Nearly everyone who goes to the doctor has a different goal in mind. For some it’s seeking to deliver a healthy baby on their terms. For others it may be to deal with a crisis, get health screenings or to establish care for an ongoing issue. No matter what the reason, knowing where to begin or how to go about choosing a good physician is difficult. For this discussion, I’m focusing entirely on women’s care but similar things could be said for any specialty.
Many people are involved in women’s healthcare. I am a physician (doctor) but work alongside physician assistants, nurse practitioners and nurse midwives among others. These are sometimes called “advanced practitioners” or “mid-level” providers and all have autonomy, to some degree, to provide primary health care and interactions with patients ranging from doing routine outpatient screenings to delivering babies in hospitals. Like physicians, various levels of training are involved for each and this warrants a further look.
With physicians, Obstetrician-Gynecologists (OB/GYN) and a number of other primary care (family practice, internal medicine, etc.) take part in women’s health. To be an OB/GYN a doctor has to first get a four-year bachelor’s degree from a university and then attend a four-year intense medical school. Most practicing OB/GYN’s go to an MD school but there are some who attend an osteopathic training program and graduate with a DO degree. In either case, they then must attend four years of residency where they get intense training in the specifics of their specialty.
Some go on to “subspecialize” by attending another one to three years of fellowship training. Such doctors end up with specific training in area such as oncology, urogynecology, high-risk pregnancy (MFM or perinatology) and infertility. Through the process of training, they also take a series of written and oral tests to assess their competency. This process is called “board certification,” which is a particular point of pride and sometimes a requirement for them in their future practices. Once board-certified, they may choose to become a member of their parent organization, ACOG (the American College of Obstetrics and Gynecology) and become a fellow carrying the letters FACOG.
I chose to go straight through school as quickly as possible and, in my case, I graduated from residency at age 30 and finished all of my board certifications at age 34. It is a long, drawn out process.
One way to choose a physician is by looking at their credentials and knowing their expertise. For particular problems like infertility or gynecologic cancer, subspecialists may be in order and your general provider can help get you in to see them. Most OB/GYN providers do a variety of surgeries, deliver babies and provide outpatient care, including birth control, health screenings, etc.
Another way, and quite frankly the most common way, that patients find a doctor is by reputation and word of mouth. Ask friends, family and neighbors, particularly those who have a similar situation as you (pregnancy or menopause, for example) and narrow the field this way. Access to care is important, so look for doctors who can see you in a timely way and make the time to know your concerns and address them.
I always enjoy being interviewed by patients. This happened a lot when I first came out of residency and was unknown, but it still occasionally happens. Feel free to call or make an appointment to get to know a physician and how they will approach your particular needs. Be sure you feel comfortable with them. If you don’t, or if at any time you feel like your needs aren’t being met and your doctor isn’t listening or addressing your needs, move on. As a physician, I want to know when my patients have concerns or issues and care that they are having their needs met, so feel free to communicate openly if you have concerns.
Lastly, I have found that many of the online grading services are less effective at picking quality or highly personal care. It is good to look at credentials first, personal referral from those you trust next and to be cautious with online grading. Like everyone else, we providers get trolled and in some cases may even game those very services to improve our reputations. If you have real concerns about someone, a better source would be the state licensure website which will show licensure restrictions or, in some cases, complaints.
I have never met a physician who didn’t want to do good for his or her patients.