Monday, February 13, 2017

Finding Dr. Right

(Sneaking in a post or two today before another lengthy hiatus)                  

When good ankles meet bad mosquitoes.  
My ankle doesn’t hurt today.  I even ran on it—not very long but who’s counting—and it didn’t hurt.  That’s how ankles should be but my left ankle (lankle) has hurt off and on since last May.  I tried to rest it and did exercises the Internet suggested to build strength.  Yet there were increasingly more nights when I’d wake up to feel it throbbing.  Finally, after seven months—that’s six months after the Internet said I should see a doctor—I saw a doctor.  She examined it, suggested exercises different from what I’d been doing, and lankle has been improving ever since. 

I felt dumb that lankle languished for so long when its fixes were so simple.  But I dragged my feet to see a doctor because I didn't have one set up.  I moved to Indianapolis last October and began the process of building a social world from scratch.  By my first weekend, I had a go-to bakery.  Finding a doctor, like finding friends and a soulmate, was much harder.  

As a health services researcher, I know the importance of having a ‘usual source of care’—a doctor I know who I can go to when things go wrong.  I have even uttered those words in a radio interview*.  Yet I actually hadn’t had a go-to doctor in almost ten years.  Just as millennials** are forgoing relationships for hookups, I didn’t see a need for a primary care physician so long as I kept up with my preventive care like vaccines and screenings.  Finding a doctor seemed like too much work; I just used student health services as needed.  But I was no longer a student (finally).  And with all my friends getting married and starting families, it was time to settle down with a doctor.

I was lucky not to start completely blind.  In fact, how to help patients find doctors was a conversation I’d had many times with my mentor Albert at Hopkins.  I knew the best first step was to first ask around.  Still, the whole process felt daunting and a little embarrassing.  Just as I often felt like the only single person in Indianapolis, it felt like everyone else already had their doctors.  It didn't help that I knew very few people in Indianapolis.  A colleague suggested I try a different type of word of mouth— the Indianapolis Monthly’s “Top Doctors List.”  The magazine rankings opened up a broader pool for me and lent some degree of validity.  Unfortunately, top doctors tended to be very popular and most were not taking new patients. 

Exasperated, I tried my insurance company's “Find a Doctor” tool.  It allowed me to filter my search by physicians taking on new patients.  Like OKCupid, it was free and online.  It was also clunky and overwhelmed me with too many options.  I wasn’t sure how to distinguish one name from another.  Finally, I realized I needed to set parameters to make the search sane.  Your parameters may be different than mine.  Asking around helped me establish what was important: distance, physician sex, age, and communication style.  I wanted clinics closest to either my apartment or office to make going to the doctor as easy as possible.  As a researcher, having a younger doctor was important because research suggests that younger, female doctors tend to be more up to date on evidence practice guidelines.  I also wanted a doctor who was comfortable with electronic communication (being a millennial and all).  Finally, a younger doctor meant someone I could possible "grow old with" and not leave me for retirement in a few years.

Of course, through all this, I also googled.  It was hard to find any meaningful information through googling.  I knew from prior research that very few physicians have reviews, and that reviews tell incomplete pictures, yet they were still my best estimates of what other patients think of these doctors and I wanted a nice one.  Despite all of this research, a large part of the experience still came down to luck and time.  I controlled what I could, but ultimately needed to take the plunge to actually see my doctor.  It wasn't always fun but in the end, finding Dr. Right was a decision and a gamble-- one that paid off and took away my pain.  Now that I’ve done this once with relative success, I won’t wait as long to see a doctor next time.

If you're ever in need, resources to consider when you look for a doctor:
  • Friends and family
  • Other trusted source
  • Yelp and other review sites, but only to a point. Know that most physicians don’t have many reviews and reviewers are very subjective. I like sites with text reviews, like Yelp and Vitals, over ones that are just stars, because they tell you how people came to their conclusions.Know what you need/want:            
Know what you want.  Consider asking:
  • Do you want an older or younger doctor? What matters to you?
  • How easy is it to see this doctor? Is that something that you care about? Do you prefer a large or small practice?
  • How do you want the doctor to communicate with you? How does this doctor respond to your questions?
*This was a humble brag.  Sometimes I worry I’m too subtle about my achievements.
**By some generous definitions, I count as a millennial.  Really.  I do.  

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