In an area crowded with healthcare providers, health administrators, health
planners, and numerous other types of healthcare professionals, it is remarkable
how many area residents violate this basic precept: Find thyself a good
Your choices of physicians, especially your primary care physician, are
the most important decisions you make in determining the quality of your
medical care. Your personal doctor will initiate diagnostic procedures,c
devise treatment plans, guide you through care decisions, prescribe medications,
authorize hospital admissions, refer you to other physicians and other
providers, and in general be the center of your healthcare experiences.
You need to select, and build a relationship with, a good primary care
physiciana family practitioner, internist, pediatrician (for children),
or geriatricianand working with that physician play an active role when
you need to choose a specialist.
We provide several types of information to help you choose the best doctors.
Our Ratings Tables for primary care doctors reports ratings of area
physicians collected in our surveys of patients. For primary care physicians,
patients are the best source of information on many aspects of quality,
including how well physicians listen, explain things, help patients coordinate
care among other physicians and healthcare providers, and make themselves
accessible for appointments and advice. These aspects of care are critical
to prevention, accurate diagnoses, and a patients ability and motivation
to do his or her part in carrying out a plan of care.
Our survey asked consumers (primarily CHECKBOOK and Consumer Reports subscribers)
to rate their experiences with doctors they had recently seen on several
aspects of care and service:
Listening to/communicating with you
Personal manner (courtesy, respect, sensitivity, friendliness)
Spending enough time with you
Seeking your input in making decisions
Coordinating your care
Giving prevention/self-help advice
Thoroughness, carefulness, and apparent competence
Arranging to see you quickly when you request an appointment
Giving timely, helpful advice by phone or email
Keeping down office waiting time
Our Ratings Tables report the percentage of respondents who rated each
physician as very good or excellent (as opposed to poor, fair,
or good) on each question. We have reported results for all physicians
for whom we received at least 10 ratings on our customer surveys.
Answers to these survey questions and other feedback are not about only
pleasantness or comfort; they go to the heart of quality medical care.
For example, research has shown that patients who receive care from doctors
who listen and communicate well tend to receive more accurate diagnoses,
respond better to treatment, and recover more quickly. Certainly, it is
hard for a doctor to make a good diagnosis or a good treatment plan without
listening to what is bothering you and hearing about any impediments you
might have to self-care. And you are more likely to do your part in your
treatmentfor example, taking medicine and making lifestyle changesif
the doctor has successfully communicated what is expected of you, why it
is important, and what you can expect to experience.
Doctors who received high ratings on our surveys are good candidates, but
keep in mind that often the number of raters is small and that a larger
number of respondents might have produced substantially higher or lower
scores. Also keep in mind that the survey responses are inherently subjective;
because doctor-patient relationships are very personal, a physician our
respondents liked may not be one you like. Click here to read about other limitations of our customer survey results and other research methods.
Our Ratings Tables also report the board certifications, if any, each
doctor holds. Board certification means that a physician has taken several
years of practical training in a field after graduating from medical school
and has passed a difficult exam in that field and met other requirements
of a specialty board. Many doctors must continue to meet educational and
other requirements and take tests every six to 10 years (depending on the
specialty) to maintain their certification. But that maintenance of certification
requirement doesnt apply to doctors originally certified more than a certain
number of years ago (about 25 years ago for most specialties) because certification
was formerly for life.
Information on physicians board certifications came from the American
Board of Medical Specialties (ABMS). We used an ABMS list from August 2015;
the list could not include certification information on doctors who subsequently
became certified. Conversely, our list may include certification information
for doctors who subsequently lost certification status. The ABMS website
indicates whether individual physicians are currently board certified.
Our Top Doctors list provides another valuable source for insight on
a physicians performance: judgments of his or her peers.
We regularly survey all actively practicing physicians in the 53 largest
U.S. metropolitan areas and ask them to tell us which one or two specialists
in each of 35 or more specialty fields they would consider most desirable
for care of a loved one. Our Top Doctors database tells you the area
physicians who were recommended most often in those surveys.
Our Ratings Tables reporting patient ratings of primary care doctors
also identifies the primary care physicians receiving at least 10 patient
ratings who were most often recommended by other doctors. But because there
are hundreds of primary care doctors practicing in the area, primary care
physician recommendations were spread out more thinly than recommendations
for most other specialties. Consequently, our list of doctors most often
recommended by other doctors doesnt begin to include all of the top-quality
primary care doctors in the area.
For more information on our ratings of doctors by other surveyed doctors,
visit our Top Doctors section.
Our Surgeon Ratings website reports which surgeons in the U.S. produced
better-than-average results for each of 14 types of high-risk surgery.
We found big surgeon-to-surgeon differences. Choosing a top surgeon greatly
enhances your chances of avoiding complications and even death.
Medicares Physician Compare Website
The Affordable Care Act (Obamacare) charged the Department of Health
and Human Services (HHS) with creating the Physician Compare website
to provide much information on physician quality. That website is moving
toward including information on physician qualifications, whether physicians
follow evidence-based clinical guidelines, whether they achieve good patient
outcomes, patient ratings, and other aspects of quality care.
So far this website has provided very little useful information: Most existing
information is reported at the physician-group level and only for groups
of 25 or more physicians; patients want to know about individual physician
performance, as significant doctor-to-doctor variation exists within medical
groups and clinics on many quality measures. However, HHS appears to be
(slowly) moving toward reporting a broad range of quality measures at the
individual doctor level. So stay tuned.
Health Insurance Plan Provider Directories
Most health insurance plans post physician directories online. The better
plans list information such as specialty, medical school and year of graduation,
hospital affiliations, biographical info, and treatment philosophy. Some
forward-looking plans use medical claims data and other data sources to
check whether doctors consistently comply with evidence-based clinical
guidelines, identify doctors who fail to perform recommended procedures
(such as eye exams and hemoglobin tests for diabetics), and perform inappropriate
or unnecessary procedures. But because most plans have as members only
a limited number of each doctors patients, sample sizes for such assessments
are often small. Also, anyone attempting to use claims data to judge physicians
will encounter difficulties, such as not knowing whether a doctor had a
good clinical reason for not performing a test in a particular case, or
whether the doctor knew the test had been performed elsewhere (for instance,
in a clinic or hospital).
Physician Recognition Programs
Some independent programs also enable physicians to seek recognition for
the quality of their practices.
The National Committee for Quality Assurance (NCQA) and the Health Care Incentives Improvement Institute (HCI3) Bridges to Excellence (BTE) have recognition programs for doctors who participate in patient-centered
medical homes (PCMHs). These are innovative efforts to provide patient
care in a setting that facilitates partnerships between individual patients,
their personal physicians, other healthcare providers, and when appropriate,
patients families. Care is facilitated by information technology, information
exchange, and other means to ensure that patients receive the indicated
care when and where they need and want it in a culturally and linguistically
NCQA and BTE also have programs in which doctors voluntarily agree to have
their practices reviewed and seek to be recognized for consistent high-quality
care of certain conditionsfor example, diabetes, heart/stroke, and back
painand also for practice connections (using up-to-date information and
systems to enhance patient care). For example, the diabetes recognition
program checks doctors success with controlling patients blood pressure
and encouraging smoking cessation.
Medical associations also provide lists of names and addresses and, in
some cases, other useful information about doctors.
For example, the American Medical Associations (AMA) DoctorFinder
allows you to search by specialty and location; it offers information on
training, hospital affiliations, specialties, and board certification for
AMA membersbut only name, primary specialty, board certification information,
city, and zip code for the many physicians who are not AMA members.
Hospital Affiliation and Medical School Faculty
Another option is to ask a top-quality hospital for names of its affiliated
physicians. Using our
ratings of more than 4,000 acute-care hospitals in the U.S.
you can check to see which doctors are affiliated with top
hospitals by calling hospitals or, for most hospitals, checking their websites.
Good sources of prospects are teaching hospitals, where you can specifically
request doctors who have teaching responsibilities. Although the full-time
faculty at a local medical school may include only a handful of primary
care physicians, a surprisingly large number of doctors teachoften putting
in two or three hours per week in clinical work with medical students and
internswhile maintaining their own practices. Doctors who teach part-time
at area medical schools are excellent prospects, as are doctors who teach
at large community hospitals.
Whichever doctor you select, the way you interact with the doctor will
have a big effect on the success of your care. Here are some suggestions.
Make Sure Your Doctor Takes a Thorough Medical History
If you feel your doctor has not asked about matters that might be important
in diagnosing or treating you, volunteer the information. If both of your
parents had colon cancer, if your dad had a heart attack at age 40, if
you recently had a bout with kidney stones, or if you periodically feel
very depressed, let the doctor know.
Find Out About Tests Your Doctor Proposes
Ask your doctor what tests he or she will perform during routine visitsmammogram,
hemoccult test for blood in your stool, PSA test for prostate cancer, electrocardiogram,
sigmoidoscopy to check your rectum and lower colon, cholesterol test, tests
for STDs? Ask why specific tests and not others. If you are concerned about
particular medical problems, ask if there are relevant tests and why they
do or dont make sense for you.
Theres a lot of debate in the medical field about which routine tests
are worth doing for which population groups, and how often. There are reasons
not to perform tests: Some are unpleasant, some are costly, some pose risks
of complications, and tests can possibly indicate problems that dont existleading
to costly, unpleasant, and possibly dangerous treatment. You should be
given an opportunity to express your preferences regarding tests, based
on information about each tests pros and cons.
Find out not only about routine tests performed during preventive exams
but also about any tests prescribed to check out specific symptoms or medical
problems. Ask what each test will tell you that you dont already know,
how reliable it is, the risks and costs, and whether the results might
make any real difference in your treatment plan.
A great source for information about unnecessary tests and procedures is
Obtain the Results of All Exams and Treatment
At the time of a doctor visit, ask when the results will be available and
how youll be informed of them. Some doctors tell you nothing unless there
is a problem, an approach that may leave you wondering long after your
doctor has the answers. Theres also the risk that phone messages will
be lost and you wont realize that a doctor called to give you results.
If you know that a doctor is supposed to call, and when, you can check
back if you do not hear from your doctor.
Discuss the Results of Exams
When you get test results, ask the doctor to compare them to results from
previous tests and whether life changes are worth making to improve results.
Even if your cholesterol count or weight is within an acceptable range,
for example, is it worse than it was? Worse enough to do something about
Prepare for Appointments
Before a doctor visiteither to a doctors office or by the doctor when
you are in the hospitalget ready. Think about what questions you want
answered, symptoms youve experienced, treatments you or other providers
Write down your questions and other information to make sure you dont
overlook something. Bring medications with you to the doctors office.
If the doctor seems to be rushing you through your list of items, explain
that discussing these matters is important to you and the doctor should
give you enough time. Take notes. Consider bringing a friend or family
member to help you push to get through your questions and remember the
Describe Symptoms in Detail
Does the problem occur only after youve just eaten, after youve exercised
heavily, when youve been standing for a long time, only when you urinate?
What does it feel like? When did you first notice the problem? Your description
is a window to whats going on insideoften a better window than all the
examining and testing the doctor can do.
If youre afraid you might have a particular medical condition, tell the
doctor. This will give the doctor a chance to investigate those concerns
or assure you that they are unfounded.
Find Out About Getting Answers by Phone
While many questions require a visit to the doctor or tests, some can be
resolved based on what you communicate by phone. Also, a phone call can
often help you determine whether a doctor visit is neededand how soon.
Ask your doctor if you can talk to a nurse about questions you may have.
And find out the best time to reach the doctor by phone.
Request a Full Explanation of Your Diagnosis, Treatment Options, and Outlook
After your doctor has had a chance to evaluate your case, obtain a full
explanation of what he or she has discovered, your choices, and what you
What isnt working right? What caused it? What can be done about it now?
If its curable, what can you do differently to avoid a recurrencefor
example, eat differently, exercise differently, sleep differently, sit
differently, change jobs, wear a brace?
How certain is the doctor of the diagnosis? What are the other possibilities?
What more can be done to confirm the diagnosis? At what cost and what risk?
What are the treatment options? What are the risks and costs? What are
the possible benefits in terms of your lifestyle and ability to function?
How will you know if the treatment is working? What will you need to report
to the doctor?
One of your fundamental rights as a patient is the right to informed consent.
If you agree to a doctors treatmentwith drugs, knives, or other instrumentsthat
you would not have chosen had you better understood your options, the doctors
actions amount to an assault. Thats why responsible doctors understand
the importance of answering all your questions.
Ask About Referrals to Specialists
If your doctor refers you to a specialist, ask why a specialist is needed
and why that particular specialist. What is known about the specialists
expertise and experience with your type of case? Is this the only specialist
of this type that your primary doctor can refer you to under his or her
arrangements with your health plan? Ask the doctor to compare the referred
specialist to other specialists listed in
our lists of doctors most often recommended by other doctors.
If it is a surgeon in an applicable specialty,
check how the surgeon compares to other surgeons in our ratings for surgical
What should you expect the specialist to do? How will your primary care
doctor remain involved in your care?
If you are not referred to a specialist, ask why not. What extra expertise
might a specialist bring to the case?
Remember that some health plans have physician compensation schemes that
penalizeor rewarda doctor for making referrals to specialists.
Ask About Medication
If medication is recommended, ask why that particular medication. What
benefits are expected? How soon? What are the possible side effects and
what should you do if you experience them? How should you take the medicationfor
example, with meals, at bedtime? Can you take it even though youre taking
other medications? What if you forget to take a dose? Will the medication
limit your capacity to drive, work, or participate in other activities?
You may find it useful to consult a drug reference guide.
Consumer Reports Best Buy Drugs
covers thousands of brand-name and generic drugs.
Free websites also provide extensive information on drugswhat they treat,
possible side effects, interactions, etc. A useful site is
Ask About Hospitalization
If hospitalization is not recommended, ask why not. Hospitals are expensive
and health plans are interested in cutting costs. If a plan provides less
income to doctors when patients are hospitalized, make sure the financial
incentives wont cause you to receive insufficient care.
On the other hand, if hospitalization is recommended, ask why. Could the
case be handled on an outpatient basis?
Also, be sure to ask why a particular hospital was chosen. Is it the only
hospital to which your doctor is allowed to refer under arrangements with
your health plan? Compare suggested hospitals with our ratings of hospitals for inpatient care.
Get a Second Opinion
If your doctor recommends hospitalization or other expensive, risky, or
burdensome treatment, get a second opinion. In such cases, most doctors
will encourage second opinions. Most plans will be glad to pay, since the
second opinion may lead to a recommendation of less careand less cost.
If your doctor recommends against certain types of care that you know are
availableor if you doubt your doctors conclusions or are dissatisfied
with the progress of your caseobtain a second opinion to consider more
or different care. In a traditional insurance plan or preferred provider
organization (PPO), the plan will generally pay for you to arrange for
a second opinion on your own. In an HMO, your doctor will have to refer
you for the second opinion for the plan to pay. Since the second opinion
might lead to more care, there may be some resistance to authorizing it.
If you think a second opinion is justified, insist on one. If the first
and second opinions are in conflict, or for some other reason you still
doubt the conclusions, insist on a third opinion.
If possible, get your second opinion from an entirely independent doctor.
If a surgeon who has recommended surgery refers you to another surgeon
for a second opinion, it will be difficult for the second doctor to recommend
against the first surgeons advice (and economic interests). Our database listing specialists most often recommended by their peers will help you
identify doctors to consult for a second opinion. Read up on your type
of caseespecially types actively researched at certain medical centersto
locate leading specialists who might be available for consultation.
To minimize the cost and time required for a second opinion, have your
first doctor send copies of your medical records, X-rays, and lab results
to the second-opinion doctor; this is standard procedure.
Dont assume that because your case is straightforward and uncomplicated
there is nothing to learn and no decisions to be made. In most cases, there
This point is brought home by studies performed by Dartmouth College medical
school researchers and others who examined variations in medical practice
in common types of cases across similar geographic areas. One study found,
for example, that about 75 percent of the elderly men in one Maine town
had undergone prostate surgery, compared with fewer than 25 percent of
men the same age in an adjacent town. Similar variations have been found
in rates of hysterectomies, caesarean sections, and other common procedures.
Significantly, studies generally find no evidence that such differences
in treatment produce differences in the health status of the affected populations.
The implication is that big differences in the ways patients are treated
result from differences in the beliefs and customs of different physicians
in different communitiespossibly influenced by the need to generate fees
and not necessarily based on sound evidence of likely benefits to the patient.
Even in common types of cases, dont assume that a physicians standard
recommendation is your best option.
Complain If Necessary
If you have a dispute with a doctor, you may be able to resolve it by discussion
with the doctor. If that fails, you can file a formal complaint with your
states medical board.
Once you have identified potential candidates, get answers to these questions
about each of them. Some questions can be answered by checking various
sources (see page 6); others will require a call to the doctors office;
and still others will require asking other patients, or meetingor usingthe
Does the doctor work as a personal, or family, doctor on a primary care
basis? For children, for adults, or both?
Is the doctor accepting new patientsspecifically patients from your health
At what hospitals does the doctor admit patients? Preferably, choose a
doctor who can admit patients to one or more top-rated hospitals. There
is a good chance that you will be admitted to one of these hospitals if
you need hospitalizationeven if you are admitted by a specialist. Your
primary care doctor is likely to refer you to specialists who practice
at the same hospitals he or she uses.
Does the doctor use an electronic health record system? There is evidence
that implementation and use of electronic health record systems represent
some of the greatest improvements in medical care.
Is the doctor board certified in his or her specialty? Board certified
means that the doctor has taken at least two to six years of post-medical
school training and has passed a difficult exam. And while a well-recommended
doctor who is not board certified may perform admirably, it makes sense
to seek out certification. Our Ratings Tables indicate each physicians
board certification status according to records available at the time of
publication, according to the American Board of Medical Specialties.
Where did the doctor take his or her residency? Hospitals where doctors
take advanced post-medical school trainingcalled a residencythat have
recognizable university ties usually provide good instruction; for instance,
Duke University Hospital or Stanford University Medical Center. But the
absence of a university connection in a hospitals name doesnt necessarily
mean it doesnt have one.
From what medical school did the doctor graduate? Virtually all U.S. medical
schools are acknowledged to be of relatively high quality, and medical
schools in countries such as Canada, the U.K., Switzerland, and Belgium
are of comparable quality. Give special consideration to doctors trained
in the U.S. or one of these countries, but remember that most experts think
the site of a physicians residency is more relevant than the medical school.
When did the doctor graduate from medical school? This tells you roughly
the doctors age. You may prefer a doctor who has many years of practical
experience and has treated a vast range of medical problems. Or you might
want a younger doctor unlikely to retire soon. A recent graduate might
also have more up-to-date training, although many older doctors stay current
by teaching, engaging in hospital activities, and participating in continuing
Does the doctor have teaching responsibilities at a hospital? If you found
the doctor through a hospital referral service, you may already have this
answer. Its important because a teaching position reflects respect from
colleagues and also ensures that the doctor is regularly exposed to new
developments and questions from medical students and residents.
Does the doctor practice in a group or alone? Doctors who share an office
may share ideas and maintain informal standards of quality. They may also
be able to operate more efficiently by sharing costly equipment and specialized
staff. Finally, if the group includes doctors with different specialties,
referrals are convenient and your medical record can comprehensively incorporate
all the specialists comments. On the other hand, doctors in a multi-specialty
group may not be as flexible about referring you outside the group to the
very best specialist for your particular problem.
What are the doctors hours? Many doctors schedule weekend or evening hours
to accommodate patients work schedules.
How does the doctor cover emergencies on nights and weekends? Be wary of
a doctor who does not have an arrangement with at least one other doctor
to share on call duties. Where will you turn when the doctor is out of
town, ill, or at a meeting?
Does the doctor give regular patients advice over the phone? Does the doctor
answer questions by email? Is there a charge for such advice? Phone and
email advice can be a great conveniencea partial substitute for the house
calls most doctors no longer make. With malpractice liability looming over
them, doctors are careful about giving such advice in questionable cases,
but most doctors offer some advice over the phone, and some now use email.
Very few charge for such advice, as long as patients occasionally schedule
office visits and dont call or email too often.
What is the usual wait to get an appointment for a non-emergency medical
problem? For a full physical exam?
Will the doctor deal with your insurance carrier? You save time if your
doctor bills your insurance company directly. Also, doctors with no relationship
with your insurance company may charge higher fees than the insurance company
will pay, leaving you responsible for the difference. And your insurance
company might expect you to pay a higher percentage of the covered fees
than you would pay plan-affiliated doctors. If you have Medicare, find
out whether the doctor participates in Medicare.
What is the charge to you for a routine follow-up office visit? For a routine
follow-up hospital visit? For a typical general physical exam? The answers
will give you a sense of the doctors charges for other services, and how
the charges relate to your health plans payment rules.
How convenient is the doctors office? Is there public transportation?
What lab, X-ray, and machine diagnostic tests can be performed in the doctors
own office? While its convenient to have all these diagnostic services
performed in one place, be aware that doctors who provide these services
have a financial incentive for prescribing them, possibly leading to additional
When you have gathered all the information you can from calls to physicians
offices, conversations with friends, and other sources, consider a visit
to the physician who seems most appealing. While a visit just to meet a
doctor should be inexpensive or free, some patients find this kind of meeting
awkward, a feeling some doctors share. A considerably more expensive alternative
is to schedule a physical exam.
If you do not feel its immediately necessary to establish a relationship
with a doctor, keep your notes on the doctors you have researched and call
your first choice when a medical problem arises.
If you are dissatisfied with your first meeting, or any subsequent encounter,
look for someone else and have copies of your records sent there (you have
a right to your records). But avoid hopping from doctor to doctor. An established
relationship with a doctor you like and trust is a healthful asset.