Notes

Authoritative and knows how the medical system works, explains and gives you options instead of forcing them upon you

you want a doctor who still admits his own patients to the hospital
In addition to selecting the best hospital and guiding your way through it, your doctor will also have developed a referral network with all the different specialists you may need
Your doctor should have a good reputation and a working relationship with the emergency medi- cine doctors in the ER.
Your doctor should also have a relationship with other specialists such as cardiologists, surgeons, and orthopedists

knowledge and support of a primal, wellness-oriented approach to health care
a free market orientation, which does not imply particular political beliefs but instead relates to the doctor’s views on the provider/client rela- tionship
someone who still admits his patients to the hospital and has a strong presence within that institution

Your doctor must also be capable of caring for illness or injury in the office. You should ask your candidate doctor if he is able to sew simple lacerations, or splint non-displaced fractures. Does he have basic lab and x-ray capabilities, or a relationship with a hospital or outpatient lab and medical imaging center? Does the practice hold daily slots open for acute illnesses or injury? You don’t want to be told to go to the ER for something that should be handled in an office. If that happens you will incur much more expense, as well as a prolonged wait time because you will be triaged low in the queue

The solution to the problems of third-party interference is to seek out a doctor who accepts direct cash payment from his patients and deter- mines the price structure for his practice, This arrangement allows the doctor to bill you directly for services and then provide you with the paperwork to file with your insurance, If you don’t want to be on a statin, your doctor can abide by your wishes without risk of third party payment denials for failing to follow “best practices.”
More ideally, you can combine this kind of care plan with a “cat- astrophic” insurance plan. This type of plan generally involves a high deductible ($5,000 is typical) and pays 100 percent of your medical bills and hospitalization after that deductible is met
Concierge doctors provide care in a manner similar to cash-only plans. The major difference is that they charge an upfront fee instead of charging by the visit. The fee can range anywhere from $500 to $5,000 annually. In exchange for this yearly fee, you get unlimited and unfettered access to your doctor. All visits during the agreed upon contract time (typically a year) are covered under the retainer fee. You will have 24/7 access to your doctor by a cell phone that he carries at all times. The money spent on the retainer may or may not apply towards the deductible of your insurance, and will depend on your policy. The chances are greater for the fee to be deductible if you make these arrangements at the time you are purchasing your insurance policy. Also, many concierge doctors are affi liated with each other and can off er promises of cross-coverage, allowing you similar access to medical care even when you are away from home.

When selecting a personal physician, you want someone whose training has given some direct experience in all the different specialty fields. This makes the physician able to deal with problems from almost any specialty. If you have a mild to moderate problem, your doctor can usually handle things as well as a specialist. If the problem is severe— such as a perforated ulcer—then your general physician won’t be doing your surgery, but he or she will have done several months of surgery rotation in residency and know what to expect, whom to call, and how to expedite your transition to specialist care. In short, I am talking about someone trained in family medicine. Having been in this position in the past, family physicians will have developed a net- work of specialist consultants who they feel are the best among those available to them. Further, since these specialists depend on family physicians for referrals, they are very responsive to their requests for consultation. This all serves to benefit you, the patient.

If you are an older adult, an internal medicine specialist may be a good choice as well. Their training is not as broad as a family medi- cine specialist, but their experience with the diagnosis and treatment of medical conditions is very extensive. Since most adult illnesses are med- ical in nature, internists can be a very strong choice. General internists tend to function well as referring doctors for surgical or non-medical issues just based on necessity and experience in community practice.

Finally, an acid test to apply when selecting a physician is his will- ingness to avoid prescribing medications, or to help you wean yourself off prescription medications if you are already taking them.