Know your goals, shop around, ask questions—and speak up when dissatisfied.

Do you get high-quality care from your doctor? Often only another doctor can know for sure. But from your end of the stethoscope, you can sense whether you’re getting what you want and need from your doctor—and that’s quality by any patient’s definition, says Vicki Rackner, M.D., a surgeon, author, and expert on the doctor-patient relationship.

“Part of what you want, of course, is getting the right diagnosis and treatment plan, and avoiding medical mistakes,” Rackner explains. “But a bigger issue might be getting your questions answered. It might be your doctor listening to your story—a reminder that you’re not alone and there’s somebody in your corner.”

To help ensure you’re receiving the high-quality care you want and need, Rackner recommends that you:

• Always have your desired outcome in mind. There’s a medical goal and there’s a personal goal, she notes. For example, if your doctor is focused on experimenting with one pain medication after another but your headaches still aren’t going away, maybe you should nudge the doctor to look beyond the treatment and revisit your diagnosis.
• Get a second opinion. “Here’s the deal: We’re all human, doctors too. And even the smartest doctors can make mistakes,” Rackner says. Asking another expert to weigh in on your treatment plan——especially when treatment is risky or costly—will give you confidence that you’re getting the best care for your needs.
• Take time to make decisions. A wise surgeon once said, “Don’t just do something, stand there,” Rackner says. “When exploring your treatment options, there are very few situations where it will risk your health or compromise your outcome if you wait a week for a second opinion.” This is true even with many cancer diagnoses.
• Shop for an experienced provider. In general, practice makes perfect. If you need surgery for pancreatic cancer, you’re likely to get a better outcome when your surgeon or hospital performs many operations for pancreatic cancer. Politely ask the doctor or staff, “How many times a year do you treat patients with my diagnosis?”
• Ask for the best. You can’t be expected to know what three medications are important after a heart attack. But you can ask the doctor if there are any evidence-based practices that might guide your treatment. “Evidence-based practices is the buzzword, the secret handshake,” Rackner says. This is care that’s highly recommended in circumstances like yours, based on a solid body of research.
• Speak up if you’re dissatisfied. If something bothers you, don’t just tell yourself it’s nothing and ignore it. Imagine you were at a restaurant and the same thing happened—what would you do? There are gracious ways to ask for what you want and need from a doctor, Rackner says. Speak up at once rather than letting frustration build.
• Make sure health personnel wash their hands before treating you. This is important to avoid preventable infections. If you suspect your doctor hasn’t sanitized his or her hands before approaching you, one easy solution is to give the doctor your personal bottle of hand sanitizer. Have it in your lap and just hand it over—you don’t have to say a word. Or try a bit of humor: “I hope I don’t have to call the handwashing police!”
• Know the names of your medications. “I cannot tell you how many patients, when asked about their medications, told me, ‘Oh it’s that little pink pill!’ ” says Rackner. “Everyone should carry a list of their medications in their purse or wallet.” The medications and herbal remedies you take are an important clue to your safe, effective treatment.
• Confirm the site of surgery with the surgeon. We’ve all heard about people having operations on the wrong side of the body. When any part of your anatomy comes in pairs—for example, you’re having surgery on one leg—before surgery write “other side” on the opposite, healthy body part with an indelible marker.
• Live up to your end of the bargain. To ensure you follow through with your treatment plan, focus on your personal goal. For example, it’s no fun to pop pills for high blood pressure when you feel fine. But once your doctor gives you a reason that makes sense—like, taking the pills can help you avoid a heart attack and be around for your grandchildren—you’ll be more motivated to follow through.
• Let the doctor be the doctor. Ask the right questions, voice your preferences, and partner with your physician to make good decisions, Rackner says. But let your doctor—not your friend, a Web site, or even you—make the diagnosis.

7 Steps to a Top-Notch Doctor
Your choice of a doctor has a lot to do with the quality of the health care you receive. To find your best fit:

1. Consider what type of doctor might best suit your health care needs. An asthma specialist? An expert in alternative therapies? A primary care physician who can treat your whole family?
2. Look to your health plan’s list of in-network physicians. Their services will cost you less than those of out-of-network doctors.
3. Ask doctors, hospital nurses, or other health professionals who work with physicians to give their recommendations. Consult your family, friends, neighbors, and coworkers, too.
4. Check a Web site that rates doctors for quality, such as www.healthgrades.com.
5. Look for other helpful information on doctors at sites such as www.docboard.org or www.ama-assn.org/aps/amahg.htm.
6. Call the office of each doctor on your short list. Ask if the physician is covered by your health plan and has privileges at the hospital of your choice. Make sure the office hours are convenient and the doctor speaks the language you’re comfortable speaking.
7. Schedule an in-person visit with your top choice. Then you’ll know for sure if the doctor is the best fit for you.

Polly Turner spoke with Vicki Rackner, M.D., a board certified surgeon, former clinical instructor at the University of Washington School of Medicine, and oft-quoted expert in the doctor-patient relationship. Rackner is founder of The Caregiver Club and author of Caregiving Without Regrets: 3 Steps to Avoid Burnout and Manage Disappointment, Guilt, and Anger. Caregiver Club Press, 2009.

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