The adventure continues…
Monday, March 2 2009
So – I’m finally getting around to looking for new doctors. This post gives some context, but the goal is to see how far I get with the online tools available for health care comparison. (You can skip to the end for a summary.)
My PCP gave me specific provider names in my references, so my next step was to look at the website for the gastroenterologist she suggested. I found the site easily enough; the doctor is very attractive and probably has tiny hands (the latter is a huge plus in gastros) but her clinical interests are “hepatology” and “esophageal disorders”, neither of which are my problem. I still want to find my own doctor.
My next stop was my insurer’s online comparison tool; it took me several tries and a couple of secret questions to remember my password. Then once I was on, I discovered the site has the fastest time-out on the whole internet. In just the time it took me to write the above paragraph, my session expired and I had to log on again, and it kept doing that over and over again. It’s the most obvious tool for making this sort of decision, but not the most user-friendly.
More behind the cut…
Having already used HospitalCompare to find hospitals, what I was really after were doctors who were privileged in those hospitals. For those who don’t know, a doctor has to have privileges in a hospital to treat patients there. If you end up in a hospital where your doctor has no privileges, that doctor can’t (or won’t?) see you there. Instead, you get assigned to a new doctor – possibly out-of-network and all that. It makes life inside the hospital if you’re somewhere your doctor has privileges.
Unfortunately, the insurer’s tool doesn’t let me search for doctors by hospital. (Or so I thought.) Instead, I had to search by specialty, location, new patients, in-/out-of-network, and so on. My first try for an in-network, board-certified gastroenterologist accepting new patients yielded two physicians near my house, a couple ten miles away, and several twenty miles away. None of them have privileges at any of the three hospitals I would consider using.
It turns out that not even my current doctor is listed as in-network – which is odd, because I pay in-network copays when I see him. The doctor I have been referred to is not listed anywhere in the system. To find doctors near me that practice in the right hospitals, I had to set the search options as broad as possible – so I got a lot of not-board-certified, not-accepting-new-patients, out-of-network doctors that are mostly useless to me.
At which point, I gave up on my insurer’s tool and went to the hospitals websites. Each site has a “find a doctor” tool that points me towards gastros relatively quickly. Each of the sites includes “clinical interest” information, so I can look for someone who specializes in IBD (and avoid the guy who lists his interest as “invasive endoscopy”; I hope he’s not so honest on his online dating profile). Once I had names from each of the three hospitals, I went back to my insurer’s tool to check them out. It turns out all the doctors are part of the network, board-certified, and roughly comparable in terms of comparison measures. One of the doctors has a higher rating on cost efficiency – three stars as opposed to two – but that seems to be mostly a function of the hospital where he practices. It also turns out that if I began by looking for hospitals, I could choose to “view affiliated providers” – which would have streamlined things considerably.
An interesting side note: the data my insurer provides for the three hospitals is spotty, much more so than HospitalCompare. In particular, the comparison tool shows a lot less information for the two academic hospitals than it does for the much cheaper community hospital. I expected the insurer to be plugged in to HospitalCompare’s data (which aren’t proprietary, after all), but apparently not. Could they be obscuring some of the data to make the cheaper hospital look more attractive? Probably not; I doubt they’re that organized.
Next I found my state’s licensing board for doctors through this page from the AMA. It took a lot of clicking, but eventually I found a “doctor profile search” that let me look at each physician’s records. None of them were particularly revelatory – no major malpractice or disciplinary actions reported – although I did learn some interesting trivia about a couple of the doctors.
Finally, I looked at the CCFA’s online tool for finding physician members. The search only shows those physicians who are members, not whether they’re any good at treating IBD. Apparently, none of the physicians on my list are members – which is okay because neither am I. Honestly, I don’t put much stock in the CCFA. I also looked at Angie’s List, but only one of the doctors is listed – and him with only a single review.
So: now I have the names and phone numbers of doctors at each of the hospitals. All I have to do now is choose one, and make sure she or he is accepting new patients (2 of the 3 are females).
For the next two referrals I’m still sitting on, I’ll follow these steps:
- Use hospital websites to “Find a Doc”.
- Use the insurer’s tool to compare those results.
- Double-check these doctors against the state’s licensing database.
So: after two-plus hours of work, I’m fairly confident I have made the best use of the available online comparison tools. But I still don’t have a lot more information than what I began with. In fact, I could have stopped at the hospital websites and not missed much (except perhaps verifying in-network status for my insurer). And I could have gotten pretty much the same information in about ten or twenty minutes of conversation with people I know – the low-tech, “irrational” method that most patients use. From what I can tell, there’s just not a lot of value-added in these tools for patients; no wonder more people don’t use them. It’s not that we don’t want the information: we do. It’s just not there.
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