we have used the military health care system for about 40 years.  pretty soon we will be entering "tricare for life".  at age 65 & medicare you have to find a "civilian" doctor that will take you AND will accept medicare (frightening situation in a way).  once you find a doctor that will take you, is there a website that you can enter his/her name and see if there were any compainst or problems with them?  any and all thoughts will be appreciated.  wife turns 65 end of may.  i have two years to go till i have to do it also.

Bullwinkle

A few thoughts Bullwinkie:

Should be a state medical license board you can look them up on the web for any violations.

US News has an annual report of best doctors and hospitals. Sometimes a local magazine will run the same information touting the docs in their area.

A local tv channel here in Cols runs a survey every three years where they survey docs in the town that THEY would go to for certain ailments. Maybe suggest to your local station to do such a survey if they haven't done so.

Nurses in a hospital are also a good resource for who is good and who isn't. 

I agree with looking for a state website which shows complaints.  However, there are still several states where AMA is all-powerful and this info is hidden from patients.  Recommendations from friends and neighbors can be helpful.  Or you may want to pay for an office call just to interview a doctor you think you may like.  Two things big on my list are (1) does the doctor listen to you and talk to you and (2) is he "pill happy"?

Some doctors are just too busy, or simply uninterested, to spend any time with their patients.  I knew of one who would tell a patient to come back in two weeks and then ask the patient why they were there when they came back.  There are still doctors out there who ask the right questions and explain things to their patients.

Some doctors prescribe medication for everything without ever trying non-medicated treatments first.  Maybe they're lazy; maybe they're getting really nice gifts from the pharmaceutical companies.  Either way, to my way of thinking, the patient is poorly served.

Bullwinkle,

Having worked in the healthcare field for most of my adult life, I can offer you a few pointers to help guide you in your search.

1) Wherever you end up residing after you retire, you can go online and do a search of the hospitals in your town. Most hospitals have their own websites and maintain online directories of their staff physicians. These directories contain a lot of information regarding a physician's specialty, education, board certifications, office hours and insurances accepted. Also, if there are any hospitals in your area which appear in the US News & World Report published reports of the Best Hospitals in the US, those hospitals would be an excellent place to start. If not, try locating an academic medical center (a teaching hospital) in your area, as a starting point.

2) Another potential source of physician information may be your insurance company (particularly if you select a Medicare HMO). There are some insurance companies in some areas of the country which survey member satisfaction with the physician care received and publish it on their websites.

Since you will be looknig for a physician and will be retired, I would look for a physician who is board certified in the field of internal medicine, as opposed to family practice. While physican personality may be an important consideration for you and your wife, I would be more concerned with physician access. (If your sick now, do you have to wait three weeks before you are able to be seen?)

Also, I wouldn't be concerned over whether your physician accepts Medicare insurance, or not. The fact is, Medicare revenue accounts for the major chunk of most practicing physician's revenue (excluding of course pediatric and OB/GYN specialties).

Hope this helps a little. If you have further questions, let us know.

Unfortunately you often find a "circle the wagons" mentality among physicians in some areas.  Plus there's a great deal of politics involved -- some years ago there was a widely-known neurosurgeon who headed a practice in a large metropolitan region who, despite countless malpractice claims, complaints and lawsuits, continued to practice for many years.  The fact the he chaired an important AMA committee no doubt played a role in his longevity before he finally lost his license.

I will only see a medical professional if I receive a compelling personal referral from either a well-regarded friend or a physician I know and trust.  Additional steps you can take, beyond checking with state licensing boards, are to run a court search, and to request the doctor under scrutiny provide you with the name of their malpractice carrier, policy number, and a signed release authorizing the insuror to disclose fully any and all pertinent claim and other information.

Remember, caveat emptor applies when it comes to selecting professionals, just like it does when picking investments.

Regards,

Doc

Doc,

Do you think it's realistic for a person, new to an area, to walk into a potential physician's office and request the kind of malpractice information you've outlined?

Chances are, when they walk into an office, they will initially speak to a receptionist. If I were to ask for this type malpractice information, both the receptionist and the physician would look at me with great suspicion. I wouldn't even be surprised to hear that the practice was no longer accepting new patients.:)

On the other hand, why not?  Physican offices and hospitals request similar types of information from their patients!!

Doc,

Do you think it's realistic for a person, new to an area, to walk into a potential physician's office and request the kind of malpractice information you've outlined?

Chances are, when they walk into an office, they will initially speak to a receptionist. If I were to ask for this type malpractice information, both the receptionist and the physician would look at me with great suspicion. I wouldn't even be surprised to hear that the practice was no longer accepting new patients.:)

On the other hand, why not?  Physican offices and hospitals request similar types of information from their patients!!

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Why not, indeed!  Contractors, consultants and I'm sure others routinely have to provide proof of insurance and/or bonding before being hired.  And yet, sadly, it's easy to imagine many doctors having the hubris to behave indignantly if you were to request the same of them -- even though we trust them with our lives.

Personally, I think if a doctor were to deny such a request, it would tell you all you need to know about them.  

Best Regards,

Doc

Just be aware that doctors check out patients and their insurance plans, and that doctors can and sometimes do fire their patients.   My advice is to get referrals from trusted friends and healthcare professionals, and then treat the physician with kindness and respect and bond with the physician.  When you do, you will quickly find that the physician will bond with you and will treat you as he/she would treat a family member.

Kevin 

Doc,

The suggestion:

"request the doctor under scrutiny provide you with the name of their malpractice carrier, policy number, and a signed release authorizing the insuror to disclose fully any and all pertinent claim and other information."

does strike me as being unrealistic.  In my years of practice, this has never, ever, been requested of me.  Although I am going to retire soon, my response to such a request would probably be that the person look for another doctor. 

Even as a medical practitioner, this is something I would never think of doing when looking for my own personal physician.  The other replies to this thread are more in line with common practice and is how I doctor shop for my family.  

If you don't like/trust/believe in the person, go elsewhere.   

You need to start backwards.  When the sh*t hits the fan, rescue is going to take you to the nearest hospital.  Do you want to be dealing with a stranger in a crisis situation?  If you develop a chronic condition which requires regular visits or treatments, do you want to be driving an hour across town or three towns away two or three times a week at 85?

Start with evaluating the facilities near you.  Who practices and works there?  Who do the medical professionals who practice there use for their families and themselves?  Who meets all of the other criteria listed even if it's in an esoteric speciality field?  Whom do they recommend?  Good doctors recommend good doctors. Other professionals who work in hospitals know.  Ask a lot of people.

Also consider just an o.k. primary who knows their limitations but listens, follows up every complaint or symptom and doesn't hesitate to refer 

Roberta 

for all the great ideas and suggestions.

Bullwinkle

Hi B-W 

I have used Kaiser Permanente here in the mid-atlantic for many years through a variety of employers - and soon, I hope to continue access to them in retirement.  Can K-P provide the Tricare kinds of services?

Kaiser is an HMO, as you probably know.  What's good - lots of facilities - good docs - good infrastructure - use of apporpriate kinds of specialists, etc (they can and do use Nurse Practitioners).  I dont have complaints.  Others may.

Depending on where you'll reside, might you look at the local Fed or State gov insurance offering booklets/sites and get some evaluations on providers?

Sorry if this doesn't help - I hope it does. 

My 2 cents as a physician, the only reliable way is word of mouth. Especially if that mouth belongs to a health care worker.  Nurses are best, they know who is crap and who isn't.

 All the other consumer web sites, state licensing boards, waste of time.  They won't tell you what YOU want to know.  If the doctor is competent and personable.  All these consumer sites will tell you is that he/she is board certified and no lawsuits.  How does that help you?

Wow - just finding a doctor is a trip.  99% of the offices/doctors i've called either aren't taking new patients or are not taking medicare patients.  Mostly it's not taking medicare patients - i can only imagine what it will be like when the baby-boomers hit the fan.  It's hard enough for the "war babies".

Bullwinkle

Bullwinkle,

Yes, your experience may become more and more commonplace.  I retired a few days ago because it is barely profitable for physicians to work for current reimbursements from managed care plans and Medicare. Ask any doctor, nurse, or hospital employee you know.  This is not generally written about anywhere.  Headlines concentrate on the high cost of healthcare, but not about how little of that money actually reaches the hands of the folks that supply the actual "hands on" care.

This is why many new graduating doctors from medical schools are competing for training programs that cater to patients who wish to have procedures done that are considered cosmetic and are not subject to insurance payment limits, such as plastic surgery and dermatology.  They are paid by patients out of pocket.  Either the well to do, or those simply willing to pony up.

There are other enterprising doctors that have learned to pad their bills with other money raising measures. I will leave to your imagination what those might be.  That form of medical practice did not interest me, hence my retirement.  So if you do find a doctor, make sure you follow their billing paper trail.....

I am a baby boomer. I am concerned about whether there will be hospitals, nurses, and doctors willing to take care of me when I need it. 

I think a lot of us should be worrying about this.  Unfortunately, the politicians aren't.

edit/2
 

Try to get referrals from nurses and other healthcare professionals.  When you have a few to choose from, schedule a 'get acquainted interview' meeting at the end of a day.  That gives you and the provider an opportunity to see how the relationship feels.  This happened on occasion when I had a medical practice and I enjoyed the visits.  Make it brief though ....  doctors are usually pretty busy.

Drew 

I worked in hospitals for 41 years, the last 18 as a CEO. I tolally agree with M.Ray's post as follows: 

"My 2 cents as a physician, the only reliable way is word of mouth. Especially if that mouth belongs to a health care worker.  Nurses are best, they know who is crap and who isn't.

 All the other consumer web sites, state licensing boards, waste of time.  They won't tell you what YOU want to know.  If the doctor is competent and personable.  All these consumer sites will tell you is that he/she is board certified and no lawsuits.  How does that help you?"