How Do You Choose Your Doctor/Does Med School and Fellowship Program Matter

Parent Cafe Health & Wellness
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Like many other professions.

You won’t use the same criteria evaluating a lawyer to do your wills and a simple trust as you would finding a lawyer to help if you are being indicted for insider trading, or for a “simple” slip and fall which has left you impaired for life.

It’s not “elitism” to look for a lawyer who clerked for a federal judge (extra points for appellate experience or SCOTUS) and has multiple bar admissions and either white shoe law firm or has been an AUSA if you are facing a federal charge. Which usually means T-14 law school, law review, order of the coif, or similar. It’s just practicality- insider trading is complex, and finding someone who is fantastic at doing contracts for strip mall tenants may not end up with the outcome you want.

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Stressful jobs It’d bug me too. Fortunately I didn’t see that.

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Not my Anthem Blue Cross. The Dr did mention Medicare but that’s not me yet. And not sure how/why but they would cover 5.

I’m glad I did what I did so in the end, that’s most important.

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Fat shaming. I get it but it’s what it is. Perhaps these folks are overweight due to medical.

Not being critical. I might be the same and with sloppy as the next post says.

But in a world where we talk about focusing on appearances is so wrong, well…..

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My current GYN is about 20 lbs overweight (I’d estimate) and I have no trouble listening to her discuss nutrition with me. In fact, hearing it from someone who clearly struggles with weight like I do is a lot more productive than being lectured by someone who looks like Christie Brinkley. Genetics? GLP-1? works out 2 hours a day and 800 calories a day except on her birthday when she gets a mint milano as a treat? Recovered anorexic who struggles to maintain her weight because when she was hospitalized she weighed 80 lbs and her hair fell out?

Smoking is a different issue…. I get it. But there are fat doctors out there who understand how tough it is to live in the modern world and maintain a healthy diet. And I have no trouble with them treating me.

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My husband’s oncologist trained at a top medical school and practices at one of the top 5 cancer hospitals. He’s also teaches at Harvard Medical School. He’s a very bright man, but has the bedside manner of a dead mouse. My husband asked him a question and the doctor’s response was, “Hey–I didn’t give you cancer!” Luckily, the nurse practitioner who worked with this doctor was an amazing and caring individual. I think it’s important to find a PCP with whom you connect. If you’re healthy and see the PCP once a year, it’s probably less important but if you have a condition where you need to see the doctor often, I think the doctor’s bedside manner is important. When my husband was being referred to hospice, this doctor turned to me and said—”hospice will also send you a cleaning lady.” WHAT??? That isn’t the case but who says something like that???

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I don’t want to be critical of a doctor based upon appearances. However, if a dermatologist who is going to be cutting off a piece of my skin doesn’t look immaculate and tidy, I don’t feel comfortable that he will do it in the most sanitary way.

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I think this is very individual. The neurologist who treated my parents with Alzheimer’s had zero bedside manner- and we saw him frequently (less so at the end of course- but in early stages very regularly). But he was on the faculty at a premier medical school, had taught a generation of neurologists doing cutting edge research, and had access to every conceivable clinical trial in the country. We didn’t need tea and sympathy– we needed to see if there was anything that could slow the progression. The day Aricept was approved he was on the phone to me; a few months before Namenda was approved he was on the phone to explain what it did and did not do and what we could and could not expect. He used medical terminology (fortunately I was in my office so could google the terms as fast as he spit them out).

He wasn’t kind or a good listener or someone who’d pat your back on the way out of his office with a “tough break” look on his face. He was just a highly knowledgeable and well connected specialist with a national reputation who pulled no punches and used no euphemisms.

Not for everyone for sure. But as I watch friends going through this now with a parent, and hear (I admit it’s second hand) what their doctors are telling them– I’m glad we went down the path we did. None of the approved drugs are panaceas; early diagnosis helps slow the progression if you get early intervention but the jump from moderate to however you want to define “end stage” is traumatic for every family; telling a patients family “Oh, don’t worry, the time when dad won’t recognize you is really far off” isn’t helpful (or even truthful in many cases).

I had my therapist for bedside manner.

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Typically I start with recommendations from medical professional too. And if I don’t know any in the area, I will call the nurse’s station at the hospital. We’ve been fortunate that I’ve worked in health care and seem to usually have a physician or two in my friend circle as well as nurses and other health care providers.

My orthopedic surgeon for my rotator cuff repair was recommended to me by a close family friend who is a physical therapist. The doc specialized in elbow and shoulders only. I ended up getting bumped because he had to do the repair for the Falcon’s starting QB. I just looked up the MD now and he went to a no name state school for undergrad and a “non prestigious” med school. But he did his subsequent training at the Cleveland Clinic. At the time I didn’t do any digging on his education at all, just read reviews, and went on my friend’s recommendation. Figured if he was good enough to be repairing shoulders of professional athletes, I’d be in good hands :wink: Bedside manner left much to be desired though but I didn’t really care about that in a surgeon as the interaction was basically one and done.

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Like most, it depends on a host of factors, though nobody from JHU is going to be located in my little town. We also don’t have much choice, if any, where to go if you want to stay in town. And generally, if you need anything important, you go out of town.

I like(d) my ob-gyn. but she is so hard to see. Appointments are made 1 year in advance, and if you have to change it; it gets pushed out 6 months. And 2/3 of the time she needed to reschedule and then soon you’re looking at 2-3 years between appointments. So I switched to a NP if the office. I love her. She takes my concerns seriously and will do any test to make me feel better. She didn’t go to a school that I’ve heard of.

For colonoscopies, we go out of town. The one place in town is definitely not recommended. H asked the scheduling person who they would have work on their mom, and that is how we got our doctor. I really like him though I don’t know where he went to school.

H’s cancer doctor is at Wake Forest. I looked up where she went, but it didn’t ring any bells. But we LOVE her. We love how calming she is to us, but at the same time explains everything at a level that we can understand. Not too dumb, not too scientific. Shes a gazillion times better than the local oncologist who we first saw that wouldn’t answer any questions, mumbled and basically told him to drink green tea and read a book.

For my knee meniscus surgery, definitely didn’t want that in town. My PT recommended the place out of town. I looked up doctors and chose one that was an Ironman triathlete. I am/was a serious runner and wanted someone who understood that. His school is very recognizable though I don’t even know what T14 is in med schools. It might make it. I loved him and he also did H’s hip. His bedside manner is Very matter of fact, no chit chat, but very efficient. But he’s very big in getting you doing everything you used to and want to do. That is what we needed in that circumstance.

When older S was born, we had one practice with 3 pediatricians. One was elderly and part time. He was the best, but impossible to get a sick visit appointment with. One made major misdiagnoses that I knew of, was very goofy and creepy and would hit on the moms with big boobs. When younger S was 1 week old and admitted to the hospital for RSV, he was on call. He told me “your baby is sick, but I’ve seen sicker” and walked out the door. That was it. Nothing else. The new pediatrician who I liked came on duty the next day and told me everything.

But the final guy… I don’t care where he went to school, he had the WORST bedside manner. He thought everyone in the town was beneath him. First time S was sick his office told me to bring him in. All the doctor did was curse me out, telling me how stupid and what an idiot I was for bringing this baby in. 50 year old me would give him a piece of my mind back, but I was a scared 25 year old and in tears. If he was the on call doctor, he either would not return your calls or curse you out on the phone for being stupid to call. So yes, bedside manner DOES matter. I loathe this guy. Ironically, a few years ago he would come into the gym. He was in his 80s by then. You could tell he recognized me and wanted to talk. No freaking way. I don’t think I could have stopped myself from cussing him out and being mean to an elderly person just isn’t right. God he was awful though.

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There are good doctors with terrible bedside manners. Bad doctors with good bedside manners and everything in between.

Getting into medical school is about how you did on your MCATs and organic chemistry, not about your personality. There is a component of interviews but test scores are an important part as they should be. There is a lot of information that physicians need to have.

As far as the comments about cardiologists, I get walking the walk and talking the talk so to speak. But we don’t need our OB

GYN to have had a baby. Or our oncologist to have had cancer. I wonder why someone’s personal appearance is important for their specialty.

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This is because there is national shortage of Ob/Gyns. And few Ob/GYNs want to train or practice in states where legislation limits their abilities to treat patients. These limitations are not just about abortion care either.

D2 is doubled boarded in ob/gyn and addiction medicine. She oversees clinics in 4 states that treat pregnant individuals with substance abuse disorders. There is one state that automatically and involuntarily drug tests anyone who delivers a child in a medical facility within the entire state. If the mother tests positive for opiates, benzos, meth, marijuana or any other drugs that are frequently abused, the state social services will take away her child(ren). This true even if the mother is in a treatment program and tests positive for maintenance drug like naltrexone, methadone or buprenorphine. D advise patients in that state to cross the state line to a different state to deliver their baby there. (She has an admitting agreement with hospital in a less oppressive state closest to restrictive state.)

She does not see patients at the clinic in that state in person ever (she manages her patients via telemedicine ) because there is a possibility she will be arrested for enabling child abuse by prescribing maintenance drugs to a pregnant individual.

Late edit:

The other reason is that smaller hospitals have been closing their OB delivery wards in record numbers because keeping them open & staffed is considered too expensive. You can’t be a practicing ob/gyn if your patients have to travel 60 miles to nearest open delivery room.

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My OB had the absolute worst patient rapport (and was a dead ringer for Jerry Lewis in Disorderly Orderly) but was head of the NICU at a Boston area hospital and was actually famous for his C-section procedure as in: I didn’t know I had one, no pain, no recovery, no eventual scar, just walked out of the hospital with my kid the next day like I’d been to the grocery store. I had no idea where he went to school, so I just looked him up-- Wayne State University in Michigan.

When our son was being prepped for an emergency appendectomy, I had no idea where the surgeon went to school (and didn’t care), but when the anesthesiologist showed up in his Michigan surgical cap, I knew he was in good hands. :joy:

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I’ve read this before and I believe it. But… How would the average non-medical person with no nurse friends or relatives go about doing this? If you were to call the OR of your local hospital and ask to speak to the charge nurse I suspect they would be a bit taken aback to be asked by a total stranger to recommend a surgeon. If you’re looking for a primary care doc and have a local clinic with several doctors on staff what nurse would you want to talk with? What are the odds they’d say anything other than “all our doctors are excellent”?

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I have a different take on this. While I’m healthy I’m happy seeing any qualified provider for primary care but nobody lives forever. At some point there may be difficult choices to make and I hope that my PCP will be a trusted and helpful advisor able to use their expertise to help me decide how to proceed.

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There’s a walk-in/Minute Clinic type place near me and the nurses who staff it are usually moonlighting RN’s at one of the big hospitals in the area. You can walk in without an appointment and get a flu shot- I asked the RN “my gastro retired. Do you know someone in town you could recommend”. She answered– “No on doctor X, yes on everyone else, but a BIG YES on doctor Y. Everyone at ABC hospital loves working with him”.

There’s a med spa place near me (crazy combination IMHO) where a friend of mine went with a groupon for a facial. The facialist was not a medical professional (despite the white coat) but the “intake” person who asks about allergies, product sensitivities, medications, blood pressure, was an RN and in fact, was the “supervising medical professional” on staff that day. My friend walked out with an entire list. The RN explained she worked Sundays at the med spa because her hospital moved to a 3 day/12 hour scheduling plan and she and her husband were saving for a down payment on a condo.

There may be a nation-wide nursing shortage, but at least where I live, nurses are always moonlighting in unexpected places. (I don’t think you need to be an RN to administer botox which seems crazy to me, but there needs to be either a physician or RN on the premises).

There’s a new place that just opened that does some crazy IV fluids treatment, vitamin and UV light therapy, even a supervised detox for hangovers. I’ll bet the nurses are lined up to work there- it looks very high end….

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The people who frequent CC tend to generally be well-educated and upper middle class. We tend to be aware of our options and feel enabled to exercise our privilege to walk away from a physician or medical practice that isn’t a good fit.

I just got back from a visit with a family member and his family. While the husband has a college education, he has been in a field far removed from science his entire life. (sales–no offense @tsbna44) His wife barely finished HS and is a hair dresser. The wife has lifelong, congenital medical condition (KTS) and came from a family where no one had ever attended college. She has an inherent distrust of physicians and hospitals because she feels she has not had the best of care. And to be fair, she hasn’t. In part because she doesn’t understand how the medical system works works.

She needs to be seen by cardiologist because she has end stage congestive heart failure, but her healthcare system referred her to a cardiac surgeon after the cardiology fellow who caught her case in the ER and was more-or-less managing her care, although she was an outpatient and not in inpatient (and therefore not really his responsibility), graduated. She didn’t understand there is a difference between a cardiac surgeon and cardiologist. They’re both heart doctors, right? Because the cardiac surgeon only wanted to talk about extreme surgical options (heart transplant) and not the management of her day-to-day care, she stopped going to the doctor.

She is now desperately ill, but in denial because her medical care has been fragmented( at best) and negligent (at worst) and she just doesn’t feel she can trust doctors. She wants to understand her condition and treatment, but right now doesn’t exactly have the cognitive capacity to do so because cognitive issues are part of the condition. The doctors have been less than patient with her because explaining something for the 3rd, 4th or 5th time when they are scheduled to be on to the next patient is not a good use of their time. She feels ignored when they explain once, she doesn’t understand exactly, but then the doctor is gone. Because she doesn’t understand and feels dismissed, she doesn’t follow their recommendations or seek follow up care. It’s a vicious circle.

She’s dying. End stage congestive heart failure is not something you can recover from. Her lips and nail beds are blue because she’s not getting enough oxygen because her heart is not pumping enough blood to fully oxygenate her body. This impairs her thinking. But because the doctors have been brusque and/or impatient and/or in a hurry to get to their next patient, she not willing to accept their recommendations. She’s been referred for palliative care, but has refused it so far because in her mind this means her doctors are giving up on her and condemning her to death.

It’s an ugly problem. I talked with her about palliative care actually is (management of not just the end stage of life, but the management of serious and life-long conditions too.) But she knee-jerk reactive right now so even my suggestion that she should get a flu shot (because the flu could kill her if she catches it…) went nowhere with her. She just shrugged and said if I catch the flu, I’ll just deal with it when it happens. (Her husband, however, listened and got his flu shot before I left.) Right now she would rather take medical advice from a co-worker selling supplements or Tik-tok videos than a medical professional.

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This has been an interesting discussion! I don’t necessarily choose my doctor based on education and medical training, but I definitely consider it.

I recently had to find two new doctors and didn’t have anyone to ask for a reference. The first was because my ophthalmologist suddenly passed away. I had an appointment scheduled for a regular exam. The office called and told me his appointments were being handled by Dr. X. I looked up Dr. X and he wasn’t one of their regular doctors; he had his own practice elsewhere although perhaps under the same group? Anyway, I wanted one of the doctors already practicing out of their office.

Dr. X had done all of his education and internship at University of Oklahoma, and his residency at University of Arkansas. Most of the awards/acievements he listed dated back to college, including Who’s Who Among Students :face_with_raised_eyebrow: He listed one professional affiliation.

I found a female doctor at my regular office who went to Harvard undergrad Magda Cum Laude, medical degree University of Rochester, internship Virginia Mason, residency UC Irvine, and a fellowship at Shiley Eye Institute UCSD. She listed six professional affiliations. It wasn’t really about the colleges per se but about the path she traveled and what her initiative must have been to achieve that.

Plus I like the idea of younger female doctors over middle aged male ones. I really like the idea of supporting them.

So when looking for a podiatrist, husband had found a practice I liked. The male doctor had a very nice pedigree. But there was a younger woman who did undergrad at Cornell and internship and residency at Harvard Medical School. So I made my appointment with her.

I lucked into my first PCP when we moved to San Diego - I knew I wanted someone with UCSD Health. The first three doctors I liked weren’t taking new patients so I went with my fourth choice, who turned out great. Then when she was transferring away, I asked her to recommend a replacement. Love the woman she suggested, whose undergrad was U of Chicago, medical degree UIC, residency U of Washington, and fellowship at Stanford.

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Everyone is in sales. I’m not offended. We all sell something - confidence, belief, knowledge, etc.

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I’m so sorry about your relative. These situations are so hard and heartbreaking to see. And you know she could be more comfortable but isn’t seeking the help she could use.

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