Finding good doctors

Curious about how people here go about finding good doctors, particularly specialists.

I am looking for a new allergist. I have only seen one in my life; went to him four times, but overall it was just not a good experience and I don't really want to go back. (My main issues are that he never EVER remembered who I was or my medical history, and he refused to fill prescriptions that I had had for years, saying I didn't need them.)

I posted online asking for recommendations, and got two so far. One is for a doctor in the same practice as the one I don't like, which I think might be awkward (although I'm not sure how much two doctors in the same office actually communicate, or if they just essentially share rent and staff). Another was in an area that's harder to get to. I looked up online reviews and reviews for the doctor who practices with my current one are excellent; reviews for the other guy not so much. I don't know how reliable online reviews are, though.

I am lucky so far that most doctors I get referred to are excellent. I have only twice in my life switched doctors due to not liking one (this will be my third time) and it is always been totally worth it. One doctor I switched to came from a recommendation from a friend, and the other I got just by chance. With the, er ... *counts* eight (!) doctors I see, I think that's pretty good luck.

Curious what strategies you all here use, and how much you are willing to put up with before switching. (I have gotten a LOT less tolerant and a lot more willing to switch over the past few years, although as I said, this will only be my third switch in my lifetime.)

I'm pretty intolerant, but it depends on what I am expecting. I live in a small rural town with not a lot of choice of doctors, and I know negative things about most of them! But I wanted a local doctor though I go to the next nearest town about an hour away for specialists. I had a PCP here that was pretty wishy washy, but he wrote my prescriptions and didn't bother me or question me so I was ok with that. On the other hand I started with a new cardiologist with a good reputation and the second and third time I saw him he started with the same routine general questions that weren't specific to my case. In their practice patients usually alternate with him and his PA. The PA is smart, personable and started out our meeting asking me about my latest med situation. So I just see him exclusively. In that practice they confer with each other so that I know if needed I have the benefit of the actual cardiologist's advanced knowledge.

One thing I've done in the past is "interview doctors". It's something I always advise my psyc clients to do and I also think it's useful for medical doctors. Mainly I ask them how they feel about me bringing information I've learned to discuss and in general how they feel about knowledgeable informed patients. I even once asked to speak briefly on the phone with the doctor before I made an appointment. But since my d diagnosis my whole approach is different, wanting a doctor that will write my scrips and lab slips and otherwise leave me alone. My specialists (cardiologist gastroenterologist and ophthamologist (sp?) are a different story.

Just by chance my current mediocre doctor left and I planned to just start with the new doctor at the same clinic. But I needed to see someone and the new doc was out so I saw a PA who I've heard good things about. I really like him! He is so much more intelligent than my doctor. He right away said he only had 3 type 1 patients and that I knew more about my own T 1 management than he did. When I got a 5.9 A1C I laughingly said he was a rare doctor that didn't lecture that it was too low! He responded that he is concerned about lows of course but that he trusts me enough to know that IF I got the A1C at the cost of too many lows I would do something about it! Cool.

So yeah my recommendation is to read the reviews - I think they do matter if there are several with a similar trend. Then if you have significant choice I would either do the phone thing or just go to a first interview prepared to ask questions about what matters to you in care and if he/she doesn't seem a good fit, to try the next one on the list!


Here there is somewhat of a choice, but ... most of the allergists get terrible reviews, and same thing when I ask people who I know have allergies if they can recommend any. The paediatric allergists all get great reviews, but the adult ones are terrible.

The only one I could find with generally positive reviews (and also two recommendations from people) was this doctor who shares and office with the one I don't want to see. I may try explaining to whoever refers me (may be my GP or my gastroenterologist) why I really don't want to see the other one and see if he can put a note.

It's too bad, because personality-wise I don't have a problem with the doctor I've seen, really. It's just that he ALWAYS forgets my history. He asks if I'm still avoiding potatoes (if he even remembers at all) even though I told him at the very first appointment that I have bad allergic reactions to tiny amounts and haven't eaten them since I was very young. I got the impression he didn't believe that my allergy was that bad, and did a skin prick test to "confirm" that I had it, even commenting on the size of the reaction. Then a few appointments later he refused to fill a prescription for an epi-pen that I requested, saying I didn't need one (even though I've had one prescribed since I was a kid). These aren't huge things (I just went to my GP and got the prescription I needed), and granted, I didn't go to him about my food allergy, but given that he can't remember me or my medical history, I am not comfortable with him directing something like allergy shots that can have big consequences if they are messed up.

In the back of my head I keep thinking maybe I should give him another try, but if I still don't like him four appointments in, I doubt that is going to change. I just hope making an appointment with another doctor in the same office wouldn't be too weird.

I have been very lucky to have an amazing primary care doctor who I respect and admire. I have been seeing her for almost 5 years. The only problem is hers is a boutique practice limited to 300 patients and that comes at a huge cost to me. So this year I am going to switch to a non boutique practice with a primary care internist who also happens to be an endocrinologist. Since I have become a lot more confident in my own ability to treat myself and really just need a doctor for prescriptions now and then, I am more particular about finding a doctor who actually listens and treats me as a teammate. My endo knows how to play the game and how to write my clinic notes so the insurance company still allows 12 strips a day and pretty much anything else I need to take care of myself. The way the US system of healthcare is set up, one needs an ally more than a doctor especially when it comes to treating PWD.

I agree about needing an ally or an advocate, Clare. I just saw my new PA and told him that I just started Medicare and they are denying my usual amount of strips. He asked me a few questions, designed to give them the info needed not to challenge me on my needs), then told me not to worry about it, the pharmacy will be referred back to him if it's declined and he will approve it.

Jen, that is exactly what I experienced with the cardiologist and since my arrhythmia progresses and I've been tried on a huge list of meds already, I wanted someone who wasn't going to start at square one every appointment. My guess is you won't like him any better. It might be awkward if you run into him in the office, but it's important to have someone who is a "good fit" (nice neutral phrase). Also at the cardiologists office I had a negative experience with a male tech who did my nuclear stress test. I just spoke with Aaron and he said he would schedule it for me with a woman who would be more considerate. I couldn't remember the names, so just said when I called for my appointment, "Aaron wants me to meet with a female tech". They must think it odd that I'm concerned about gender when it comes to taking pics of my But again, Aaron is in a position to advocate for my needs.

I came across my GP by chance about five years ago and I continue to see him even though I have moved across the city and have to travel for over an hour to get there. I was impressed at my last appointment when he asked what I thought of one of the specialists he had referred me to. Good to know that he is actually interested in connecting his patients with specialists who work for them.

I am willing to work with doctors—I accept that they do know more than I do about many diseases, and for me my medical history is far more than "just" diabetes—but I also want a doctor who I can ask questions and have them not get defensive or dumb down answers. I also need a doctor who is going to respect if I ask for (or against) a treatment and not keep refusing or pushing for it, and one who is actually going to listen to my symptoms and take me seriously. I left my old GP mostly because for years he continuously brushed off any symptoms I would go in with as nothing. I finally had an image of me going in complaining about thirst and peeing all the time and weight loss and him telling me to come back if it was still bothering me in a month—which I could totally picture him doing! As we all know, for diabetes that could equal DKA. Often I leave symptoms for weeks or months to see if they go away, and will only bring symptoms up with a doctor when they are really worrying me or interfering with my daily life.

An advocate, I totally agree! I need a doctor who is going to work with me. I've been doing a lot of research online and I found a few allergists who are associated with a hospital here, appear to be involved in clinical research, and teach at a local university. And at least one appears to be involved in the condition I just found out I have have (eosinophilic esophagitis), which is relatively rare. I'm thinking of going with one of them, even though they didn't get the best reviews on the review sites. My ophthalmologist is a professor and involved in clinical research and I like that because I know they are keeping on top of new developments, are interested in continuing to learn, etc. I think some doctors just get set in their ways and treat everyone the same. The allergist I've been seeing just recommends allergy shots every time. All four appointments have literally almost been carbon copies of each other.

Sounds like some good possibilities!

I wonder if you have checked the online reviews. I don't know how accurate they will be but may give some idea. I don't belong to Angie's list but that may be another source.
Do you know other allergy persons whose advice you would trust about their docs?

In my city, patients can not switch drs within the same practice. I don't know if your city or practices are that way or not. It makes it awkward and could also be awkward to switch. I tried another dermatologist because the one I was with for many years was not looking beyond the common treatments for me. I am not sure how I feel about the new one yet but he at least is suggesting more drastic treatments. Which is another more difficult decision!

Anyway, another source I use is NPs in a practice. The good nurses usually know the reputations of others in their community and can give recommendations. I have been successful with that on occasion.

I've asked others with allergies and most of them say their doctors are terrible, or they're not satisfied, or they have similar stories to mine. LOL. Part of my problem is that I know lots of people with seasonal allergies who might see an allergist once or twice in their life, but I don't know many who are seeing one on an ongoing basis. Given how many allergy issues I have (and they only seem to be increasing), I would like an allergist who I am comfortable going to on a regular basis for potentially years.

So far, for some reason, none of the doctors I have seen have ever had nurses or assistants. Actually, my cardiologist does have an assistant, but all they do is an ECG and other tests before seeing the doctor. I don't know what kind of qualifications they have.

The more I've thought about it, the more I'm not really comfortable going to another doctor at the same office, whether it's allowed or not. I just think it would be awkward ... I saw an endocrinologist for 13 years who wasn't that great, and I really wanted to ask if I could see the other endocrinologist at the same office, but never did. (I've since switched to a new endocrinologist since I moved.) I found some allergists associated with hospitals, and from my experience the doctors associated with hospitals seem to be more on top of their game ... I care most about doctors who know their stuff and have a pleasant bedside manner. I don't care about things like waiting time (which most people seem to freak out about) or travel distance.

I'll probably get a referral to an allergist in the new year, so I have some weeks to make up my mind.

I'm curious, for those who "interview" doctors, do you do it over the phone or at the first appointment? And do you actually tell the doctors what you are doing? I imagine some of them would get defensive about it, but maybe those are the ones you want to avoid ...

Yep, I think how doctors respond to my intention to interview them is definitely revealing. I think that it it possible to interview doctors without it being hostile or threatening, in effect stating "I want to see if you are the right doctor for me" or "I want to see if this is a good fit".

I have never known a dr who would have time to be interviewed over the phone. Maybe you do.
I try to do that in the first visit. I just space out a few questions to try to find out his/her approach to management of the condition. I can usually tell whether they will work with me by whether they talk with me (a conversation) or just ask questions of me. I also note how the staff responds to the dr. Is there respect shown? Too much deference? Rigidity in procedures, etc.? Are the staff friendly? Reserved? More business-like than I prefer?
If it seems appropriate, with some of the early intake staff, I might ask "say, which one is your favorite dr here?" Even how they answer, not whether they answer, tells me something.

I can't always tell at the first visit but usually can. I then decide if I can live with any concern or not. I like my endo and internist but am not as satisfied with my Dermatologist but not enough to change at this point.

Even though I have a lot of health issues, you have much more complex issues than I so I do understand your need for a "good fit" with all your specialists. I wish you luck with the search.
Oh, and I totally agree with your assessment that the odds are better, though still not perfect, if you choose an allergist affiliated with a hospital but more especially if they are faculty in a med school or appropriate school for their specialty.

Jen, you may recall I posted about my search for a new endo. I think I had some of the same concerns as you did. I was particularly concerned at the time to not cause my previous endo to start a war against me. Dr's talk, you have records exchanged. If a Dr labels you as a pain, non-compliant, etc, you may have difficulty finding a new Dr. So I would encourage you to not burn bridges even if you think this guy has not given you the best care.

If you do consider switching within a practice, you may have difficulty as many practices don't allow you to switch between Drs. They may want to avoid competition and poaching of patients. They may want to discourage you from "shopping" a diagnosis. Whatever. Many practices have written policies against this, it would be good to understand what you are up against before trying to change within a practice.

ps. And what I discovered is that sometimes a Dr can be the worlds best specialist and still be a lousy Dr.

I've had both extremely bad luck with doctors and extremely good luck with doctors, and I rarely have lukewarm feelings about them.

For the most part, I trust friend's recommendations, which has only once served me wrong. When no one knows anyone good, I ask current doctors for recommendations. I've also had maybe one or two bad experiences there, despite the number of doctors I've seen.

The problem with online reviews is that people only post when they have exceedingly bad experiences or exceedingly good experiences, so it filters out the rest. (And generally people complain more than they praise, so everything does need to be taken with a grain of salt.)

The weird thing is, a doctor should remember someone with a history like yours. At the very least, this stuff should be in your chart and he should review your chart before you see him.

I do think it would be weird to see a doctor in the same practice. My experience is that doctors in the same practice do communicate with each-other, especially about difficult or rare cases.

If I were you, I'd bring it up with your PCP and see what he/she says.