Vital Signs

March 17, 2015

Beware the Quickie Second Opinion

Because I monitor the marketplace of medical advisory services, I see trends come and go. One that’s currently in vogue is the “quickie” second opinion – a virtual case review that’s completed in about 2 – 3 days. After taking a closer look at the quickie second opinion, I think I have a better understanding of how it works, and so I have just one question –

Why in the world would you want one?

At Best Doctors, the problem we hear about all the time is that physicians don’t have enough time to spend seeing their patients and reviewing their cases, which invariably leads to missed diagnoses and incorrect treatment plans.

stopwatchI get it – we all want things quicker, but with second medical opinions, speed comes at the expense of getting it right. So let’s look at the anatomy of both kinds when a member needs help—

With a quickie second opinion, the member submits an online form that asks questions like, What’s your existing condition?, Describe the problem you’re having, or What type of doctor do you want to review your case? Here’s the trick – when facing medical uncertainty, the most common answer to those questions is “I have no idea.” With the right second opinion, a phone call is scheduled at the member’s convenience and a clinician takes whatever time is needed to go through the member’s medical history and questions.

With a quickie second opinion, members submit their own medical records online, or records are collected on their behalf from a single office. The problem? Members don’t often have their complete records (I certainly don’t have glass pathology slides lying around the house) and they typically have seen different doctors in different facilities. With the right second opinion, members grant permission and a records professional collects all relevant records and test samples from wherever they might be.

With a quickie second opinion, once (partial) records are in, the case goes to a specialist who has a particular affiliation or has an arrangement to do a certain number of cases. With the right kind of second opinion, the case goes to a specialist who has been peer nominated for clinical skill and independently verified, and that doctor gives the case a full and complete review.

With a quick second opinion, once the case review is done, findings are immediately sent to the member to ‘stop the clock’. With the right second opinion, a detailed report is written, which is reviewed for quality by a staff physician, and recommendations are put into plain English. Furthermore, rather than digitally dumping it on the member, a conversation takes place between the member and clinician, so that all questions are answered and the necessary time is spent.

It’s true – there are absolutely some cases (acute injuries, surgeries already scheduled, etc.) that demand a speedy turnaround, and there are mechanisms to do that. But what most cases demand is the clinical rigor that only comes from a detailed, deliberate case review.

I don’t blame other companies for trying to be like Best Doctors, but when you take a closer look at the services, it’s far from an apples-to-apples comparison. More like apples to aircraft carriers. In the world of virtual second opinions, it’s quickie or quality, and when it comes to your health, who has time for shortcuts?

Because I monitor the marketplace of medical advisory services, I see trends come and go. One that’s currently in vogue is the “quickie” second opinion – a virtual case review that’s completed in about 2 – 3 days. After taking a closer look at the quickie second opinion, I think I have a better understanding of how it works, and so I have just one question –

Why in the world would you want one?

At Best Doctors, the problem we hear about all the time is that physicians don’t have enough time to spend seeing their patients and reviewing their cases, which invariably leads to missed diagnoses and incorrect treatment plans.

stopwatchI get it – we all want things quicker, but with second medical opinions, speed comes at the expense of getting it right. So let’s look at the anatomy of both kinds when a member needs help—

With a quickie second opinion, the member submits an online form that asks questions like, What’s your existing condition?, Describe the problem you’re having, or What type of doctor do you want to review your case? Here’s the trick – when facing medical uncertainty, the most common answer to those questions is “I have no idea.” With the right second opinion, a phone call is scheduled at the member’s convenience and a clinician takes whatever time is needed to go through the member’s medical history and questions.

With a quickie second opinion, members submit their own medical records online, or records are collected on their behalf from a single office. The problem? Members don’t often have their complete records (I certainly don’t have glass pathology slides lying around the house) and they typically have seen different doctors in different facilities. With the right second opinion, members grant permission and a records professional collects all relevant records and test samples from wherever they might be.

With a quickie second opinion, once (partial) records are in, the case goes to a specialist who has a particular affiliation or has an arrangement to do a certain number of cases. With the right kind of second opinion, the case goes to a specialist who has been peer nominated for clinical skill and independently verified, and that doctor gives the case a full and complete review.

With a quick second opinion, once the case review is done, findings are immediately sent to the member to ‘stop the clock’. With the right second opinion, a detailed report is written, which is reviewed for quality by a staff physician, and recommendations are put into plain English. Furthermore, rather than digitally dumping it on the member, a conversation takes place between the member and clinician, so that all questions are answered and the necessary time is spent.

It’s true – there are absolutely some cases (acute injuries, surgeries already scheduled, etc.) that demand a speedy turnaround, and there are mechanisms to do that. But what most cases demand is the clinical rigor that only comes from a detailed, deliberate case review.

I don’t blame other companies for trying to be like Best Doctors, but when you take a closer look at the services, it’s far from an apples-to-apples comparison. More like apples to aircraft carriers. In the world of virtual second opinions, it’s quickie or quality, and when it comes to your health, who has time for shortcuts?

March 04, 2015

The Great Vaccination Debate

It’s an issue that’s been dominating headlines lately, one that galvanizes people on both sides of the debate.

A measles outbreak that originated in California’s Disneyland and has spread to several U.S. states and Canadian provinces has ignited a veritable firestorm over the issue of vaccination. “Pro-vaxxers” and “anti-vaxxers” alike have been digging their heals further into the ground as they offer up stories and statistics to bolster their arguments.

What’s clear is that vaccination is a deeply polarizing subject, striking a strong emotional chord with many. But why?

Let’s break down this complex topic by looking at both sides of the debate.

shutterstock_171044057The pro-vaccination argument

Pro-vaccination arguments are grounded in scientific studies, and there are many examples and statistics to support the position of those in the pro-vaccination camp.

Consider this: in the pre-vaccine era (before 1954), measles epidemics were a frequent occurrence. In Canada, measles was responsible for 400 cases of encephalitis (swelling of the brain) and 50 to 75 deaths annually. In the U.S., 3-4 million people were infected each year, an estimated 4,000 suffered encephalitis and 400 to 500 people died annually. Since the vaccine for measles, mumps and rubella was introduced in 1963, the number of measles cases has declined by over 99 percent in Canada, while in 2000, the United States declared that measles had been eliminated from the country (defined as the absence of continuous disease transmission for 12 months or more.)[1]

There are similar statistics for other diseases for which vaccines now exist. For example, more than 15,000 Americans died from diphtheria (an upper respiratory tract illness) in 1921, before there was a vaccine. The DPT (diphtheria, pertussis and tetanus) vaccine was licensed in 1949, and only one case of diphtheria has been reported to the Centers for Disease Control and Prevention in the U.S. since 2004[2].

Then there are the examples of what can happen when a disease that had previously been under control returns. For instance, in the 1970s in Japan, vaccinations rates among children for pertussis (whooping cough) dropped from 80 percent in 1974 to only 10 percent a few years later. In 1974, there were 393 cases of whooping cough in Japan and not one pertussis-related death. But in 1979, following the dramatic decline in vaccination rates, more than 13,000 people got whooping cough and 41 died. Routine vaccination ultimately resumed, leading to a drop in the rate of the disease[3].

While this is merely a small snapshot, there are countless other examples of devastating diseases (such as polio) that have now been largely eradicated, particularly in the developed world, thanks to vaccines.

The anti-vaccination argument

Those against immunization claim vaccines can cause seizures, developmental delays in children, paralysis and autoimmune disorders. To be sure, there are stories about children who experienced symptoms soon after being vaccinated. In most of these cases side effects tend to be mild adverse effects, such as fever, crying or minor irritability. A small minority of those who experience symptoms may have more serious side effects, however, in many cases it’s extremely difficult to prove a causal link between the vaccine and the symptoms. Still, personal stories are powerful and fuel the fears that some have about injecting otherwise healthy children with a weakened form of a virus or bacteria.

Anti-vaxxers also often point to a theory that posited a link between autism and the MMR vaccine. This 1998 study has since been retracted by the medical journal in which it appeared, as it contained incorrect information[4]. By the time this was revealed a belief had already firmly taken root in the minds of many, further bolstered by other concerns.

Anti-vaxxers also view compulsory immunization as an encroachment of their individual rights. Pro-vaxxers often counter this argument by bringing up the issue of social responsibility versus personal rights. If the majority of the population is vaccinated, what’s referred to as “herd immunity” is achieved, so that people who can’t get vaccinated (for instance, those with compromised immune systems, such as chemotherapy patients) are protected from certain diseases. This is a complex and nebulous area, pitting individual rights against the greater good.

The final word

Despite all the ink that’s been devoted to the issue, vaccination remains a confusing issue for many. In fact, a recent poll revealed that 40 percent of Canadians say the science behind vaccinations isn’t clear[5].

If you have questions about vaccination, make sure to consult with your family doctor, who can address your concerns and help you make a well-informed decision your  health and the health of your family.

[1] Sources: U.S. Center for Disease Control & Immunization Canada (http://www.cdc.gov/measles/about/faqs.html; http://www.immunize.ca/en/diseases-vaccines/measles.aspx)

[2] http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm

[3] Centers for Disease Control and Prevention (http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm)

[4] The National Center for Biotechnology Information (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/)

[5] http://angusreid.org/vaccines/

It’s an issue that’s been dominating headlines lately, one that galvanizes people on both sides of the debate.

A measles outbreak that originated in California’s Disneyland and has spread to several U.S. states and Canadian provinces has ignited a veritable firestorm over the issue of vaccination. “Pro-vaxxers” and “anti-vaxxers” alike have been digging their heals further into the ground as they offer up stories and statistics to bolster their arguments.

What’s clear is that vaccination is a deeply polarizing subject, striking a strong emotional chord with many. But why?

Let’s break down this complex topic by looking at both sides of the debate.

shutterstock_171044057The pro-vaccination argument

Pro-vaccination arguments are grounded in scientific studies, and there are many examples and statistics to support the position of those in the pro-vaccination camp.

Consider this: in the pre-vaccine era (before 1954), measles epidemics were a frequent occurrence. In Canada, measles was responsible for 400 cases of encephalitis (swelling of the brain) and 50 to 75 deaths annually. In the U.S., 3-4 million people were infected each year, an estimated 4,000 suffered encephalitis and 400 to 500 people died annually. Since the vaccine for measles, mumps and rubella was introduced in 1963, the number of measles cases has declined by over 99 percent in Canada, while in 2000, the United States declared that measles had been eliminated from the country (defined as the absence of continuous disease transmission for 12 months or more.)[1]

There are similar statistics for other diseases for which vaccines now exist. For example, more than 15,000 Americans died from diphtheria (an upper respiratory tract illness) in 1921, before there was a vaccine. The DPT (diphtheria, pertussis and tetanus) vaccine was licensed in 1949, and only one case of diphtheria has been reported to the Centers for Disease Control and Prevention in the U.S. since 2004[2].

Then there are the examples of what can happen when a disease that had previously been under control returns. For instance, in the 1970s in Japan, vaccinations rates among children for pertussis (whooping cough) dropped from 80 percent in 1974 to only 10 percent a few years later. In 1974, there were 393 cases of whooping cough in Japan and not one pertussis-related death. But in 1979, following the dramatic decline in vaccination rates, more than 13,000 people got whooping cough and 41 died. Routine vaccination ultimately resumed, leading to a drop in the rate of the disease[3].

While this is merely a small snapshot, there are countless other examples of devastating diseases (such as polio) that have now been largely eradicated, particularly in the developed world, thanks to vaccines.

The anti-vaccination argument

Those against immunization claim vaccines can cause seizures, developmental delays in children, paralysis and autoimmune disorders. To be sure, there are stories about children who experienced symptoms soon after being vaccinated. In most of these cases side effects tend to be mild adverse effects, such as fever, crying or minor irritability. A small minority of those who experience symptoms may have more serious side effects, however, in many cases it’s extremely difficult to prove a causal link between the vaccine and the symptoms. Still, personal stories are powerful and fuel the fears that some have about injecting otherwise healthy children with a weakened form of a virus or bacteria.

Anti-vaxxers also often point to a theory that posited a link between autism and the MMR vaccine. This 1998 study has since been retracted by the medical journal in which it appeared, as it contained incorrect information[4]. By the time this was revealed a belief had already firmly taken root in the minds of many, further bolstered by other concerns.

Anti-vaxxers also view compulsory immunization as an encroachment of their individual rights. Pro-vaxxers often counter this argument by bringing up the issue of social responsibility versus personal rights. If the majority of the population is vaccinated, what’s referred to as “herd immunity” is achieved, so that people who can’t get vaccinated (for instance, those with compromised immune systems, such as chemotherapy patients) are protected from certain diseases. This is a complex and nebulous area, pitting individual rights against the greater good.

The final word

Despite all the ink that’s been devoted to the issue, vaccination remains a confusing issue for many. In fact, a recent poll revealed that 40 percent of Canadians say the science behind vaccinations isn’t clear[5].

If you have questions about vaccination, make sure to consult with your family doctor, who can address your concerns and help you make a well-informed decision your  health and the health of your family.

[1] Sources: U.S. Center for Disease Control & Immunization Canada (http://www.cdc.gov/measles/about/faqs.html; http://www.immunize.ca/en/diseases-vaccines/measles.aspx)

[2] http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm

[3] Centers for Disease Control and Prevention (http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm)

[4] The National Center for Biotechnology Information (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/)

[5] http://angusreid.org/vaccines/

February 25, 2015

Diagnosis and Treatment: Getting it Right

When 11-year-old Samuel* was readmitted to the hospital with a history of soft-tissue infection and escalating symptoms, test results didn’t look good: infection had spread to his right tibia. After IV antibiotics didn’t work and serious complications continued to intensify, the recommendation was a below-the-knee amputation.

diagnostic errorThat’s when Best Doctors experts were called in to give a second opinion. After a careful review of Samuel’s symptoms, medical records, and test results, there was no change to the diagnosis. But the experts identified an alternative to amputation. Why not try a different antibiotic that was known for better absorption by the bone, plus some strategic, regular lab work, treatment, and tests for up to six months?

As it turned out, Samuel responded well to the new treatment plan and was able to avoid a life-altering amputation—not to mention all of the medical bills for a prosthesis and rehab.

Even with the best intentions, careful examinations and diligent research, sometimes doctors get it wrong. In fact, research reveals some startling information about the prevalence and consequences of diagnostic error:

  • 40,000 – 80,000 deaths in the United States each year are blamed on diagnostic error.[1]
  • 10-15% of all diagnoses are missed, wrong or delayed.[2]
  • 1 in 20 patients receive a diagnostic error each year.[3]
    • More than half of these errors occur in ambulatory care settings.
    • 28% happen in inpatient hospital settings.
    • 16% happen in the pressure-filled environment of the emergency room.
  • Primary care physicians and internists misdiagnose 13% of cases where a chronic condition exists.[4]

Getting the right diagnosis and treatment plan is critical for everyone. For the patient, nothing can compare to having peace of mind, quality care and, of course, the best possible outcome. For doctors and health plans, it’s crucial to know that patients are receiving excellent care, and it’s important to ensure quality while also controlling costs.

“I am so grateful to have had access to such a program,” Samuel’s dad said. “The guidance that both experts provided definitely gave my wife and I confidence knowing that our son was getting the most appropriate care.”

For more facts about diagnostic error and what Best Doctors is doing to confront the problem, download our new white paper here.


*The patient’s name was changed to protect his privacy.

[1] Leape LL. Counting deaths due to medical errors. JAMA. 2002;288:2404-05.

[2] Elstein A. Clinical reasoning in medicine. In: Higgs J, ed. Clinical reasoning in the health professions. Oxford, England: Butterworth-Heinemann Ltd. 1995;49–59.

[3] Singh H, Meyer AND, Thomas EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf. 2014; 0:1-5.

[4] Peabody JW, Luck J, Jain S, et al. Assessing the accuracy of administrative data in health information systems. MedCare. 2004;42:1066–72.

When 11-year-old Samuel* was readmitted to the hospital with a history of soft-tissue infection and escalating symptoms, test results didn’t look good: infection had spread to his right tibia. After IV antibiotics didn’t work and serious complications continued to intensify, the recommendation was a below-the-knee amputation.

diagnostic errorThat’s when Best Doctors experts were called in to give a second opinion. After a careful review of Samuel’s symptoms, medical records, and test results, there was no change to the diagnosis. But the experts identified an alternative to amputation. Why not try a different antibiotic that was known for better absorption by the bone, plus some strategic, regular lab work, treatment, and tests for up to six months?

As it turned out, Samuel responded well to the new treatment plan and was able to avoid a life-altering amputation—not to mention all of the medical bills for a prosthesis and rehab.

Even with the best intentions, careful examinations and diligent research, sometimes doctors get it wrong. In fact, research reveals some startling information about the prevalence and consequences of diagnostic error:

  • 40,000 – 80,000 deaths in the United States each year are blamed on diagnostic error.[1]
  • 10-15% of all diagnoses are missed, wrong or delayed.[2]
  • 1 in 20 patients receive a diagnostic error each year.[3]
    • More than half of these errors occur in ambulatory care settings.
    • 28% happen in inpatient hospital settings.
    • 16% happen in the pressure-filled environment of the emergency room.
  • Primary care physicians and internists misdiagnose 13% of cases where a chronic condition exists.[4]

Getting the right diagnosis and treatment plan is critical for everyone. For the patient, nothing can compare to having peace of mind, quality care and, of course, the best possible outcome. For doctors and health plans, it’s crucial to know that patients are receiving excellent care, and it’s important to ensure quality while also controlling costs.

“I am so grateful to have had access to such a program,” Samuel’s dad said. “The guidance that both experts provided definitely gave my wife and I confidence knowing that our son was getting the most appropriate care.”

For more facts about diagnostic error and what Best Doctors is doing to confront the problem, download our new white paper here.


*The patient’s name was changed to protect his privacy.

[1] Leape LL. Counting deaths due to medical errors. JAMA. 2002;288:2404-05.

[2] Elstein A. Clinical reasoning in medicine. In: Higgs J, ed. Clinical reasoning in the health professions. Oxford, England: Butterworth-Heinemann Ltd. 1995;49–59.

[3] Singh H, Meyer AND, Thomas EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf. 2014; 0:1-5.

[4] Peabody JW, Luck J, Jain S, et al. Assessing the accuracy of administrative data in health information systems. MedCare. 2004;42:1066–72.

February 04, 2015

6 Tips to Make the Most of Your Doctor Appointments

No one wants to walk away from a doctor’s appointment with unanswered questions and nagging health concerns they didn’t address during the visit. To prevent this from happening, here are six tips to help you get the most out of your doctor appointments:

1. Speak up and ask questions. When it comes to your health, remember that you’re your own best advocate. As a patient, you have the right to understand your symptoms and illness. Taking charge of your health means being involved in every facet of your health care. Be sure to be an active participant during visits with your doctor, rather than just an audience. This means:

  • Having a thorough understanding of any illnesses you have, and making sure you understand your treatment plan and any medications you’ve been prescribed
  • Voicing any concerns you may have
  • Making sure you have all the information you need to make educated decisions about your health
  • Making sure you understand any medical procedures or tests being administered

2. Bring all medications to your first visit. The first visit with your doctor will be that much more productive if you come to the appointment armed with all the information your doctor needs. This means bringing your medications (or a list of your medications) to the appointment, and making sure you tell the doctor when and how you take your medications. Having this information will help your doctor evaluate any potential interactions between various medications.

3. Bring copies of relevant investigations or tests. Any missing information or test results that have not been transferred before your visit will only bog down the process. So be sure that your doctor has access to all your medical information, including test results. Making sure your doctor knows you well can only benefit you. It’s also a good idea to build your own medical file, so that you have all the information your doctor needs – just ask for copies of your tests from your doctor and any specialists you have visited.

4. Bring a friend or family member. For some people, bringing a friend or family member to their doctor’s appointment may help ensure they don’t forget anything important during the visit. A friend or family member can remind you of questions or may be better able to speak up and ask the doctor to clarify any uncertainties or address any misunderstandings, particularly if you tend to feel nervous or overwhelmed during appointments.

If you’re bringing another person to your appointment, it’s a good idea to hash out a plan prior to meeting with your doctor. That way you can make sure you both agree on what the other person’s role is during the visit.

5. Leave your shyness at home. This may be easier said than done, but it’s crucial to check any shyness at the door before entering your doctor’s office. Your doctor won’t be able to properly address any medical concerns or health issues unless you’re open and honest and share all pertinent information. Be sure not to minimize or omit any symptoms you’re experiencing. You can rest assured that anything you share is strictly confidential, so make sure your doctor has all the information they need before you leave their office. This will make the process more efficient and expedient, ensuring you get the best medical care possible.

6. Describe your symptoms, not your diagnosis. These days, it’s tempting to self-diagnose when most of us enlist the help of Dr. Google at the first sign of any symptoms. Resist this temptation and allow your physician to make the diagnosis. Your doctor relies on you to accurately describe what you’re experiencing and any concerns you have. And you should rely on your doctor to determine any patterns and make an accurate diagnosis, employing their accumulated years of knowledge, experience and medical training.

Although you may have the best intentions in wanting to help out your doctor, conveying what you think is the diagnosis rather than properly describing your symptoms is ultimately counter-productive and, in the worst case scenario, may even lead to a misdiagnosis.

No one wants to walk away from a doctor’s appointment with unanswered questions and nagging health concerns they didn’t address during the visit. To prevent this from happening, here are six tips to help you get the most out of your doctor appointments:

1. Speak up and ask questions. When it comes to your health, remember that you’re your own best advocate. As a patient, you have the right to understand your symptoms and illness. Taking charge of your health means being involved in every facet of your health care. Be sure to be an active participant during visits with your doctor, rather than just an audience. This means:

  • Having a thorough understanding of any illnesses you have, and making sure you understand your treatment plan and any medications you’ve been prescribed
  • Voicing any concerns you may have
  • Making sure you have all the information you need to make educated decisions about your health
  • Making sure you understand any medical procedures or tests being administered

2. Bring all medications to your first visit. The first visit with your doctor will be that much more productive if you come to the appointment armed with all the information your doctor needs. This means bringing your medications (or a list of your medications) to the appointment, and making sure you tell the doctor when and how you take your medications. Having this information will help your doctor evaluate any potential interactions between various medications.

3. Bring copies of relevant investigations or tests. Any missing information or test results that have not been transferred before your visit will only bog down the process. So be sure that your doctor has access to all your medical information, including test results. Making sure your doctor knows you well can only benefit you. It’s also a good idea to build your own medical file, so that you have all the information your doctor needs – just ask for copies of your tests from your doctor and any specialists you have visited.

4. Bring a friend or family member. For some people, bringing a friend or family member to their doctor’s appointment may help ensure they don’t forget anything important during the visit. A friend or family member can remind you of questions or may be better able to speak up and ask the doctor to clarify any uncertainties or address any misunderstandings, particularly if you tend to feel nervous or overwhelmed during appointments.

If you’re bringing another person to your appointment, it’s a good idea to hash out a plan prior to meeting with your doctor. That way you can make sure you both agree on what the other person’s role is during the visit.

5. Leave your shyness at home. This may be easier said than done, but it’s crucial to check any shyness at the door before entering your doctor’s office. Your doctor won’t be able to properly address any medical concerns or health issues unless you’re open and honest and share all pertinent information. Be sure not to minimize or omit any symptoms you’re experiencing. You can rest assured that anything you share is strictly confidential, so make sure your doctor has all the information they need before you leave their office. This will make the process more efficient and expedient, ensuring you get the best medical care possible.

6. Describe your symptoms, not your diagnosis. These days, it’s tempting to self-diagnose when most of us enlist the help of Dr. Google at the first sign of any symptoms. Resist this temptation and allow your physician to make the diagnosis. Your doctor relies on you to accurately describe what you’re experiencing and any concerns you have. And you should rely on your doctor to determine any patterns and make an accurate diagnosis, employing their accumulated years of knowledge, experience and medical training.

Although you may have the best intentions in wanting to help out your doctor, conveying what you think is the diagnosis rather than properly describing your symptoms is ultimately counter-productive and, in the worst case scenario, may even lead to a misdiagnosis.

January 20, 2015

Boosting Our Brain Health

As we usher in a new year, many of us have resolved to get in better shape for 2015. Indeed, working out more (or for some, just working out) ranks as a popular New Year’s resolution. But while we often focus on exercise for our bodies, what about exercise for our minds? With rates of Alzheimer’s disease soaring in North America, there’s very good reason to be concerned about our brains as we age.

shutterstock_172743725

January is Alzheimer’s awareness month in Canada, a sharp reminder of just how serious and widespread the disease is. The statistics are alarming: 747,000 Canadians live with it, a number that’s projected to nearly double to 1.4 million Canadians by 2031[1]. In the United States, more than 5 million people are living with the disease, which is ranked as the sixth leading cause of death. One in three seniors in the United States dies with Alzheimer’s or another form of dementia[2]. Alzheimer’s is often associated with the elderly, yet it can also strike at a younger age. Early onset Alzheimer’s affects people in their 40s and 50s – up to five percent of Americans with Alzheimer’s have early-onset.

Alzheimer’s disease is the most common form of dementia and its personal toll is devastating. Those affected experience memory loss and a deterioration of their intellectual abilities as symptoms gradually worsen over time. In the later stages of the disease, those afflicted are unable to carry on a conversation and have trouble with daily tasks. There is an effort to increase understanding about the disease – and reduce the stigma that keeps people from talking about it – and talking to their doctors, because early diagnosis is key [3].

While these statistics are sobering, we can also take heart in the fact that there are concrete steps we can take to improve our brain health as we age. These include:

  • Avoiding smoking and excessive alcohol consumption
  • Reducing stress
  • Challenging the brain by trying something new, playing games (for instance, crossword puzzles) or learning a new language
  • Eating a healthy diet rich in fish, legumes and vegetables
  • Staying socially connected and regularly interacting with others
  • Being physically active
  • Keeping blood pressure, cholesterol, blood sugar and weight within recommended ranges

Taking charge of our overall health must include looking after our cognitive health too, because if we ignore our brain health the costs of doing so could be very high. Right now, there’s no cure for Alzheimer’s disease so taking active steps to help guard against dementia is our best defence.

[1] Alzheimer Society of Canada http://www.alzheimer.ca/en/About-dementia/What-is-dementia/Dementia-numbers
[2] Alzheimer’s Association  http://www.alz.org/alzheimers_disease_facts_and_figures.asp#quickFacts

[3] Canadian Institute of Health Research. http://www.cihr-irsc.gc.ca/e/47856.html

 

As we usher in a new year, many of us have resolved to get in better shape for 2015. Indeed, working out more (or for some, just working out) ranks as a popular New Year’s resolution. But while we often focus on exercise for our bodies, what about exercise for our minds? With rates of Alzheimer’s disease soaring in North America, there’s very good reason to be concerned about our brains as we age.

shutterstock_172743725

January is Alzheimer’s awareness month in Canada, a sharp reminder of just how serious and widespread the disease is. The statistics are alarming: 747,000 Canadians live with it, a number that’s projected to nearly double to 1.4 million Canadians by 2031[1]. In the United States, more than 5 million people are living with the disease, which is ranked as the sixth leading cause of death. One in three seniors in the United States dies with Alzheimer’s or another form of dementia[2]. Alzheimer’s is often associated with the elderly, yet it can also strike at a younger age. Early onset Alzheimer’s affects people in their 40s and 50s – up to five percent of Americans with Alzheimer’s have early-onset.

Alzheimer’s disease is the most common form of dementia and its personal toll is devastating. Those affected experience memory loss and a deterioration of their intellectual abilities as symptoms gradually worsen over time. In the later stages of the disease, those afflicted are unable to carry on a conversation and have trouble with daily tasks. There is an effort to increase understanding about the disease – and reduce the stigma that keeps people from talking about it – and talking to their doctors, because early diagnosis is key [3].

While these statistics are sobering, we can also take heart in the fact that there are concrete steps we can take to improve our brain health as we age. These include:

  • Avoiding smoking and excessive alcohol consumption
  • Reducing stress
  • Challenging the brain by trying something new, playing games (for instance, crossword puzzles) or learning a new language
  • Eating a healthy diet rich in fish, legumes and vegetables
  • Staying socially connected and regularly interacting with others
  • Being physically active
  • Keeping blood pressure, cholesterol, blood sugar and weight within recommended ranges

Taking charge of our overall health must include looking after our cognitive health too, because if we ignore our brain health the costs of doing so could be very high. Right now, there’s no cure for Alzheimer’s disease so taking active steps to help guard against dementia is our best defence.

[1] Alzheimer Society of Canada http://www.alzheimer.ca/en/About-dementia/What-is-dementia/Dementia-numbers
[2] Alzheimer’s Association  http://www.alz.org/alzheimers_disease_facts_and_figures.asp#quickFacts

[3] Canadian Institute of Health Research. http://www.cihr-irsc.gc.ca/e/47856.html

 

January 06, 2015

EMPLOYER INSIGHTS: ‘Big Data’ Meets Health Care

We’ve been hearing for years that we’re in the era of Big Data, and that employers in particular have scads of data at their fingertips, just waiting to be utilized for everyday decision making. But there are two key problems posed by Big Data today—

best doctors data1)  Collection is a burden and not always reliable. Every time I buy a product online, I get a request to rate the item (…or its timeliness…or its packaging). The contractor who redid my bathroom wants an online review. My optometrist wants an online review. The ticketing company wants a review of the concert I attended. A community I subscribe to wants feedback on the experience. And on and on. I don’t blame them for trying and I’m sure it’s a boon to these folks, but if I supplied a data point every time I was asked, there wouldn’t be time for anything else.

The corollary to this problem is the veracity of the data we supply. It turns out that the actions we take often aren’t the same as what we report. Better than asking me what I think of the packaging from an online order would be to observe my behavior while unwrapping it: how long did it actually take; did I cut myself; what special tools or techniques did I have to use to open it; and how do these metrics compare to all my other recent online purchases? That kind of insight is as impactful as it is impractical to get.

2)  Someone has to do something with the data. This is the one I run into all the time on the job. As a marketing professional, I have myriad companies approaching me with ‘analytics tools’ and ‘dashboards’ – solutions that supposedly take the data created by my activities and create hundreds of charts, graphs, and reports. And therein lies the other problem with Big Data: someone has to make sense of it on the back end. But just as I don’t have time to create data points all day by reviewing products, I don’t have the time to pour over countless bar graphs and tables to make my best guesstimate at what that fraction of a % difference means.

So what to do about Big Bad Data when it comes to health care, the realm with more data points than perhaps any other? Rather than having members supply the data points, why not focus on listening, by securely monitoring the digital health records, claims data, demographics information, and other relevant health data that’s already being created by members in the course of managing their health? When properly set up, members create the actionable data by simply going about their business as they normally would. As the doctor famously says, “This won’t hurt a bit.”

The other piece is to go beyond incomprehensible charts and reports to get at insights that are truly actionable. By connecting enough data sources and a critical mass of data points, patterns begin to emerge. Add to the mix algorithms that enable interaction with the data, and now we can begin to target specific condition and high-cost claim areas, and ultimately use the data to predict what’s next for the health of a population.

The best part is that it’s reality and it’s available in 2015. Rise Health joined with Best Doctors to combine powerful predictive data capabilities with the world-leading medical interventions to allow employers to target their specific concerns and ensure the health of their populations. Actionable insights and powerful interventions to enable the right care. And the year’s just getting started! Learn more and continue the conversation with us.

We’ve been hearing for years that we’re in the era of Big Data, and that employers in particular have scads of data at their fingertips, just waiting to be utilized for everyday decision making. But there are two key problems posed by Big Data today—

best doctors data1)  Collection is a burden and not always reliable. Every time I buy a product online, I get a request to rate the item (…or its timeliness…or its packaging). The contractor who redid my bathroom wants an online review. My optometrist wants an online review. The ticketing company wants a review of the concert I attended. A community I subscribe to wants feedback on the experience. And on and on. I don’t blame them for trying and I’m sure it’s a boon to these folks, but if I supplied a data point every time I was asked, there wouldn’t be time for anything else.

The corollary to this problem is the veracity of the data we supply. It turns out that the actions we take often aren’t the same as what we report. Better than asking me what I think of the packaging from an online order would be to observe my behavior while unwrapping it: how long did it actually take; did I cut myself; what special tools or techniques did I have to use to open it; and how do these metrics compare to all my other recent online purchases? That kind of insight is as impactful as it is impractical to get.

2)  Someone has to do something with the data. This is the one I run into all the time on the job. As a marketing professional, I have myriad companies approaching me with ‘analytics tools’ and ‘dashboards’ – solutions that supposedly take the data created by my activities and create hundreds of charts, graphs, and reports. And therein lies the other problem with Big Data: someone has to make sense of it on the back end. But just as I don’t have time to create data points all day by reviewing products, I don’t have the time to pour over countless bar graphs and tables to make my best guesstimate at what that fraction of a % difference means.

So what to do about Big Bad Data when it comes to health care, the realm with more data points than perhaps any other? Rather than having members supply the data points, why not focus on listening, by securely monitoring the digital health records, claims data, demographics information, and other relevant health data that’s already being created by members in the course of managing their health? When properly set up, members create the actionable data by simply going about their business as they normally would. As the doctor famously says, “This won’t hurt a bit.”

The other piece is to go beyond incomprehensible charts and reports to get at insights that are truly actionable. By connecting enough data sources and a critical mass of data points, patterns begin to emerge. Add to the mix algorithms that enable interaction with the data, and now we can begin to target specific condition and high-cost claim areas, and ultimately use the data to predict what’s next for the health of a population.

The best part is that it’s reality and it’s available in 2015. Rise Health joined with Best Doctors to combine powerful predictive data capabilities with the world-leading medical interventions to allow employers to target their specific concerns and ensure the health of their populations. Actionable insights and powerful interventions to enable the right care. And the year’s just getting started! Learn more and continue the conversation with us.

December 18, 2014

What’s Happening @ Best Doctors, 2014 Edition

It’s the time of year again – when we look back on some of the goings-on at Best Doctors and roll it all up into an infographic. The numbers tell quite a story!

Best_Doctors_infographic_Dec2014

It’s the time of year again – when we look back on some of the goings-on at Best Doctors and roll it all up into an infographic. The numbers tell quite a story!

Best_Doctors_infographic_Dec2014

November 26, 2014

Winter May Be Making You SAD

The shorter days at this time of year may leave many of us feeling down, but for some people it’s more than a simple case of the winter blahs.

SAD womanThe lack of sunlight that begins in late autumn can trigger a type of clinical depression for some people that can last until spring. Aptly referred to as SAD – seasonal affective disorder – this form of depression affects an estimated 10 million Americans (another 10 to 20% may have mild SAD[1]) and up to six per cent of Canadians (another 15% of Canadians experience a milder form of SAD[2]).

So if you’re feeling glum around this time of year, how can you tell if it’s just the winter doldrums or something more serious? Here are a few signs you may be suffering from SAD:

  • Sleeping more than usual (up to two to four hours a day)
  • Feeling lethargic (low energy levels)
  • Craving foods high in carbohydrates
  • Weight gain
  • Withdrawal from people and social activities
  • A depressive mood that has occurred over at least two consecutive winters, alternating with a non-depressive mood in the spring and summer.

SAD Facts:

  • Women are up to eight times as likely as men to report having SAD
  • SAD tends to run in families
  • SAD is more common among people who live in northern latitudes
    (Source: Mood Disorders Association of Ontario)

Feeling blue on some days can be normal. But if you feel down for extended periods and this is coupled with difficulty getting motivated to do activities you normally enjoy, changes in sleep patterns or changes in appetite, it may be time to seek medical help. Be sure to tell your doctor about any symptoms you’re experiencing and how they’re impacting your daily life (for instance, if you’re missing work, having trouble getting out of bed, etc.)

Thankfully, there are treatment options available that may help if SAD is seriously interfering with your day-to-day life. For some people – especially those with milder cases of SAD – getting a daily dose of sunlight in the form of light therapy can work wonders.

This consists of regular, daily exposure to a “light box” that simulates high-intensity sunlight. Daily sessions are typically 30 to 60 minutes long and should be continued until there’s sufficient natural daylight (so until the spring.)

Light therapy is ideal for anyone who prefers not to (or is unable to) take antidepressant medication. Studies have even shown that this treatment is as effective as antidepressants in many cases of non-severe SAD, and a bonus is that side effects are also uncommon.

If light therapy doesn’t work or your case of SAD is more severe, antidepressant medication (such as Prozac) may be helpful. Just be sure to discuss the risks and benefits of taking this route with your doctor.

Another treatment option is cognitive behavioural therapy – this is a type of psychotherapy that’s been shown to be effective in the treatment of depression. You’ll need to get a referral for a psychologist who specializes in this area.

If you think you might have SAD and would like a second opinion or need help finding a specialist, remember that Best Doctors is always here to help.

[1] Psychology Today (http://www.psychologytoday.com/conditions/seasonal-affective-disorder)
[2] Mood Disorders Association of Ontario (http://www.mooddisorders.ca/faq/seasonal-affective-disorder-sad)

The shorter days at this time of year may leave many of us feeling down, but for some people it’s more than a simple case of the winter blahs.

SAD womanThe lack of sunlight that begins in late autumn can trigger a type of clinical depression for some people that can last until spring. Aptly referred to as SAD – seasonal affective disorder – this form of depression affects an estimated 10 million Americans (another 10 to 20% may have mild SAD[1]) and up to six per cent of Canadians (another 15% of Canadians experience a milder form of SAD[2]).

So if you’re feeling glum around this time of year, how can you tell if it’s just the winter doldrums or something more serious? Here are a few signs you may be suffering from SAD:

  • Sleeping more than usual (up to two to four hours a day)
  • Feeling lethargic (low energy levels)
  • Craving foods high in carbohydrates
  • Weight gain
  • Withdrawal from people and social activities
  • A depressive mood that has occurred over at least two consecutive winters, alternating with a non-depressive mood in the spring and summer.

SAD Facts:

  • Women are up to eight times as likely as men to report having SAD
  • SAD tends to run in families
  • SAD is more common among people who live in northern latitudes
    (Source: Mood Disorders Association of Ontario)

Feeling blue on some days can be normal. But if you feel down for extended periods and this is coupled with difficulty getting motivated to do activities you normally enjoy, changes in sleep patterns or changes in appetite, it may be time to seek medical help. Be sure to tell your doctor about any symptoms you’re experiencing and how they’re impacting your daily life (for instance, if you’re missing work, having trouble getting out of bed, etc.)

Thankfully, there are treatment options available that may help if SAD is seriously interfering with your day-to-day life. For some people – especially those with milder cases of SAD – getting a daily dose of sunlight in the form of light therapy can work wonders.

This consists of regular, daily exposure to a “light box” that simulates high-intensity sunlight. Daily sessions are typically 30 to 60 minutes long and should be continued until there’s sufficient natural daylight (so until the spring.)

Light therapy is ideal for anyone who prefers not to (or is unable to) take antidepressant medication. Studies have even shown that this treatment is as effective as antidepressants in many cases of non-severe SAD, and a bonus is that side effects are also uncommon.

If light therapy doesn’t work or your case of SAD is more severe, antidepressant medication (such as Prozac) may be helpful. Just be sure to discuss the risks and benefits of taking this route with your doctor.

Another treatment option is cognitive behavioural therapy – this is a type of psychotherapy that’s been shown to be effective in the treatment of depression. You’ll need to get a referral for a psychologist who specializes in this area.

If you think you might have SAD and would like a second opinion or need help finding a specialist, remember that Best Doctors is always here to help.

[1] Psychology Today (http://www.psychologytoday.com/conditions/seasonal-affective-disorder)
[2] Mood Disorders Association of Ontario (http://www.mooddisorders.ca/faq/seasonal-affective-disorder-sad)

November 25, 2014

Changing Culture to Address Diagnostic Error

Lewis M. Levy, MD, is SVP, Medical Affairs & Chief Quality Officer at Best Doctors. He also chairs the Medical Advisory Board, the group established to guide and inspire medical leadership at Best Doctors. Occasionally, the board shares their perspectives in this forum, and below are the highlights of a conversation between Dr. Levy and one of the board members.

Despite the many advances in diagnostic devices, imaging and labs, diagnostic errors remain common. Recently, Best Doctors spoke with Dr. Martin A. Samuels, Chairman of the Department of Neurology at Brigham and Women’s Hospital and a recent addition to the Best Doctors Medical Advisory Board.  Dr. Samuels has discussed his own mistakes in diagnosis in his presentation How Neurologists Think: What My Errors Have Taught Me.

Martin Samuels“Getting the right diagnosis is an essential feature of medicine, especially for nonsurgical fields, and is the most important measure of quality in medicine, and yet, it’s the most difficult to measure and improve,” said Dr. Samuels. “We’ve made great strides in addressing ‘mechanical errors’ such as removing the wrong organ in surgery or lack of hand washing in the hospital thanks to the work of Atul Gawande and others, but diagnosis is a cognitive process and we are dealing with a biological system, not a mechanical one. That’s much harder to address.”

Cognitive science studies have helped identify some of the mental errors that lead physicians to an incorrect diagnosis. Physicians use heuristics (problem-solving short cuts) to enable them to quickly arrive at a diagnosis. These short cuts turn the patient’s history and presenting symptoms into a working diagnosis while the physician listens, identifying and eliminating other potential diagnoses in the process. The difficulty, notes Dr. Samuels, is commanding an awareness of when those heuristics may have led to an incorrect diagnostic conclusion.

“We all use heuristics, but the problem is that we use them unconsciously. We have to bring the heuristics to consciousness and be able to identify which heuristic you were using when you were led astray,” said Dr. Samuels.

Other psychological processes such as overconfidence can affect the way physicians use heuristics. “As you get older and people pay attention to what you say, you start to believe your own press,” said Dr. Samuels. “You believe that you really are becoming infallible. That’s a part of our national culture even outside of medicine, but it’s particularly dangerous in forming a medical diagnosis.”

Also embedded in our national culture are patient expectations of diagnostic certainty which aren’t always realistic.

“In most of medicine, you are not entirely certain of the diagnosis because we are dealing with a biological system, not a machine. Americans are particularly intolerant of uncertainty and this is one reason we spend so much on medical testing. What we need is a cultural shift in thinking, in realizing that medicine is part science but also part art.”

Admitting mistakes and accepting uncertainty would be a brave new paradigm in the US physician/patient relationship. According to Dr. Samuels, a big step toward promoting that starts with frank, personal discussions about medical mistakes.

“There is shame and risk involved in admitting mistakes, and that discourages people from talking about them. But inevitably one does make them. The object is to learn the correct answer, and alter one’s thinking. That process never ends and that’s how medical knowledge grows and evolves. Physicians have to come out and say, ‘Look, I’m 65 years old, and these are my mistakes.’”

Lewis M. Levy, MD, is SVP, Medical Affairs & Chief Quality Officer at Best Doctors. He also chairs the Medical Advisory Board, the group established to guide and inspire medical leadership at Best Doctors. Occasionally, the board shares their perspectives in this forum, and below are the highlights of a conversation between Dr. Levy and one of the board members.

Despite the many advances in diagnostic devices, imaging and labs, diagnostic errors remain common. Recently, Best Doctors spoke with Dr. Martin A. Samuels, Chairman of the Department of Neurology at Brigham and Women’s Hospital and a recent addition to the Best Doctors Medical Advisory Board.  Dr. Samuels has discussed his own mistakes in diagnosis in his presentation How Neurologists Think: What My Errors Have Taught Me.

Martin Samuels“Getting the right diagnosis is an essential feature of medicine, especially for nonsurgical fields, and is the most important measure of quality in medicine, and yet, it’s the most difficult to measure and improve,” said Dr. Samuels. “We’ve made great strides in addressing ‘mechanical errors’ such as removing the wrong organ in surgery or lack of hand washing in the hospital thanks to the work of Atul Gawande and others, but diagnosis is a cognitive process and we are dealing with a biological system, not a mechanical one. That’s much harder to address.”

Cognitive science studies have helped identify some of the mental errors that lead physicians to an incorrect diagnosis. Physicians use heuristics (problem-solving short cuts) to enable them to quickly arrive at a diagnosis. These short cuts turn the patient’s history and presenting symptoms into a working diagnosis while the physician listens, identifying and eliminating other potential diagnoses in the process. The difficulty, notes Dr. Samuels, is commanding an awareness of when those heuristics may have led to an incorrect diagnostic conclusion.

“We all use heuristics, but the problem is that we use them unconsciously. We have to bring the heuristics to consciousness and be able to identify which heuristic you were using when you were led astray,” said Dr. Samuels.

Other psychological processes such as overconfidence can affect the way physicians use heuristics. “As you get older and people pay attention to what you say, you start to believe your own press,” said Dr. Samuels. “You believe that you really are becoming infallible. That’s a part of our national culture even outside of medicine, but it’s particularly dangerous in forming a medical diagnosis.”

Also embedded in our national culture are patient expectations of diagnostic certainty which aren’t always realistic.

“In most of medicine, you are not entirely certain of the diagnosis because we are dealing with a biological system, not a machine. Americans are particularly intolerant of uncertainty and this is one reason we spend so much on medical testing. What we need is a cultural shift in thinking, in realizing that medicine is part science but also part art.”

Admitting mistakes and accepting uncertainty would be a brave new paradigm in the US physician/patient relationship. According to Dr. Samuels, a big step toward promoting that starts with frank, personal discussions about medical mistakes.

“There is shame and risk involved in admitting mistakes, and that discourages people from talking about them. But inevitably one does make them. The object is to learn the correct answer, and alter one’s thinking. That process never ends and that’s how medical knowledge grows and evolves. Physicians have to come out and say, ‘Look, I’m 65 years old, and these are my mistakes.’”

October 29, 2014

Finding the Right Doctor for Your Family

YoungBoyJust as most of us go for regular haircuts, you’d expect that the vast majority of people would also be going for regular check-ups with their family doctor. But the reality couldn’t be further from the truth – in fact, a significant number of people don’t even have a family doctor to visit.

Consider this: more than 15 percent of Canadians aged 12 and older –around 4.6 million people[1] – do not have a regular family doctor. In the United States, the American Academy of Family Physicians projects the demand for primary care physicians will increase at least through the year 2020, however, the percentage of general practitioners has been declining dramatically[2].

This shines a spotlight on an important issue. Millions of North Americans who don’t have a primary care provider are, quite literally, gambling with their health. Family doctors help give patients access to the full resources of the health care system. They are the first point of contact for most health issues and provide a link to other medical services, including providing referrals for specialists, diagnostic tests (such as ultrasounds, MRIs and X-rays) and prescriptions for medications.

It’s clearly not hard to make a case for why it’s so important to connect you and your family with a general physician. If the very thought of finding a family doctor – let alone, the right doctor for your family – is daunting, here are some tips to ease your search.

  1. In Canada, you can start by checking with the College of Physicians and Surgeons in your province. Some provinces and territories also provide “find a doctor” directories. In the United States, check state-level medical associations, nursing associations and associations for physician assistants for referrals. Many health plans also have websites and/or customer service staff who may be able to help you.
  2. Try visiting your local community health centre or a walk-in clinic and ask about doctors accepting new patients. Even if a doctor is full, maybe you can be placed on a wait list.
  3. Your pharmacist may know about any new doctors that have moved into your community, so try speaking with them. You can also try asking your dentist, optometrist or another health care professional for a referral.
  4. Ask friends, neighbours and co-workers if they have a doctor they like, and ask if they can recommend you as a patient (if the doctor isn’t accepting new patients, ask to be added to their wait list).
  5. Ask the human resources department of your workplace for a referral.

Now that you’re armed with a few tools for locating a family physician, you might find yourself in the position of choosing between potential doctors. If this happens, here are a few questions to consider that will help you decide which doctor is right for you and your family.

Is the doctor part of a group where you can access another doctor if yours is unavailable?

  1. Is the doctor available for appointments outside of typical business hours? Are the hours provided convenient given your schedule?
  2. Is the doctor focused on disease treatment or wellness and prevention? Which approach suits you and your family best?
  3. Is the doctor’s communication style warm and friendly or more conservative and formal? Which style works best for you?
  4. Is the office staff friendly and helpful?

You can also try to get more information about a primary care physician by speaking with the doctor’s patients to help determine if a particular physician is the right fit for your family.

If you’re in the midst of finding a family doctor and need help with a medical issue, or even just general assistance navigating the health care system, always keep in mind that Best Doctors is here to help. And once you find the right doctor, Best Doctors is still here to guide you if you encounter any health challenges, or simply need extra support.

[1] Statistics Canada, http://www.statcan.gc.ca/pub/82-625-x/2014001/article/14013-eng.htm
[2] American Academy of Family Physicians, http://www.aafp.org/about/policies/all/workforce-reform.html

YoungBoyJust as most of us go for regular haircuts, you’d expect that the vast majority of people would also be going for regular check-ups with their family doctor. But the reality couldn’t be further from the truth – in fact, a significant number of people don’t even have a family doctor to visit.

Consider this: more than 15 percent of Canadians aged 12 and older –around 4.6 million people[1] – do not have a regular family doctor. In the United States, the American Academy of Family Physicians projects the demand for primary care physicians will increase at least through the year 2020, however, the percentage of general practitioners has been declining dramatically[2].

This shines a spotlight on an important issue. Millions of North Americans who don’t have a primary care provider are, quite literally, gambling with their health. Family doctors help give patients access to the full resources of the health care system. They are the first point of contact for most health issues and provide a link to other medical services, including providing referrals for specialists, diagnostic tests (such as ultrasounds, MRIs and X-rays) and prescriptions for medications.

It’s clearly not hard to make a case for why it’s so important to connect you and your family with a general physician. If the very thought of finding a family doctor – let alone, the right doctor for your family – is daunting, here are some tips to ease your search.

  1. In Canada, you can start by checking with the College of Physicians and Surgeons in your province. Some provinces and territories also provide “find a doctor” directories. In the United States, check state-level medical associations, nursing associations and associations for physician assistants for referrals. Many health plans also have websites and/or customer service staff who may be able to help you.
  2. Try visiting your local community health centre or a walk-in clinic and ask about doctors accepting new patients. Even if a doctor is full, maybe you can be placed on a wait list.
  3. Your pharmacist may know about any new doctors that have moved into your community, so try speaking with them. You can also try asking your dentist, optometrist or another health care professional for a referral.
  4. Ask friends, neighbours and co-workers if they have a doctor they like, and ask if they can recommend you as a patient (if the doctor isn’t accepting new patients, ask to be added to their wait list).
  5. Ask the human resources department of your workplace for a referral.

Now that you’re armed with a few tools for locating a family physician, you might find yourself in the position of choosing between potential doctors. If this happens, here are a few questions to consider that will help you decide which doctor is right for you and your family.

Is the doctor part of a group where you can access another doctor if yours is unavailable?

  1. Is the doctor available for appointments outside of typical business hours? Are the hours provided convenient given your schedule?
  2. Is the doctor focused on disease treatment or wellness and prevention? Which approach suits you and your family best?
  3. Is the doctor’s communication style warm and friendly or more conservative and formal? Which style works best for you?
  4. Is the office staff friendly and helpful?

You can also try to get more information about a primary care physician by speaking with the doctor’s patients to help determine if a particular physician is the right fit for your family.

If you’re in the midst of finding a family doctor and need help with a medical issue, or even just general assistance navigating the health care system, always keep in mind that Best Doctors is here to help. And once you find the right doctor, Best Doctors is still here to guide you if you encounter any health challenges, or simply need extra support.

[1] Statistics Canada, http://www.statcan.gc.ca/pub/82-625-x/2014001/article/14013-eng.htm
[2] American Academy of Family Physicians, http://www.aafp.org/about/policies/all/workforce-reform.html