Picking a PCP – for the squeamish
At every annual checkup, in front of the vet’s office, my 70-pound shepherd mutt, Rosie, hams a scene for the Oscars. Collapsing dramatically on the concrete. I tug; she wails. I pull; she howls like she’d glimpsed an afterlife without liver bits, belly scratches, squirrels.
But I’m her. I hate going to doctors. Last year, I got my blood pressure almost down – there they went lowering the cutoff again.
Having the right primary care physician helps. How do you begin?
Within insurance network
Recommendations from your neighbors, yoga instructor or dentist are good starts. But don’t start with an out-of-network provider, not unless you absolutely need a second opinion from an expert – the only one of two in the U.S. who can explain why your family has odd-numbered toes.
My friend had a small practice on the west side of town for 10 years. Within a year of joining a bigger hospital on the east side, she was on a “best doctors” list. She and I used to laugh how she’d gotten “smart” overnight.
Are the doctors on those lists good? You bet. But they aren’t the only good doctors around. Or the only ones good for you.
Reading resumes and patient evaluations helps little. An impressive resume reflects more IQ (intelligence quotient) than EQ (emotional quotient). Patient comments, skewed to the rant-and-rave or doctor’s sociability, are subjective and too few to be meaningful.
In my old practice, I often sought the help of a colleague, who, like a seasoned cheese, was a bit of an acquired taste. But I trusted his crusty, honest answers.
Less is more
Not every bad headache is a brain tumor. But it requires good, old-fashioned history taking, a physical exam, clinical experience – and steely nerves – for doctors not to test and test and test.
Doctors who cast a wide net of tests and treatments are not necessarily doing what’s best for their patients. A friend’s relatively healthy, 87-year-old father tired easily. She took him for evaluation. He took a stress test and an echo test, got two stents and bled out.
Now he lives by a pillbox – and still tires easily. My friend thinks doctors saved her dad’s life. I wonder.
So, don’t be alarmed or disappointed if you’re told that nothing needs to be done – yet. Or told how to “live with it” when you’re looking for a cure or relief. While we’ve mapped out the entire human genome, cloned sheep, grown bladders on petri dishes, we have no cure for the common cold – or aging.
In the office
I value doctors who listen. (Or convincingly appear to, like my husband and Rosie.)
Their questioning follows a thread, anticipatory. Then they explain why they suspect A, maybe B and C. “If I were you,” they say, “I’d try X then Y, or let’s wait and see.” They answer “silly” questions. You leave feeling “listened to.” Even without a definitive diagnosis, you understand your options. When to call back.
Trust your gut. Because in life, there are two people you can’t lie to: your priest and your primary care doctor.