Bad Doctors Vs. Good Doctors

Many doctors take much better care of their stock portfolio these days than their patients. I can't name all the bad doctors in this article but I can tell you how to determine if they are good or bad based on your experience with them. In addition, there are internet sites which rate doctors based on experiential data left by their patients. Are these useful? First I will give you my reasons for this trend toward inferior patient treatment.

Why Good Doctors Go Bad

There are several reasons patients have not received first rate diagnosis and treatment during the last few decades. They all boil down to insurance and monetary issues. Insurance companies often pressure doctors to give minimal time, less than the best medications, fewer tests and less preventive care than the patient should receive.

Insurance companies, especially health maintenance organizations (HMOs), pay doctors who participate with them a nominal rate per month per patient. In additions they pay incentives to doctors who cost them less money by prescribing less and cheaper tests, fewer procedures, shorter hospital stays and fewer referrals to specialists.

Contemporary doctors often form or join large physicians associations, which are run as a business rather than a doctor's office. Patient's visits per day are maximized by office personnel trained in allocating time to increase through-put for a doctor's daily workload. Some procedures done by doctors in the past such as blood drawing, ear wax cleaning, wart removal by freezing or cauterizing are no longer reimbursed. A doctor who does these procedures will fall behind on the number of patients they can see daily. Similarly diagnosis time is shortened to increase patient through-put. If they fall behind the goals set by the insurance companies, their bonuses are reduced. A more thorough doctor makes less money than the doctor who takes less time per patient. This is a strong incentive to be fast not thorough.

For example I see two doctors not just one. Usually I see a primary care physician (PCP) who is covered by my insurance except for a $15 per visit co-pay. About twice a year I see another doctor who is excellent but not covered by my insurance. The later said that I probably had diabetes 2 and that I should get a three hour glucose tolerance test. This is an expensive test for me unless signed off by my PCP. He would not prescribe the test. He said he took my blood for many years to monitor my cholesterol level and never saw a high blood sugar indicated. This was a poor diagnostic technique since my cholesterol tests were all done after an evening and morning of fasting. I needed a letter from the other doctor to get the test approved by my PCP. Most people would not get this far but I persisted. Sure enough I had 3 out of 4 readings of the glucose tolerance test show diabetes. One high reading would have been indicative of the presence of diabetes. If I had not seen this other doctor, I might have had severe problems before my diabetes was diagnosed.

Physician associations are also crowded with physician assistants (PAs) who are not doctors. A PCP can outsource a patient to a PA to save time and money. My doctor's office has many PAs. The PAs also have to maintain a patients through-put.

If you feel rushed when seeing a doctor, you probably have a bad doctor. If you do not get the tests to determine the state of your health or if the doctor does not take the time to listen to you, go through your records, and provide a good diagnosis you have a bad doctor. A doctor is bad if he does not devote himself to keeping you healthy.

Good Doctors

A good doctor will read your medical files, prescribe tests and follow up. He or she will ask you questions and listen to your answers. Not just questions about what you came in for, but all questions necessary to keep you healthy or treat your medical problems.

Internet Doctor Rating Sites

I find these of little use at the current time. I went to several sites and none had any of my doctors rated. The problem is they depend on patient feedback, yet charge a monthly fee while building their data base. This is backwards! First they should accumulate ratings until most doctors are rated. Then they could think about charging a fee. It is very discouraging to pay a fee and find none of your current or perspective doctors rated.

We have been heading toward fast food medicine for a while now. I don't see this being reversed unless the people get fed up and start to proactively demand improved medical care.