A Seamless Switch
Sally Metcalf of Mill Valley favors alternative medical treatments over conventional ones. So, for many years, she put her faith in an M.D. whose practice offered an integrative approach to patient care. “When I first started with her, my cholesterol was sky-high,” Metcalf recalls. “She prescribed a bunch of neutraceuticals. Within two years of starting my numbers were totally back to normal.”
But as time went on, Metcalf’s health issues grew more complicated. “I suffered from debilitating PMS as well as depression,” she says. “The doctor kept pushing all these alternative treatments on me that were extremely expensive, not covered by my insurance and, ultimately, ineffective in treating my condition.” Eventually, Metcalf decided it was time to find a new doctor.
Metcalf is hardly the only Marin resident who’s had to fire her internist. People switch for a variety of reasons. Physicians retire; insurance policies change, as do people’s financial circumstances. Occasionally, a conflict in personalities or philosophies can be the impetus. Whatever the reason, there’s a right and a wrong way to switch providers. We asked local medical experts for their best advice on how to smooth the way from one practice to the next. Here’s what we learned.
Do Your Homework
For starters, it’s imperative that you find a new doctor before leaving your old one. Health problems can develop suddenly, and a doctor who lacks good bedside manner or doesn’t return calls promptly is still preferable to no doctor at all.
Keep in mind that finding a new doctor can take some time. “It’s not uncommon for physicians to close a practice to new patients if they feel they have a full caseload,” says Marcy Territo of Marin IPA, a health care network that administers benefits for HMO subscribers countywide. In fact, the number of medical students choosing a career in primary care has plummeted in recent years, according to Dr. Josh Adler, professor of clinical medicine and chief medical officer at UCSF. “As doctors retire, there simply isn’t a sufficient supply to replace them,” he says.
So you’ll need to do a little reconnaissance—in other words, network. “The best way to find a new doctor is to ask family, friends and colleagues for recommendations,” says Territo. Co-workers can be particularly helpful if you’re on the same insurance plan, since they can provide names of good in-network doctors.
If you still come up empty-handed, Adler says, try the 21st-century approach. “Consider using Yelp,” the consumer-reviews website, he says. “I don’t know if I would trust this method in terms of gauging a doctor’s competence, but with regards to the service component, it’s incredibly relevant—it provides you with real-patient experiences.”
Ironically, Adler puts less faith in the seemingly more scientific site HealthGrades.com, which provides reports and ratings on more than 750,000 doctors nationwide. “I think at some point it might become a useful tool,” he says, “but at the moment the information simply isn’t robust enough, and some of the reports can be misleading, meaning you might end up passing on a really good doctor because the information about him or her isn’t altogether accurate.”
Once you’ve assembled a short list, contact physicians you’re considering to see if they’ll schedule a “meet-and-greet,” a short interview appointment to help you decide if the doctor might make a good health care partner. “Some doctors charge a flat fee for this meeting; others will do it for free,” Territo says. “It’s not a time to discuss medical issues, but rather to see if you have good chemistry together.” Adler agrees that can be useful, but warns that it’s not at all standard for doctors to offer this option. “So I wouldn’t eliminate a person simply because they don’t do meet-and-greets.”
Prepare for Departure
Once you’ve decided on a new physician, call your current doctor’s front office staff and let them know you will be leaving the practice. “If you’re leaving because you were unhappy, it’s helpful to give the doctor feedback as to why,” Adler says. “If you are uncomfortable doing this face to face, a letter or e-mail is usually appreciated.” Next, ask the new physician’s office for a transfer of records form. This is a legal document that compels your old doctor to forward your medical files to the new office. Unfortunately, says Adler, filling out a records transfer form doesn’t always yield quick results. As a fail-safe, he advises going in person to the current doctor’s office and requesting a condensed version to take away. “The staff may not have time to copy 20 or 30 pages on the spot, but you can ask them to at least give you notes from your last several visits, radiology and lab reports as well as reports from specialists that you have seen.” You’ll also want to notify those specialists you’ve switched doctors so future reports aren’t sent to the wrong office.
Also, if you regularly take medications, make sure you have a sufficient supply to get you well past your first appointment with the new doctor. “You’ll need a month beyond what you would expect you would need,” cautions Adler. “You don’t want to cut it close in case you need to switch the appointment or your new doctor has to reschedule.”
Once you’ve switched practices, keep in mind that as with personal relationships, a good doctor/patient relationship requires work on both ends. If you left your last doctor because you were unhappy about something, let your new doctor know what that was, so that all parties are clear on expectations. Also, remember that while your doctor can give advice on how to stay healthy, it’s up to you to comply.
Metcalf, for her part, embraced her new doctor’s medical direction and couldn’t be happier with the results. “The new doctor took one look at my history and got me on a bioidentical hormone patch. I’ve never felt better in my life,” she says. “I still favor alternative cures, but I realize now that sometimes you have to find the right balance, and in this case a doctor willing to use a conventional treatment was the right one.”
Dawn Margolis Denberg has worked as a professional journalist for 20 years. Her work has appeared in top publications, including Wired, Shape and Parenting. She has also written several books for children including, The Men in Black Agent’s Manual The Official Godzilla Movie Fact Book. And, most recently, an episodic audio series for Tales Untold.