Specialist as Gateway Doctor

Posted on: September 22nd, 2009 by

In a previous posting, I wrote about the importance of an excellent gateway physician; that is, the primary care physician. You need this person to refer you to excellent specialists and to make decisions on whatever is in your best interest, not health-management corporations.

If you find yourself in the position of needing a specialist, and you get an outstanding one based on the same litmus tests you used to find your general physician, you can also use your specialist as your gateway to other specialists. (Notice that I said an “outstanding” doctor because nothing less will do.)

For your convenience, I’ve repeated the litmus tests below:

Litmus test one: During your meeting, give an emotional prompt, like: “I’m afraid of blood tests.” Observe the doctor’s reactions. Is he/she emotionally vested in you? Reassuring? If not, find another doctor.

Litmus test two: Sometime in the week following your exam, call the doctor to ask a question. Does the doctor call you back promptly? Does he or she communicate with you clearly and patiently? Does he or she take your concerns seriously? If the answer to any of these is “no,” find another doctor.

Litmus test three: Based on litmus tests one and two, do you LOVE your doctor? If you are feeling badly about him/her or just so-so, find another doctor. Don’t settle for mediocrity because if there were a medical crisis, a doctor you love and who cares deeply about your welfare will be the one who fights for you.

Litmus test four: Does the doctor play “ring around the patient,” where he/she continuously throws statistics to impress you with his or her know-how? Does he/she come with print-outs of pages from the Internet to illustrate these statistics? Do you feel confused during and/or after the session?

Run – do not walk – away from this doctor.

Litmus test five: Does the doctor use scare tactics, telling you all the terrible things that can happen to you? Is he/she dismissive of your emotional and physical needs? Does he or she sound like a doctor who has watched too many ER or Grey’s Anatomy episodes? If so, this is not the doctor for you.

My oncologist meets — actually exceeds — all the above criteria. When I need a referral to a specialist, therefore, I call my oncologist. He’s an extraordinary, brilliant doctor, yet down to Earth.  He also returns ALL my calls in a matter of a few hours, even when he’s on vacation.
For those of you who think this type of doctor is a rarity, you are right. 

However, with persistence, checking a variety of specialists out, and by asking questions, you can find such a doctor.

Take the incompetent pediatrician I fired, for example. I needed a real pediatrician to examine my daughter, so I called my oncologist, who gave me the name of one he said was excellent. I told my specialist about my bad experience, and he said, and I quote: “I can guarantee you that you won’t be disappointed with her.”
Yes, a doctor used the word “guarantee.”

And we all know that doctors rarely put such a gold seal of approval on other doctors, nor is “guarantee” in doctors’ general vocabulary. That filled me with confidence, and my appointment with the new-hire pediatrician is, thankfully, next week.

While my oncologist’s word has proven to be good as gold, I know that, at the end of the day, it’s still me who has to make the decision about whether a specialist is good. But it sure helps to have an excellent specialist gateway doctor on your side.

In a near-future posting, I will be covering how I get the records from the pediatrician I fired to the one I’m probably going to hire. 

Yes, the answer is fax machine, or showing up in person to get copies. 

Seems simple, doesn’t it? Stay tuned because bad doctors often have bad administrative personnel (and trust me, these people were in a daze on the day of our appointment). This may be another Traincar Named Quagmire episode, minus the train.

Beth L. Gainer is a professional writer and has published numerous academic and magazine articles, as well as an essay on her breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. She writes about a potpourri of topics, including motherhood and her Chinese adoption experience at http://currents-living-discovery.blogspot.com/, and her cat Hemi blogs at http://www.catterchatter.blogspot.com/. Beth teaches writing and literature at Robert Morris University in the Chicago area. She has a guest posting on The World’s Strongest Librarian at http://worldsstrongestlibrarian.com/3597/sharing-a-loved-ones-pain-guest-post-by-beth-gainer/.

She can be contacted at bethlgainer@gmail.com and gainercallingtheshots@gmail.com.


This blog posting is an excerpt from my book in progress, Calling the Shots: Coaching Yourself Through the Medical System. Stay in loop for when it comes out. Subscribe to the blog in upper righthand corner.

4 Responses to Specialist as Gateway Doctor

  1. Alicia (aka Dr. Mom) had this to say about that:

    Another fantastic post! :)

    my internet has been so flukey and unreliable for the past month its been difficult for me to catch up on everyone, but i always love your supportive comments you leave on my blog! :)

    I also wanted to let you know that I nominated you for the Lemonade Award. Just pop over the my blog and read the recent post on the award. It will explain what to do if youre nominated (if you want to… its optional :) ) and you can also read my write up of your blog in my list of nominees !!

    And again, a GREAT post!

  2. Beth L. Gainer had this to say about that:

    Thank you, Alicia!! I’m so honored about the writeup you gave regarding my post. I will definitely accept the award and try to get the logo on my site. (Notice I say “try” because I can be computer-challenged).

  3. livefitblog had this to say about that:

    Great post! I couldn’t agree more with you about the need to choose a gateway doctor.

    I’ve just about come to the conclusion that most doctors (specialists, too) detest dealing with me. I’m a complete geek, so when I go to see a doctor, I don’t hesitate to question them. It’s been my experience that most “specialists” really don’t like to be questioned. Even if it’s innocuous.

  4. Beth L. Gainer had this to say about that:

    You are so right about doctors in general not liking questions; it somehow threatens their power. Many doctors are on power trips, which is why it’s so important to find ones who like answering your questions.

    They are out there. I surround myself with these types of doctors; however, it’s taken a lot of work to find them.

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