As reported by The Hartford Courant, August 27, 2008.

Looking for Dr. Right

Asking the Correct Questions When You're Seeking a New Physician

By Alix Boyle

Choosing a primary health care provider is a lot like choosing a spouse. The sickness-and-health part is obvious, but there are other things to consider.

Is there great chemistry? Do you share the same values? Will this person be there for you over the long haul? Does it take forever to get an appointment?

Martha Kubrynski, a physician's assistant at Kensington Primary Care — an internal-medicine practice in Kensington owned by the Hospital of Central Connecticut — advises that trust and communication are two important qualities to seek in a physician or physician's assistant.

"You are coming in at your most vulnerable," Kubrynski said. "You should look for somebody that you connect with."

Before signing up with a practice, call the various primary care offices you are interested in and ask the receptionist questions about how that particular office is run. First, ask if the practice is taking new patients — some popular doctors are full up. Then, find out if the office is conveniently located and how long patients typically wait to be seen by a physician, a physician's assistant or nurse practitioner. (A physician's assistant always works under the supervision of a doctor. A nurse practitioner can prescribe medication and make diagnoses without supervision.) Ask if the office has services on the premises that you may need, such as a radiology department or lab.

"Some offices have special interests like women's health, diabetes or preventive care," said Kubrynski. As a physician's assistant, Kubrynski does about 80 percent of what a physician does, performing physicals required of students by colleges and universities, reviewing safe sex practices with teenage patients and prescribing and reviewing medications with elderly patients.

She reviews visits with the physician in the practice, Dr. Katarzyna Wadolowski, who tends to see the older patients with more complicated conditions. Both providers speak Polish, a bonus for the many Polish patients who come from the New Britain area, and a receptionist in the office speaks Bosnian.

"That makes a lot of our patients comfortable because they can speak their native languages during their visit," Kubrynski said.

Don't be afraid to shop around, says Dr. David Dale, president of the American College of Physicians and a professor of medicine at the University of Washington in Seattle. He is also a practicing internist with a special interest in blood cell disorders.

"If you are employed and have health insurance, ask a friend or a colleague at work to look at the panel of doctors your health insurance allows," says Dale. "If you are moving within Connecticut, ask your current doctor to suggest someone in the new community."

The county medical society maintains a list of doctors and it is easy to review credentials online. It is also useful to network in any group of which you are a member: professional societies, college alumni groups and even book clubs.

"I would consult my medical school directory if I were moving to Katmandu," Dale said.

Look for a physician who matches your health values and treat the first visit as a meeting to see whether you click with this particular provider.

"Whether you have a special condition or are just perfectly healthy and want to stay that way, everyone needs a physician," Dale said. "The first person doesn't always match so it's a good idea to work on it and keep looking."

With all that said, people without health insurance must either pay cash to private doctors or depend on emergency rooms, neighborhood health centers or hospital clinics.

Specialists are somewhat easier to find because there are limited numbers of them. For example, Dr. John Nash, a gynecologic oncologist at University of Connecticut Health Center, said there are only about 800 board-certified physicians in his specialty with another 500 training in the field.

"You want to find a specialist with a track record that you can hang your hat on," said Nash, an associate professor of obstetrics and gynecology and director of administration and clinical affairs at the Carole and Ray Neag Comprehensive Cancer Center. Doctors should have board certification and experience in their specialty, Nash said.

"You also want to know what the individual has contributed to the world in the way of studies or research that has been published in journals," Nash said. "Is this person actively participating in clinical trials?"

Involvement in clinical trials is a sign that a doctor is up to date on the latest treatments for a given disorder. Patients at UConn are given the option of participating in clinical trials. For example, some women are participating in a study of whether Avastin, a drug used to treat colon cancer, is helpful for ovarian cancer as well. Information about getting into a trial is on the hospital's website (cancer.uchc.edu/clinical_trials/index.html).

Some hospitals are recognized as centers of excellence by the U.S. Department of Health and Human Services. That designation is another good way to find high-quality specialists.

How do you know when it's time to break up with your health care provider and find someone new?

If the health care provider isn't taking the time to answer your questions or you feel you're on too many medications and don't know why, it might be time for a fresh start with someone new, Kubrynski said.

"It's your life, and your health," Nash said. "Just do it."