On Choosing a Better Doctor: Improving Your Chances
By Ted Sherwood
Knowledge is invaluable – especially when it comes time to assess the doctors who are caring for your family.
A client’s husband suffered from sleep apnea. He also had a pacemaker. Because the sleep apnea was causing a strain on his heart, he elected to have sinus surgery to correct the problem. The surgery required him to undergo general anesthesia, which is never completely without risk. This procedure also is performed in the airway and often results in excess bleeding.
The patient had a pre-surgery consultation with an anesthesiologist who evaluated the potential risk factors and approved the surgery. On the day of the procedure, the original anesthesiologist was not available and another doctor was called in to administer the anesthetic. This new anesthesiologist had never seen the patient before, indeed, he saw him for the first time when the patient was on the operating table. In the recovery room, the patient had his breathing tube removed prematurely by the anesthesiologist, went into respiratory distress and then “coded”. He was resuscitated, but his brain had been deprived of oxygen too long. He remained in a coma for about six weeks and then died. He was 44 and left behind a wife and daughter.
If the family had known who their doctor was going to be, they would have learned that he had only practiced anesthesiology for six months. Although he was a member of a well-established group and practiced in one of the better hospitals in town, the doctor was not a seasoned physician.
While the outcome of this particular situation was heart-breaking, it illustrates the many variables that go into assuring you a successful outcome in the hospital. Anesthesiologists in particular present a trickier problem because they are scheduled by the hospital. You can carefully research the anesthesiologist you have requested, and then have a different doctor show up on the day of surgery, as happened with my client. At that point, you should not move forward until you ask several important questions. Is the anesthesiologist experienced (ten years or more in practice)? Board Certified? Acceptable to your surgeon? If not, consider what my wife did. The anesthesiologist she had requested did not show up and was replaced by a young lady who announced she “would be doing our anesthesiology today”. My wife asked, “Are you a doctor?” “No, I’m a nurse anesthetist,” she replied. “Next” said my wife. We got a new anesthesiologist.
How can you choose a better doctor to increase your chances of a successful outcome?
- Obtain a list of names from your Internist, family friends, nurses, and others who have had the procedure.
- Choose a doctor who is Board Certified by the American Board of Medical Specialties. Board certification is rigorous and includes both written and oral examination. It also must be renewed every five (5) years. As to surgeons, look for someone who is a Fellow with the American Board of Surgeons.
- You can get background information on Medical Doctors at www.okmedicalboard.org and on Osteopathic Physicians at www.docboard.org. Both websites tell you when the doctor graduated from medical school, specialty, board certification, disciplinary action, hospital privileges, HMO/PPO’s accepted, and whether the doctor is accepting new patients. Neither site gives information about where the doctor completed his/her residency or fellowship.
- Look for a surgeon who specializes in the procedure you are going to have performed. For example, some orthopedic surgeons only do knees or shoulders or backs. Studies have shown that higher surgical volume means less patient mortality. (Birkmeyer U. and others, “Surgeon Volume and Operative Mortality in the United States,” New England Journal of Medicine, 2003; 349(22).)
- But don’t stop there. Interview several doctors. Ask for a copy of the doctor’s Curriculum Vitae or C.V. Look for articles published by the doctor in his specialty or whether the doctor has taught at any medical schools. Run a Google search on the doctor. Lastly, check and see if the doctor has been sued for malpractice at www.oscn.net. You can search by name of defendants in Oklahoma’s eight largest counties. Just because a doctor has been sued for malpractice doesn’t make him unfit, but if a doctor has been sued a number of times there may be a problem. A recent study by Public Citizen of the National Practitioner Databank from 1990 – 2003 showed that 3.6% of all doctors in Oklahoma were responsible for 43.4% of all malpractice payouts to patients.
Doing this research does take a little time and effort. But it’s time and effort well spent if it positively impacts the health of your family.
