With our constantly changing medical system, how does one choose a primary care physician?  What does one take into account when making this very important decision?

• 44,000 to 98,000 deaths annually from medical errors (Institute of Medicine)
• 225,000 deaths annually from medical errors including 106,000 deaths due to “nonerror adverse events of medications” (Starfield)
• 180,000 deaths annually from medication errors and adverse reactions (Holland)
• 2.9 to 3.7 percent of hospitalizations lead to adverse medication reactions
• 7,391 deaths resulted from medication errors (Institute of Medicine)
• 2.4 to 3.6 percent of hospital admissions were due to (prescription) medication events (Australian study)

Given these facts, and given that we all tend to put our health in the hands of our physicians, it is incredibly important that we pick the right professional.  Here are a few criteria to consider when picking your primary care doctor.  Primary care doctors can be either:

• Family practitioners — doctors who have completed a family practice residency and are board certified, or board eligible, for this specialty. The scope of their practice includes children and adults of all ages and may include obstetrics and minor surgery.
• Pediatricians — doctors who have completed a pediatric residency and are board certified, or board eligible, in this specialty. The scope of their practice includes the care of newborns, infants, children, and adolescents.
• Internists — doctors who have completed a residency in internal medicine and are board certified, or board eligible, in this specialty. The scope of their practice includes the care of adults of all ages for many different medical problems.
• Obstetricians/gynecologists — doctors who have completed a residency and are board certified, or board eligible, in this specialty. They often serve as a PCP (Primary Care Physician) for women, particularly those of childbearing age.

Be sure that they:

• Provide preventive care and teach healthy lifestyle choices
• Identify and treat common medical conditions
• Assess the urgency of your medical problems and direct you to the best place for that care
• Make referrals to medical specialists when necessary
• Is the office staff friendly and helpful? Is the office good about returning calls?
• Are the office hours convenient to your schedule?
• How easy is it to reach the provider? Does the provider use email?
• Do you prefer a provider whose communication style is friendly and warm, or more formal?
• Do you prefer a provider focused on disease treatment, or wellness and prevention?
• Does the provider have a conservative or aggressive approach to treatment?
• Does the provider order a lot of tests?
• Does the provider refer to other specialists frequently or infrequently?
• What do colleagues and patients say about the provider?
• Does the provider invite you to be involved in your care? Does the provider view your patient-doctor relationship as a true partnership?

In addition to all of this, when you first visit you doctor, he will be interested in your health history and family history.  This is all very important.  However a good contemporary doctor who is up to date on what keeps people healthy and understands that drugs and surgeries alone are very often not the best answer will want to know your weight, your Body Mass Index and should ask you how often and what types of exercise you do.  He should also be interested in the basics of your dietary consumption.  Although he is not an exercise specialist or a dietician, he should look for lifestyle deficiencies in terms of lack of proper exercise/activity and if you are getting the necessary nutrients in your diet (Does your eating include vegetables, fruits, whole grains, and lean proteins?).  Does your doctor encourage you to make lifestyle changes to better your state of health and is he as interested in preventing illness as much as treating it?

Also just as important.  Does your physician try other means before drug therapy?  Proper diet and exercise with weight loss can often times solve problems like high blood pressure, high cholesterol, and a pre-diabetic or type 2 diabetic conditions.  Drugs have side effects; every one of them.  Lifestyle changes generally don’t.  And, just as your doctor understands that he or she must refer out to specialists when necessary, are they willing to refer out to exercise specialists and registered dieticians?  Will they insist that you come back for a follow up 8 weeks after starting an exercise program to see if you have lost weight and if your vital signs and blood work have improved?

One of the unfortunate outcomes of Kupat Cholim, or HMO medicine, is that you may not get the kind of time with your doctor that you need and deserve.  It isn’t their fault–that is the system as opposed to private medicine.  You must use your allotted time well.  Come in prepared with intelligent questions and if your doctor does prescribes something for you, ask if there is a non-medicine alternative and if you do indeed need to take drugs, be sure you understand the side effects.  Although doctors are very busy, you should be able to contact him when necessary.

Please remember that your health is your responsibility.  Leading a life that includes healthy habits is crucial, but choosing the right doctor to be a partner and work together with you in that endeavor is an important step. Please remember that doctors have some knowledge of nutrition and exercise, but not extensive knowledge.  Personal Trainers, Exercise Physiologists and Dieticians do have extensive expertise.  Choosing a doctor interested in preventative health measure that will hopefully keep you OUT of his office will “add hours to your day, days to your year and years to your life.”

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 17 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at [email protected]  Check out the Lose It! web site – www.loseit.co.il    US Line: 516-568-5027