Talking with your doctor: a guide for older people

The first step in good communication is finding a doctor with whom you can talk. Having a main doctor (often called your primary doctor) is one of the best ways to ensure your good health. This doctor knows you and what your health normally is like. He or she can help you make medical decisions that suit your values and daily habits and can keep in touch with other medical specialists and health care providers you may need. If you don't have a primary doctor or are not at ease with the doctor you currently see, now may be the time to find a new doctor. The suggestions below can help you find a doctor who meets your needs.

Things to consider when selecting a doctor: • Is the location of the doctor's office important? How far can I travel to see the doctor? • Is the hospital the doctor admits patients to important to me? • Is the age, sex, race, or religion of the doctor important? • Do I prefer a single doctor or a group practice? • Do I have to choose a doctor who is covered by my insurance plan? • Does the doctor accept Medicare? • Is the doctor board-certified? In what field?

1. Decide what you are looking for in a doctor--A good first step is to make a list of qualities that are important to you. Then, go back over the list and decide which are most important and which are nice, but not essential. 2. Identify several possible doctors--After you have a general sense of what you are looking for, ask friends and relatives, medical specialists, and other health professionals for the names of doctors with whom they have had good experiences. A doctor whose name comes up often may be a strong possibility. Rather than just getting a name, ask about the person's experiences. For example, say, "What do you like about Dr. Smith?" It may be helpful to come up with a few names to choose from, in case the doctor you select is not currently taking new patients. 3. Consult reference sources--The Directory of Physicians in the United States and the Official American Board of Medical Specialties Directory of Board Certified Medical Specialists are available at many libraries. These references won't recommend individual doctors, but they will provide a list to choose from. Doctors who are "board certified" have had training after regular medical school and have passed an exam certifying them as specialists in certain fields of medicine. This includes the primary care fields of general internal medicine, family medicine, and geriatrics. Board certification is one way to tell about a doctor's expertise, but it doesn't address the doctor's communication skills.

What are the doctor's office policies? • Is the doctor taking new patients? • What days/hours does the doctor see patients? • Does the doctor ever make house calls? • How far in advance do I have to make appointments? • What is the length of an average visit? • In case of an emergency, how fast can I see the doctor? • Who takes care of patients after hours or when the doctor is away?

4. Learn more about the doctors you are considering--Once you have selected two or three doctors, call their offices. The office staff can be a good source of information about the doctor's education and qualifications, office policies, and payment procedures. Pay attention to the office staff--you will have to deal with them often! You may want to set up an appointment to talk with a doctor. He or such is likely to charge you for such a visit. 5. Make a choice--After choosing a doctor, make the first appointment. This visit may include a medical history and a physical examination. Be sure to bring your medical records and a list of your current medicines with you. If you haven't interviewed the doctor, take time during this visit to ask any questions you have about the doctor and his or her practice. After the appointment, ask yourself whether this doctor is a person with whom you could work well. If you are not satisfied, schedule a visit with one of your other candidates. Summary: Choosing a Doctor You Can Talk to • Decide what you are looking for in a doctor. • Identify several possible doctors. • Consult reference sources, current patients, and colleagues. • Learn more about the doctors you are considering. • Make a choice.

Questions to ask the doctor: • Do you have many older patients? What are your views on health and aging? • How do you feel about involving the patient's family in care decisions? • Will you honor living wills, durable powers of attorney for health care, and other advance directives? • Do you still work with your patients when they move to a nursing home?