Finding And Evaluating A Doctor

To insure that your loved one receives proper medical care, you must first find a doctor that you both feel comfortable with.

One of the biggest problems for caregivers is the sheer volume of information that exists and how to dig out precisely what is needed. For example, the phone book is full of doctors. But who will best understand the special health care needs of your loved one? Use this checklist to find out:

Note: It may not be possible, but it’s better to look for a doctor before a crisis, while you have the time to make an informed decision.

A good first step is to make a list of the things that matter to your loved one. Decide which are most important and which are nice, but not necessary. Consider the following:

  • Check your loved one’s insurance plan. Is the doctor a participant? If not, can you afford to pay extra for services and treatment not covered?
  • Is the doctor’s office conveniently located?
  • Is he or she affiliated with the hospital of your choice?
  • Would the age and sex of the doctor, and the languages the doctor speaks be a factor in a decision?
  • Is the doctor board certified?

Start with your own personal primary care physician. He or she can help you make medical decisions and oversee the care your loved one gets from specialists.

Look to relatives, friends, coworkers, and health professionals for recommendations. Ask doctors, “If your (mother, father, sister, brother, child or grandparent) had this problem, who would you want to treat them?”

After choosing two or three doctors, call their offices and let them know that you are deciding on a doctor. Make an appointment to meet with each doctor with your loved one. (Note: You may be charged for such a visit).

Ask any questions relevant to your loved one’s condition. Does the doctor:

  • Encourage your loved one to ask questions?
  • Listen to your loved one?
  • Explain things clearly and to your loved one’s satisfaction?
  • Treat your loved one with respect?
  • Take active steps to prevent illness?

Some of our loved ones aren’t as forthcoming with information as they could be. They may think that because they describe their problem to one doctor and he or she knows their history, then all successive doctors will automatically be clued in as well. It’s better to provide too much information to each doctor than not enough.

After the appointment, ask your loved one whether they feel comfortable with and have confidence in this doctor. If he or she was not satisfied, schedule a visit with one of the other doctors on your list.

If you need more help finding names of doctors, contact your local medical society, local physician referral services, nearby medical schools and university medical centers in your area.

How Does The Type Of Insurance Plan Affect Your Choice Of Doctors?

Most people who are 65 or older are eligible for Medicare hospital insurance (Part A). Almost anyone 65 or older also can enroll in Medicare medical insurance (Part B) by paying a monthly fee. Medicare medical insurance helps pay for doctors' services and many other medical services and supplies that are medically necessary but are not covered by the hospital insurance part of Medicare.

Medicare beneficiaries can choose how they will receive doctor, hospital, and other health care services. Many older people use the original fee-for-service health insurance program. Under this program, your loved one may see any doctor or health care provider he or she chooses. Your loved one usually pays Medicare's deductible and coinsurance and any other charges not covered by Medicare. Medicare pays the rest. Your loved one (or you) are responsible for handling bills and payments.

Medicare Managed Plans

More and more older people are choosing Medicare managed care plans. When you enroll your loved one in a managed care plan, you select their doctor from a list of primary care physicians who are part of that plan's network of doctors. Your loved one’s primary care physician then is responsible for coordinating all of their health care needs. If your loved one hasn’t chosen a doctor, he or she will be assigned one.

In some plans, your loved one can see a health care provider outside the network, but it will cost them more money. They may be required to pay a small co-payment for some services and visits. The plan handles bills and payments, not your loved one.

Today, there are many different kinds of managed care plans with varying benefits, costs, and rules. Be sure to compare each plan and consider each type of insurance (fee-for-service and managed care) carefully to make the choice that is right for you and your loved one.

© Copyright FamilyCare America, Inc. All Rights Reserved.

Adapted from Age Page: Choosing a Doctor. Prepared by the National Institute on Aging/National Institutes of Health, U.S. Department of Health and Human Services.

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