Sunday, November 4, 2012

The Smart Patient Consumer

The other day, I received a list of three doctors from the Workers' Compensation Appeals Board.  I still have some problems with one of my hands, and before my case is completely closed, it was suggested I take part in a QME--a "qualified medical examination."  My task was to pick one of the three doctors on the list and make an appointment.  How would I decide which one to see?  Well, I thought this subject might make a helpful blog post for anyone out there who needs to find a doctor and doesn't know how to weed out the less favorable candidates.

Because of my job working for a law firm that represents doctors, I suppose I have a little more knowledge about doctors and the resources available to me.  The first thing I did was to check each of the doctors with the California Medical Board.

The Board has a website where anyone can put in a physician's name--even if it's just the last name of the doctor--and find out information about them such as their schooling, how long they've been licensed, and whether they have had any significant legal actions against them.  If an accusation has been filed with the Medical Board, that legal document can be viewed also.

What I found when I checked the three doctors was that the first one had been sued in federal court and had a $170,000 judgment against him.  Because it was federal court, that implied to me that it may have been a case involving a prisoner, although there are a couple other possibilities.  But whatever it was, $170,000 is a pretty big judgment.

For doctors, when it comes to settlements and judgments, there are what are referred to as "reporting limits."  A settlement or judgment under $30,000 is not reportable to some of the databanks, and so sometimes a doctor will agree to settle a case under that limit just to have it done and over with, even if he or she didn't believe they had done anything wrong.  Finding out a doctor has had a settlement or judgment in an amount under $30,000 doesn't raise red flags the way a settlement or judgment over that limit would.

When I checked the second doctor, I found out the Medical Board had taken action against him some years prior.  In fact, his license to practice in the State of California and two other states had been suspended for three years, and he had only gotten his license back in June 2011.  It usually takes quite a bit to have a physician's license revoked or suspended.  I was able to access the accusation against him on the website and skim through it--I can't remember now why his license was suspended but I decided he probably wasn't the physician for me.

When I checked the third doctor, I didn't find anything negative about him.  He'd been practicing for around 35 years and his license looked clean.

Just to doublecheck, I went to another website--this one was for the ABMS (the American Board of Medical Specialties).  This website lists physicians in every state in the United States.  Doctors can apply for certification in a particular field of practice and will be required to pass a written examination and, in many cases, an oral examination.  Just because a physician isn't board certified doesn't mean he or she is a bad doctor, but it's just one more assurance we patients have that our doctors are competent and knowledgeable.  (If you want to check to see is a physician is board certified, the site will ask you to register with an email address and password, but you won't receive spam from them and anyone can sign up.)

When I checked all three of the physicians from the list I was provided, I found that all three were board certified--which was reassuring.  Given all the circumstances, I ended up making an appointment with that third doctor.  I should also mention that this third doctor was the one I'd have to travel farthest to see, so if I didn't know what resources were available to me to check on all of the physicians, he'd probably have been my last choice--I would have gone with the doctor whose office was only a couple blocks from my office, and that was the one with the big verdict against him.

Please keep in mind that just because a doctor has a judgment against him or her or had his or her license suspended at some point doesn't, in and of itself, mean the doctor is a bad one.  Doctors, like the rest of us, make mistakes on occasions; the mistakes made by doctors, though, tend to be more serious than the mistakes many of us make in our jobs.  But doctors aren't perfect.  The key is to make sure your doctor doesn't have a long history of mistakes, and in most cases, the information is out there; you just need to know where to look.

All states have medical licensing boards, and many can be accessed through the internet.  The other day I checked a physician's New York license, and I found that state had their records online.  If your state doesn't, though, you can call your state's medical board and find out how to get the information you need.

I have a little more information I wanted to pass on, but this post is long enough for now.  I'll post the rest of my thoughts on this subject in a day or two.


Marla said...

Fascinating information Kim. I probably told you before but I do medical case management in Illinois and of course the laws are very different than California. I too would not settle your case without checking it out further. Wish you luck!

Teresa in Music City said...

Thanks so much for sharing this info Kim! These are things the average Joe (like me) just wouldn't have the opportunity to know. I am currently looking for a new physician, and I will follow your advice here to make my decision. You just never know what you will learn when you sit down to cyber-chat with sewing buddies :*D

Pat said...

What great advice.

Miss Jean said...

Great information. I'll remember your post if I ever need to check on a doctor.

Rabid Quilter from CA said...

Excellent post! I added these websites to my bookmarks bar in a folder labeled "Doctors". Thanks!

Nancy said...

You have passed on valuable information but having worked in the medical field all my life pre-disability, I am a bit surprised that of the three names supplied to you, two had judgments against them - which as you said does not always mean a lot but........... One would certainly feel safer with a physician without anything against him or her. You can also check with the state licensing board (if you said that, I am sorry) as well as the Chief of Staff for that specialty at the hospital where the physician works. Some are more than willing to be open when asked directly - because I imagine they could be in a lot of trouble later for lying! Good luck and I wish you a complete recovery. I am very fortunate that when I had to see a disability physician as recommended by social security, it was actually someone with exceptional credentials and I felt like his evaluation and decision were accurate.

Anonymous said...

As a registered nurse, I see things from the other side of the mirror. Just as there are physicians who may no longer be qualified to practice a speciality, there are people who are other words, I have seen people pick out their sutures and scratch at their incisions to prevent healing. That and worse, only to be able to file a suit against a doctor. Oh the innocent mind, good people cannot even imagine all the things people with agendas can do.

There are so many variables to why people do not always respond to a treatment. If doctors knew EVERYTHING and could do no wrong, they would be miracle workers or God-like.....but they are after all, human. We can excuse everyone else's shortcoming, but never
a doctor. Why is that? Even if something is not their fault, they get blamed.

debbie m said...

Did you know a Dr can loose his license for treating a patient's condition in a manner considered unacceptable by the AMA, CDC, etc.
Off label use of meds is one. Watch the movie Under Our Skin, on lyme disease to see just one example. The CDC guidelines would have let me die, due to illness from tick bites. I had been treated more than once with their 2-3 week regiment of Doxycycline, but over a 5 year period of time (seeing a Dr. regularly) had become so weak I could not vaccuume my 13 x 16 living room. It had attacked my brain and central nervous system, causing my diaphram and heart to not work well. My muscles would get inflexible and cramp, due to the bacteria living in the tissue, and lack of blood and nutrients (heart not working, blood not flowing, lungs not oxygenating), and my brain function was that of a mid-stages alzheimer's patient. I was in my late 40's when I went to another doctor. He saved my life. It was a long process, and I am not as strong as I use to be, but am able to function...mostly.
Life is not always black and white, and LONG ago i learned that those in charge do not necessarily have our best interest in mind. These days the medical industry (and yes that is what it is) only has it's best interest in mind.

debbie m said...

I know you have had surgery on your hands/wrists with fairly good results, but still have some issues.
I have a friend who had knee issues, bone to bone, all the cushioning gone. The osteo said she needed surgery. Someone recommended a technique called PRPT- Plasma Rich Platelet Therapy (or maybe the plasma/platelet are reversed). It is fairly new, but she found a Dr who does it and without surgery, in less than half the time she would be in therapy after the surgery is completely well, no pain, exercising, etc, 6 months later.
It is used instead of surgery any time there is soft tissue/connective tissue damage. It uses your own blood, so there is no chance of getting a contaminated blood supply. I thought you might want to read about it as an option. Good luck on what ever you choose..