How to Choose a Top-Notch Doctor as You Age

3. Training. You shouldn’t base your decision solely on where a doctor went to school or where they did residency, but it’s still good to know.

4. Online ratings. Occasionally worthwhile, but be warned: They’re always going to skew negative, because happy patients rarely bother to post reviews. The worst online evaluation I ever got was from a man I never met who was mad because I prescribed his 16-year-old sexually active daughter birth control pills. He gave me a “1,” but I’m sure his daughter would have given me a “5.” And if your doctor has 100 percent 5-star ratings, they may actually be great, but know that there are quite a few ways to juke the stats. Think about it: Was your last Uber ride really a 5-star?

5. Top doctors lists: Media-generated lists of “top” or “best” doctors can help (full disclosure: I’ve been on a few), but this comes with a giant caveat. They tend to be popularity contests, and often don’t surface the most diverse candidates. Also, once you’re on them, they’re loathe to take you off. So use them to source names, but then do your own sleuthing to learn more.

After you’ve identified a primary care prospect, call the office and talk to the administrator — an actual human being. They will not be trying to have a long conversation with you, so come prepared and be persistent. Tell them you’d like to become a new patient and want to make an appointment, but you have a few questions first. They should be willing and able to help. If they’re not, that’s a red flag worth jotting down in a place you reserve for keeping track of your health care journey.

There are several versions of mass-produced health care organizers and journals available online. Whether you prefer one of those or a blank journal, a binder or a spreadsheet of your own making, create a system you’ll depend on long-term. Now is no time to rely on your memory. So keep scribbling as you ask:

What’s the average wait time to make an appointment?

What’s the average wait time once I arrive for an appointment?

How will test results be communicated? (Patient portal? Text?)

Will I be seeing a doctor most often or a nurse practitioner or physician’s assistant?

Is it okay for me to bring a friend or relative to my appointments?

Does the office have evening or weekend hours?

How do you handle emergencies and acute care?

This last one is important because, as a rule, the emergency room should not be your Plan B for nonemergency care.

What to know about visiting the ER

I don’t know when we started adding that sentence, “If you think you are experiencing a medical emergency, hang up and dial 911,” to doctors’ voicemail greetings, but it changed medical care forever. Just like with the appearance of hospitalists, we didn’t discuss it. It just took hold and metastasized. It’s as if the entire medical community in America decided that we either could not or would not call our patients back in a timely manner. And if something bad happened, the fallback would be, “Well, I told you to go to the emergency room.” Don’t get it twisted. That message is not there out of concern for your health. It’s about medical liability. It’s what we in medicine call a CYA move — as in “cover your ass.”

I know. That’s terrible, right? We put that “go to the emergency room” thought in your head, and we, the medical profession, have to own it.

The problem is, the ER — even if there’s one walking distance from your home — is not a viable substitute for having an established medical home and an accessible doctor to advise you in times of uncertainty.

Here is some news you can use: When you show up in an emergency room, they don’t know you, and they probably don’t know your doctor either. An ER physician will evaluate you and a hospitalist will admit you if you are deemed sick enough to stay in the hospital. If hospitalization is not warranted, you will be sent home with an instruction sheet and told to follow up with your own doctor.

And let’s be clear, emergency rooms are great for some things and not so great for many others. Trying to figure out what is and is not an emergency is what most patients need help deciding. What you should be aware of is the fact that if you do not notify your doctor that you are in the emergency room, the chance that someone in the emergency room will let your doctor know and forward your records to their office is not zero, but it’s pretty darn close.

Bet you didn’t know that it is your responsibility to arrange for your records to be sent by any hospital that is not within the same system as your doctor. This is why it is extremely helpful to have doctors and hospitals within the same network. Even if your doctor was not made aware that you went to the hospital, they will at least be able to see the doctor’s notes and test results from your visit.

If you are unsure whether your doctor and hospital are in the same network, rather than guess, to be safe, create an online portal account in that hospital system. The nurse or clerk can instruct you on how to sign up. This will allow you to access all records and test results from your recent visit, which can then be printed out and taken to your doctor when you go for your follow-up appointment.

From the book Grown Woman Talk: Your Guide to Getting and Staying Healthy by Sharon Malone, M.D. Copyright © 2024 by Sharon Malone, M.D. Published in the United States by Crown, an imprint of the Crown Publishing Group, a division of Penguin Random House LLC.