How a Doctor Chooses a Doctor

I have to give thanks to Dr. Anonymous and KevinMD for reminding me that I need to choose a physician of my own. Now that I'm over 40, I realize that I have to start taking better care of myself. I've seen too many patients with my profile who suffered premature medical disasters that might have been avoided by regular preventive maintenance.

My warranty is running out already, so I need to head into the shop for a tune-up.

I've gained 25 pounds in the two years since I quit smoking, and my blood pressure is now persistently elevated. I am a sedentary internet addict with poor exercise tolerance. A heart attack waiting to happen. Who knows what my cholesterol is? My blood probably looks like a bacon double cheeseburger smoothie. As I learned from my recent dental fiasco, letting things go for too long can get painful and expensive in a hurry. Getting myself into shape is already going to be difficult, but if I don't start now it's only going to get harder. I'm not waiting for the New Year.

I was going to just prescribe myself a blood pressure pill, but I am afraid of running afoul of the Texas State Board of Medical Examiners, who have been on a vikingesque rampage lately. So I decided to be good and turn my care over to another physician.

That's not so simple for someone like me to do, though. I'm used to making medical decisions, not having them be made for me. Since I've been a doctor, I've been my own doctor. I'm afraid I'm going to be a terrible patient, like the cliche says. It's not going to be easy for me to be passive, but I know from experience that no doctor wants a patient who is overly presumptuous. I guess I will just have to relax, take a deep breath, and surrender control.

I think it's hard for doctors to choose a personal physician. To be honest, there are not many physicians who I would trust enough to follow their recommendations over my own judgement. My standards are high. I've seen too many docs who just get by, floating with the current of mediocrity. Not to mention the bottom-dwellers. Because I know all too well what it's like dealing with on-call physicians who are jerks, I immediately eliminate from consideration any physicians whose partners are incompetent, uncaring, or just plain mean. There are some docs that I would never allow to be involved in my care under any circumstances, and I refuse to be at their mercy after business hours. They are the ones who refuse to admit their partners' patients and incredibly seem to scorn even their own. Often they are as venomous as they are clinically incompetent; certainly a discrace to our profession. Unfortuately, this restriction of mine rules out some of the larger groups entirely thus eliminating some quality physicians from consideration. I think it's worth it.

So obviously I must have some previous experience with the physician I choose; some firsthand knowledge of their practice style. But I cannot be too sociable with them personally. There are a couple of docs I know who are absolutely outstanding physicians, but I am too friendly with them to feel comfortable giving them that power over me. And I wouldn't want to spoil our relationship. That would be awkward. Would you trade a friendship for a good doctor? Can you have both? It seems to me that if you choose as your physician someone who is already a good friend, you lose some friendship from the "friend" part of the relationship, and you also take away some of the respect from the physician-patient relationship. It seems like a lose-lose situation. Besides, the friendship may cloud the judgement of the physician and the medical care is likely to suffer. An impersonal relationship is better, I think.

I ultimately decided on a physician who I once supervised in our residency program. He is a bit older than me, having started his medical career later than most. I always found him to be easygoing and quietly confident. I know for a fact that he is an excellent clinician, because I helped train him. But we are really just casual acquaintances, which is perfect. I hope he's comfortable with the idea of taking me on as a patient.

I'm sure I could have called him and gotten an earlier appointment, but that is just the sort of pushiness I'm trying to avoid. I can wait. Now I've got a couple of weeks to start my diet and exercise program and hopefully avoid antihypertensive medication altogether. I'll keep you posted.