By: Dr. Mark Lachs
As we age, we will all need to find a doctor who can provide the right primary care for this new stage of life. I am frequently asked for advice about how to find a primary care doctor for an aging patient: Where do I start? What attributes or qualities should I look for in a physician? Should I look for superb diagnostic skills? Exemplary physical examination skills? Exceptional bedside manners and empathy? It may surprise you, but the answer is, ‘none of the above.’
What To Look For In A Primary Care Physician?
It’s pretty straightforward –you want a doctor who sweats everything: every pill you take, every consultant he sends you to, every test result that comes back, every symptom you experience, no matter how trivial it is. As we age, big and often permanent life-altering problems can arise from neglected medical and social issues. Compounding this is the fact that elderly patients are in a stage of life when it is likely that they are seeing an increasing number of doctors. In the era of managed care, physician/patient loads are ever-increasing which can lead to shortcuts and carelessness, which can lead to medical errors.
Simple Steps to Help You Make Intelligent Choices About Elder Medical Care
Be on the Lookout for Troubling Patterns of Doctoring:
- Talking down: The doctor should not have an assumption of informality and intimacy with a new patient.
- Ignoring the patient: This happens most frequently when a patient is accompanied to the medical visit by someone else. Doctors should talk directly to the patient, make eye contact, and acknowledge them.
- Interrupting: This happens with patients of all ages, but especially oldsters. There’s evidence to suggest that most patients get interrupted by the doctor within the first minute of articulating their “chief complaint.”
- Dismissive of complaints: Physicians increasingly tend to minimize elderly problems and attribute them to just getting old. Your doctor should thoroughly evaluate any complaints before you decide you have to ‘live with it.’
- Quick to refer, test or prescribe: In order to deal with patients that take up too much time, doctors will write a prescription or send them to another doctor to more save time.
Things You Can Do to Ensure the Best Physician-Patient Encounter
Plan your Doctor’s Appointment Accordingly Ahead of Time:
- Articulate your chief complaint: Clearly, state the reasons why you sought out treatment. Even if you can’t tick off specific symptoms, note whatever functional problems you’re having.
- Organize your thoughts before the doctor visit: This is key in understanding the patient’s medical history so an accurate diagnosis can be made.
- Prioritize your complaints: Office visit time is precious – pick your top three complaints.
- List all “interval events”: Mention to the doctor all of the important things that have happened since the last visit, such as infections, hospitalizations, surgeries, as well as life events that can influence health (like loss of a job).
- Bring a list of your medications: This list should be up-to-date and complete, including dosages and frequencies.
- Get a specific follow-up plan: At the end of the visit, you should leave with ‘action items’ that need to be followed up on, such as further testing, doctor referrals, or changes in medication.
- Get the doctor to be transparent: Make sure the patient understands what the doctor is saying before the visit ends – using terminology the patient can comprehend.
And what happens if attempts to follow the guidance above is not fruitful? Unfortunately, it might be time to seek out a new physician. The good news is that there are many excellent, caring, compassionate and attentive primary care physicians.
Mark is the Co-founder, Executive Vice President and Chief Gerontological Officer at CompassCare. He is MD, MPH and Co-Chief of Geriatrics at NY Presbyterian Hospital and a Distinguished Professor of Medicine at Weill Cornell Medical College. Mark is a bestselling author and is internationally recognized as an expert in aging.