How to choose a doctor within the new Affordable Care Act

Don't just choose a doctor who's nearby. Credit: Metro File
Don’t just choose a doctor who’s nearby.
Credit: Metro file photo

Every week, Archelle Georgiou, MD, Strategic Advisor at Healthgrades, will explain one facet of the Affordable Care Act.

 

The Affordable Care Act mandates that the new Health Insurance Marketplace include information on each health plan’s in-network providers so that consumers can preview the doctors and hospitals they’ll have access to before selecting a plan.

However, the mere listing of nearby providers is not sufficient to make a smart choice about who will be best able to care for you and your family.

What information do you need to make a good decision? Use these five P’s as a guide to selecting the right health care providers for your needs:

Professional. Select only doctors who are board certified. All physicians have an MD, but board certification is the way to be sure a doctor has reached a certain competence level in his specialization.

Practice. Find doctors whose clinical focus within their specialties matches your needs. For example, a woman with hot flashes needs an OB/GYN whose specialty is treating menopause, rather than one who focuses on delivering babies.

Procedure. The number of procedures a doctor has done correlates with results. This is especially important if you need specialty care. Having your colonoscopy done by gastroenterologist who does 500 procedures per year is preferable to having it done by someone who does 50.

Performance. Review doctors’ malpractice history and look for any disciplinary actions from their state’s medical board.

Personal. Look at statistics on other patients’ experiences with how well the doctor communicates and the office staff’s interactions with patients.

You can easily get this information, for free, on several online ratings sites such as HealthGrades.com, which just released new research by Harris Interactive that found consumers who have selected a physician in the past three years are more concerned about convenient location and friendly office staff than success rates.

Don’t fall into the trap of selecting your doctors based on how close they are to your home or how easy it is to get an appointment. It’s not about convenience; it’s about your health.


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