Regular TAE listeners know may be familiar with Dr. Pradeep Kumar, better known as “P.K.”  He is a frequent caller who contributes invaluable insights on all things medical.
Recently, “P.K.”, who is a gastro-enterologist based in Greensburg, joined Ron in studio, where he detailed ways that you can take full advantage of the often complex products and services that make up what we know to be health care.  He stressed five major points that you should consider when it comes to figuring out whether or not you are making the most out of your health care and medical coverage.

 

1. Medical transactions are different than other purchases.

For starters, the medical transactions that you make over the course of your lifetime are THE most important purchases you will ever make, more so than any home or vehicle or anything you purchase for a business.  Medical transactions, generally speaking, can literally be matters of life and death, where the wrong choice can be fatal.  Along those lines, there is usually just a one-time deal on serious health issues.  Unlike other major purchases, there are no do-overs, replacements, or return warranties with matters pertaining to the human body. 

• Also along those lines, medical issues are the most likely to directly cause physical pain to the body.  A major material purchase may cause some emotional stress or discomfort, but any concern or anxiety involved with these purchases generally passes after a brief period of time, with no real lingering side effects. 
• There is also a greater aura of mystery surrounding issues involved with the human body.  Generally, the interaction between doctor and patient is a private one, and only the patient knows how sick or hurt he or she truly is.  With material purchases, the needs and the problems to be addressed are much more apparent. 
• And with medical transactions, there isn’t as much “shopping around”, so the actual cost of the encounter isn’t as big a factor as the overall encounter itself..  If you’re sick or hurt, you need to get treated, and you’re generally willing to pay to get better.  This is at least the case for the vast majority with insurance.  On the other hand, it can still be a factor to varying degrees, because, in general, paying anything for health care isn’t favorable, even a mere co-pay.

 

2.   What to look for when finding a doctor.

More often than not, the biggest factor in determining which doctor is best is simply knowledge.  Does the doctor know his or her stuff?  The doctor needs to know not just the normal everyday physiology so that he or she may properly diagnose your condition, but also abnormal physiology in the event that you come to the doctor with something that he or she may not have seen before.  The doctor also needs to know all of the options that are available to the patient, as well as the pro’s and con’s of each option. 
(On the other hand, the doctor absolutely cannot “know everything”.  The doctor has to be a lifelong learner and innovator, as the medical profession changes more rapidly than many can keep up.)

• In terms of knowledge, the doctor must be the “go-to guy” (or gal) for any patient question or issue that can arise.  The patient just knows that something is wrong, and expects the doctor to be there to answer any and all questions pertaining to the patient’s situation.  The doctor should be able to observe and collect relevant data, then turn that data into a diagnosis and plan of action.  (Kind of like putting together a jigsaw puzzle).   The doctor must also be able to make these diagnoses in uncertain situations as well, sometimes instantaneously when the situation is urgent and the information provided to the doctor is incomplete.
• The doctor must also have a high level of technical skill, especially in situations where precision is essential, like surgical procedures.  The doctor must have a high rate of good outcomes and a low rate of complications in comparison with other like specialists.     
• Though it’s a subjective criteria, a good doctor must have the zeal necessary to act in the best interest of the patient at all times despite any obstacles that may stand in the way.  This generally takes the form of the doctor putting him- or herself in the patient’s shoes and sometimes, though it may not be in the doctor’s best interest, recommending a better alternative process for the patient, even if it means relinquishing the care of the patient to somebody else.
• A good doctor must also be able to communicate effectively at all times.  Not just with the patient, but with the patient’s family, fellow doctors, payers, and other people with whom the doctor interacts on a daily basis. The doctor must be able to accurately convey the findings, procedures, and possible outcomes with each patient situation, as well as convey the idea that in some cases, knowledge of a situation may be more limited due to the knowledge base that exists, as well as the complexity of the human body.
• A good doctor must be available.  He or she must be reachable on an urgent basis, or be reasonably able to set an appointment time frame based on the need of the patient.  Often times, this requires a good doctor to be available after hours.
• A good doctor should also be able to take a collaborative, compassionate stance with the patient.  Optimism and cheerfulness is essential, in order to relax the patient and to convey the idea that the patient and doctor are working together to get the patient well.  The doctor should be able and willing to educate the patient on good life style measures and work with the patient to ensure that the patient is meeting the stated objectives.

 

3.  How do you find a good doctor?

Sometimes, a patient can anticipate a need for a medical service a few weeks and months down the road.  If this is the case, it’s best to do your searching now, before you actually need the service.  Check the internet for data relevant to your situation or, if possible, go along with somebody else who is having the procedure done and observe what’s going on with that person.

• Ask around to friends and family to see if they know which health care facilities and providers would be best for you.   Also, it may be a stretch, but see if the doctor you’re possibly interested in has prior patients with whom you can talk about your situation.  While this may violate a doctor-patient privilege, there are doctors out there who would gladly share with you a successful tale of somebody who went through your situation.
• Assess your situation to find out what about that situation is most important, then go find a doctor that can complement that situation.  Sometimes, the diagnosis is the most important thing.   Maybe it’s the long term management that is crucial, or a procedure or related surgery that is a must. 
• Don’t just consider the doctor….if you’re looking at surgery or a procedure, take into account other members of the medical team, such as  nurses or anesthesiologists.  Their opinions, which are generally more candid than others, may be good indicators of the best fit for your situation.  (Related strategy: don’t just consider the hospital…for specialists, sometimes they’re on staff at multiple facilities.  Call around to these facilities and get a deeper perspective of the strengths and weaknesses of the specialist.)
• If you try asking around within the medical industry, be advised that sometimes, their answers may be influenced by a number of factors.  If you ask a family doctor about a specialist, they may give you a name, but generally, they may not have first-hand observation of the specialist performing the specific procedure you need “in action”.  The family doctor’s hand may also be forced by social or business connections that may flat out tell the doctor to which specialists he or she can refer patients.
• You should also be wary of the potential bias in the doctor’s self-description.  At the end of the day, it’s in the best interest of the doctor to have your business, so he or she may misrepresent his or her abilities to ensure that business.  Ask the doctor specific, direct, and quantifiable questions about your situation.  How often does the doctor encounter your situation.  What is the doctor’s success rate for the procedure you’re discussing?  How is the doctor’s major complication rate compared to the benchmark?

 

4. Don’t be fooled by misleading indicators.

There is a lot of data out there that would seem logical when considering whether or not a doctor is the best fit for your situation.  Some of it isn’t as relevant as you may think.

• “Busy” does not necessarily mean “good”.  A busy doctor may very well be good, but he or she may also be a good business person who knows how to go out and get patients.  Besides, if the doctor was so busy, would you trust that he or she would be available to meet your needs?
• Be wary of associations with big institutions.  Most instances of doctor/patient care are one-on-one, and the location of this interaction isn’t really that big a factor unless you’re dealing with a major technical situation, such as a transplant.   And the big institutions may also have complex processes that may limit your ability to be treated in a simple, effective manner. 
• Don’t be fooled by malpractice data.  Thanks to the litigious society, good doctors are getting sued more and more often nowadays.  The amount of lawsuits a doctor faces becomes more and more useless when compared to more intrinsic data, like the frequency of adverse outcomes.  If THIS number is higher than the benchmark, you may have a problem. 

 

5.  Do your part

• Don’t give your doctor anything to work against as he or she tries to keep you well.  Don’t smoke or drink heavy.  Learn about preventive activities, good habits, and preventive measures, including screening for such things as colon cancer.  Keep a detailed record of your medications, procedures, surgeries, and doctors.  Keep track of what your prior responses were to different forms of medication.  Learn about the diseases, procedures and the importance of followup.  This will give you a better indication of how to react if you notice that something is noticeably different. 

If you have any further questions, or want to discuss any of these points further with Dr. Kumar himself, he is reachable by telephone at (724) 837-8118.