcomplicate it but since we only have 1 we can spend the time ;)

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  5. I try to check out a doctor's credentials/reviews on healthgrades.com or some other similar website. It's not foolproof as reviews are sparse but I have checked out reviews of my current doctors and most reviews are spot-on. It also has hospital ratings so that helps.

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    1. O&G - interesting that you find those review sites useful. I mostly find that they have No info in my area, or it's not terribly useful and they want me to pay to get the details. We have a pretty good referral network at work, so I can use that since I live close to my work as do a lot of people here. But even then, what works for one person isn't often the same for me.

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