Before doctors check your vitals, check out theirs

WASHINGTON (AP) -- Americans consider insurance and a good bedside manner in choosing a doctor, but will that doctor provide high-quality care?

A poll shows that people don't know how to determine that.

Being licensed and likable doesn't necessarily mean a doctor is up to date on best practices. But consumers aren't sure how to uncover much more.

Just 22 percent are confident they can find information to compare the quality of local doctors.

That's according to the poll by The Associated Press-NORC Center for Public Affairs Research.

Today, 6 in 10 people say they trust doctor recommendations from friends or family, and nearly half value referrals from their regular physician.

The poll found far fewer trust quality information from online patient reviews, health insurers, ratings web sites, the media, even the government.

Referrals from another physician or family and friends are a first step in choosing a doctor, but specialists advise doing some research to finalize your choice.

Some tips:

• The insured typically look in-network. Some insurers are starting to score their providers on certain quality and cost measures. Ask what your plan's listing means.

• Check if the doctor is board-certified, which indicates particular expertise in an area such as internal medicine, gynecology, allergy and immunology. You don't want plastic surgery from a primary care physician, said Doris Peter, director of Consumer Reports' Health Ratings Center.

• Check if a doctor has been disciplined by the state licensing agency. The Federation of State Medical Boards has a directory of state boards, plus a license search service for a fee.

• If you need surgery or a specific procedure performed, ask how often the doctor provides that treatment to patients like you. Studies show volume makes a difference.

• Interview the doctor. Do you want someone who discusses the pros and cons of tests and treatments upfront? Avoid physicians who discourage seeking a second opinion, said Dr. Elliott Fisher of the Dartmouth Institute for Health Policy and Clinical Practice. Also, ask if the doctor has any financial relationships with drugmakers or device manufacturers, said Consumer Reports' Peter.

• Ask about specific health conditions. What percent of their diabetic patients have their blood sugar under control? Do they follow national guidelines on cancer screenings? That's the kind of information many quality programs are seeking. Fisher said physicians can't work to improve patients' outcomes if they don't track them.

• Team-based care makes a difference, he said. Is there a nutritionist to help diabetics control blood sugar? Someone who calls to tell the blood pressure patient he's overdue for a check?

• Ask how a primary care physician and specialist will coordinate care, perhaps via electronic medical records, so you're not prescribed conflicting medications or duplicative tests.

• Ask about after-hours care. Will the person who answers the phone have access to your medical record?

• Check if your state has any report cards to track health care quality. The nonprofit National Committee for Quality Assurance publishes online directories of doctors recognized for providing high-quality care for certain diseases or who are affiliated with "patient-centered medical homes," practices it recognizes as meeting certain requirements for coordinated care.

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