<p>I have health insurance with my firm, and so I am trying to figure out who I need to look for regarding health. I have a problem with my intestines (despite a recent trip to the ER) that isn’t going away even after following recommended treatment, a problem with my hand that I need fixed, and I also need a general checkup, I’m assuming.</p>
<p>What kind of doctor should I be seeking out? Do I need separate doctors for all three of these things? </p>
<p>I’m finding doctors on my insurance website that have different specialties – for instance, a PCP who specializes in Internal Medicine and Rheumatology (so I presume he can help me with the checkup + hand problem), but I’m not sure if he could help me with my current intestine issue, etc.</p>
<p>You can go to an Internist for all three problems but if your health problems are stubborn, the internist will refer you to a Gastroenterologist (specialist) for your intestines, a ortho surgeon, neurologist/neurosurgeon, or rheumatology for the hand depending upon what is wrong with it. Broken/cracked bones - ortho, nerve damage (carpal tunnel) rheu,</p>
<p>Can an Internist scan various parts of the body for problems (such as scanning intestines, scanning the hand to see what composes the problem, etc), or is this local to specialists only?</p>
<p>I am just not sure who I need to call/sign up with/etc. I want to get all three of these problems taken care of as quickly/efficiently as possible.</p>
<p>Your best bet is to find a family doctor who can diagnose all your problems and would make referrals to specialists as needed. In many cases, you cannot just call up specialists yourself and make your appointments with them personally, you need to have a referral by your primary care doctor.
Ask your co-workers and friends to recommend a primary physician who is in your insurance network. For your age, you can see either a physician in family practice or internal medicine.
I am glad you took our earlier advice and bought insurance from your employer.</p>
<p>Made an appt with an in-network internist for tomorrow morning at a hospital two blocks from where I live (manager is letting me take half the day off) – would I be able to have problems taken care of immediately or is it more of a diagnostic thing?</p>
<p>Physician here. Medical care today requires a gatekeeper- your primary care doctor. That person should listen to your problems, asking questions to clarify them and then do whatever physical exam is required. Based on the information gathered s/he can then direct you to any specialists that may help and/or order tests. Sometimes seemingly unrelated problems can be the result of one underlying problem, other times they are a collection of unrelated ones. You are best off having one physician who knows of all of your problems instead of fragmenting your care among different specialists yourself. Even physicians need a primary care doctor for insurance companies to pay for care- there has to be a referral from someone else (still have to jump through the hoops although a specialist may be telling their primary care doctor which tests in their specialty are indicated).</p>
<p>Addenda. Any test results and consults by other physicians usually yield information being sent to the referring/primary care doctor. This way you have one medical record that includes information from all of the different sources.</p>
<p>Totally agree with wis75.
PCP who specializes in Internal Medicine and Rheumatology is a good choice. He will refer you to a specialist if needed, but will follow and oversee your care.</p>
<p>Personalities and expectations may differ, yielding different reviews. Pay attention to the nature of the comments and choose according to whether you feel the complaints are important to you. Some will complain about nonmedical issues that may/may not matter to you. Some may have a problem no physician will handle well in the patient’s eyes, or it may not be easily solvable. Like all nonexpert reviews you have to evaluate them yourself.</p>
<p>One other thing is to make sure that your primary doctor knows about any specialist care you are getting, in order to have an overall view of your health and medical treatment. Otherwise, different physicians may not be aware of other medical issues and other physicians’ prescribed treatments, which may lead to conflicting treatment plans or drug interactions.</p>
<p>You’ve got a great start – an appointment tomorrow morning with a doctor of internal medicine who can probably help you sort through the issues and figure out a plan of attack. I wouldn’t bet that all will magically be resolved with one visit, but this seems like a good way to kick it off. I would not jump into appointments with other, more specialized physicians at this point. It will also (probably) be cheaper.</p>
<p>Do read up a bit on your health plan so you know what to expect in the way of cost-sharing.</p>
<p>Your primary physician may refer you to a specialist. Be sure that any information or treatment recommendations from the specialist are reported back to the primary physician so that s/he can have a complete picture.</p>
<p>It’s good to hear from you, legendofmax. Have your dental problems been taken care of? Be sure to mention them to your interntist, as dental issues can affect various parts of the body.</p>
<p>About the reviews, sometimes negative reviews have to do with length of time waiting or attitudes of office staff, rather than the competence or bedside manner of the doctor. You will be know right away whether you will be able to work with this doctor. Go in with a list of issues/questions so that you can be efficient. If this doctor is a good fit (communicates well, listens to you, etc.) then he/she will coordinate your care from now on.</p>
<p>Oh, one more point about health care these days - I have found this year that it can be less expensive to go to an out-of-network provider, because co-pays have gone way up. For any specialist, my co-pay is now $30. A $100 visit to an optometrist costs me $30 in-network and $20 out-of-network (80% coverage of usual-and-customary). So when choosing specialists, do some homework.</p>
<p>Max, you mentioned an expectation of scans to identify exact issues. I find that often doctors don’t order scans of various kinds to start with. Sometimes they want to try cheaper alternatives first if they have a pretty good guess at the diagnosis. And sometimes they are right (physical therapy, for example, sounds… wimpy). But it can be amazingly effective, and might be what your doctor has you do for your hand (for example) if the doctor doesn’t think it is broken (or if they do take an xray, and it isn’t). It does take more visits to a physical therapist, but I have found it worth doing.</p>
<p>Another thing you might want to read up on is your co-pay/deductible structure for your insurance. If you have a certain amount you have to cover for the year before the insurance kicks in, that is incentive to get things taken care of all in one year. So if you reach your deductible through these upcoming visits, keep that in mind later in the year if something is nagging you in the 4th quarter Go then to take care of it, instead of waiting until Jan/Feb and starting your deductible cycle all over again.</p>
<p>The hand’s definitely screwed up (I’ve had an injury on it since fifth grade that’s made it extremely difficult to directly touch anything with an open left hand) and will likely require something more drastic to fix.</p>
<p>When I’ve needed a referral for a specialist, I often ask for more than one name (prefer three if possible). Then I’ll ask someone else (such as one of the office nurses or another medical source) who they would refer a family member to, and see if one of the names the physician suggested is on the list.</p>
<p>It all depends on the experience the PCP has with gastrointestinal issues. Some have more interest and have developed their knowledge base more than others. Some may not have any interest in keeping up with current trends in treating gastrointestinal issues/diagnostic testing, etc. and may prefer to refer out if it’s anything beyond a typical stomachache, etc.</p>
<p>For several years, when I was first diagnosed with GERD, my PCP followed me. He even handled the treatment when I was diagnosed with H. pylori. Then when it escalated and the meds he was prescribing weren’t cutting mustard, he referred me out to a gastroenterologist. She managed my treatment (after choosing to do an endoscopy) for several years, which required an occasional tweaking. Then after five years or so of stabilization, she told me I could go back to my PCP for medication management, which I did. Then when I hit 50 and needed a baseline colonoscopy, he referred me back to her. It was kind of nice because we had a prior working relationship before the morning I showed up for the colonoscopy, and I had complete confidence in her clinical skills, based on past history. So it’s kind of been a back and forth, depending on how comfortable my PCP is with whatever I need. </p>
<p>Sometimes you get referred to a specialist, and they are able, through an initial consultation and maybe one or two follow up visits get things stabilized. Then they might refer you back to your PCP if it’s just a matter of medication management appointments. It’s kind of a fluid process.</p>
Go then to take care of it, instead of waiting until Jan/Feb and starting your deductible cycle all over again.</p>