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Massachusetts Medical Society's Physician Focus

November 2016

Choosing Your Care


  • The most important aspect of choosing your care is selecting a primary care physician and building a relationship based on mutual trust.
  • Websites that evaluate physicians and give them ratings can be useful, but all have limitations and shouldn’t be the sole source of a decision.
  • A good way to find a physician is to ask family, friends, or trusted colleagues.
  • Two-way trust and communication form the bedrock of a solid physician-patient relationship that leads to good medical care.

Health care is undergoing rapid change today, affecting hospitals, physicians, and patients alike in many ways. These changes are making the health care system increasingly complex, raising questions and confusion for patients.

How to simplify the process, get questions answered, limit the confusion, and obtain good, quality care are key elements that patients should consider when choosing their care. And the first critical step when deciding on your medical care is selecting a primary care physician.

“Everyone should have a primary care physician that they see on a regular basis,” says Barbara Spivak, M.D., a primary care physician with Mouth Auburn Medical Associates in Cambridge, Mass., “and the reason for that is simple. There are some very important screenings that occur at every age. And as you get older, the screenings become more important.”

Dr. Spivak, who is a clinical instructor in the Department of Medicine at Harvard Medical School and Chair of the Massachusetts Medical Society’s Committee on the Quality of Medical Practice in addition to her patient practice, appears on the November edition of Physician Focus to discuss what patients should consider when choosing their medical care. Hosting this edition is Bruce Karlin, M.D., a primary care physician in Worcester, Mass.

Picking a primary care physician is not only critical, says Dr. Spivak, but also complicated. “The first step, says Dr. Spivak, “is to figure out what’s important to you. Every physician has plusses and minuses.”

The basics apply, said Dr. Spivak. Location, accessibility, hours the doctor’s office is open, staff coverage when the doctor is not available, affiliation with medical facilities that you might want to go to should you need hospitalization, and whether the physician accepts the insurance you have are all factors that should be considered.

But Dr. Spivak suggests the primary consideration should be something else entirely. “The most important part of picking a physician is to find a physician that you trust is going to give you high quality care and take care of you as a person, so they can help you maneuver through the health care system, which, if you’re ill, can be quite complicated. You have to have a physician you can trust to talk to about what’s going on in your life.”

As Vice Chair of Massachusetts Health Quality Partners, a nonprofit coalition of multiple healthcare stakeholders engaged in objective, independent health care quality measurement and reporting, Dr. Spivak is well versed in how difficult rating health care providers can be. She urges patients to use many sources when seeking a physician, most notably recommendations from family, friends, or trusted colleagues.

And how does she regard those websites that rate physicians and hospitals? Many of them can provide useful information, particularly those from reputable sites such as major health care organization or facilities. But she is quick to caution about putting too much faith in them. “All of those sites have limitations,” she says.

She stresses that the key to good medical care is based on a trusting physician-patient relationship, and the best way to get that good care is “creating a relationship with a physician so that when you need him or her they know who you are.”

Medicine is both art and science, adds Dr. Spivak, and “part of the art of medicine is getting to know and trust your patient and have them get to know and trust you. “

She is adamant about emphasizing mutual trust and communication between doctor and patient. “If we do the right thing for our patients,” she says, “and if patients really trust their doctor and communicate with their doctors, they actually get better care and take better care of themselves. Then we all win.”

Watch the above video for more conversation, including discussion about the best ways to select a physician, the limitation of online sites that rate physician and hospitals, the trend to team-based care and how it affects patients, and what to do if you decide you don’t like your physician.

MMS/Richard Gulla

Massachusetts Medical Society - Choosing a Physician

Massachusetts Health Quality Partners

Consumer Reports - How to Find a Good Doctor

Choosing Wisely

Left to right; Bruce Karlin, M.D., Barbara Spivak, M.D.
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