Enjoy the following excerpts from Choosing Your Doctor

From the Forward: STOP!!
Check your doctor carefully—Very Carefully!

Read this book like a road map, something you store in the glove compartment of your car and refer to it often whenever you visit your doctor. Read a chapter here and there, think about its message, and apply it to your new doctor every time you see him or her.

Heath insurance systems are managing your doctor intensively, almost demanding that he ration your health care to save money. They want the doctor to limit the number of referrals, limit the number of tests and, especially, the number of hospitalizations carried out on your behalf.

To paraphrase an old saying, they are saying to your doctor: “Don’t just do something Doctor, stand there”.

I call these insurance systems the new HMO’s: “Handcuffed Medical Organizations” for that is what they are trying to do to your doctor. The whole point of this book is to teach you how you can manage your doctor and beat the insurance system. I want you to tell your doctor, in so many unspoken words, how he or she is to: “Do something, doctor, don’t just stand there.”

If you learn nothing else from this book, learn that the key to managing your doctor is to carry a small notebook and pen with each visit to your doctor. Open it up and write down things he is telling you. This will send a powerful message that you take these visits and his words very seriously.

From Chapter 3: What is a Primary or Personal Physician?

Time out indeed! So long as third parties control the dispensation of monies to pay for health care, the physicians will be handcuffed and a true relationship between a primary-care physician and his or her patient cannot exist. The kind of relationship I am describing in this book becomes pure fantasy.

Is there any hope? Indeed there is! Slowly but surely the public is beginning to cast off HMO medicine and managed care. The whole point of this book is to make you aware of the damaging effects of managed care and insurance-controlled medicine so that you can state your case strongly and boldly whenever you visit a physician handcuffed by number crunchers and rationing agents of insurance companies or government health bureaucracies.

You will be amazed if not shocked with how quickly these systems react and cave in once you become knowledgeable about the rationing game they are playing and you demand more personal care.

From Chapter 7: The Most Important Sign of a Good Doctor

I have never met a doctor who cared for his patients, whom I would not trust with my own life. A doctor who cares senses his own limitations long before they have been reached. His concern acts as a fail-safe device—a warning system when he needs help. Unwillingness to refer patients to other specialists is a sign of arrogance—not really caring about the well-being of the patient.

One of the really great and good doctors in my community, a general practitioner in his 60s, was recovering from a massive second coronary in our coronary-care unit. He had a huge practice and had not limited his work after his first heart attack thirteen years earlier. This coronary came out of the blue and will ultimately force him to retirement, although that was the furthest thing from his mind when I visited him four days after his attack. He was pale, reasonably comfortable, fully alert, and more angry than depressed over the situation. But he was not taking well to his doctor's recommendation that he retire:

"The bastard thinks I'm ready for the shelf, " Peter said. "Who the hell's going to take care of these people?" He waived a small, thick notebook filled with loose pages of patients’ names, office appointments, nursing home visits, et cetera. This was Peter's pocket file cabinet—a potpourri of scribbled clinical notes and reminders which he flipped through incessantly as he made his hospital rounds each day. Palm pilot was a gadget totally foreign to this man of the past.

As he thumbed through the book, almost forgetting where he was, his eyes lit upon two or three patients he had recently referred to me for surgery.

"How's that old duffer, Ostrowski? You know, the gall bladder I sent you? Nice people, George, treat ‘em well. I remember Ostrowski from way back when he was blinded trying to cross a picket line. Stupid bastard he was."

Then he came upon Mary Jaspers, a sad case with inoperable breast cancer. "Mary still OK? Did you get her home from the hospital yet?" He was still flipping through his portable file cabinet.

"For God's sake, Peter," I interrupted, "will you forget your damned patients and just concentrate on getting over this coronary?"

"The bastard thinks he's going to put me on the shelf. Who the hell's going to pick up this crew of patients?"

Peter knew he was finished but wanted me to agree with him. I hadn't the heart to do otherwise. "You'll be back in a month driving yourself as usual. You're too thickheaded to quit," I said, choking a bit.

He gave me a sidelong glance and said, "You lying bastard."

That was Peter. He cared for his patients and his patients knew it. They said it with dozens of get-well cards—humorous cards that poked fun at the medical profession, the greedy docs, the golf-playing docs, the suave, the polished superspecialists. They sent these cards to Peter because they knew he cared for them—and because they cared for him.

From Chapter 11: The Word "Doctor" Means "Teacher"

The critical question you must ask yourself:

The most highly trained doctor can be useless if she doesn't cover the big picture by teaching her patient about good health and how to maintain it. The single most important question you must ask yourself after talking to your new doctor is this: How well do I understand my body, its illnesses, the drugs I am to take and the regimen I must follow to keep my health or restore it?

If your answer is less than enthusiastic, if you feel rather empty after this appointment, if you're walking out with a prescription in hand, an appointment for a blood test and another appointment with this doctor, and you know next to nothing about what I've been talking about, you've made a bad choice of doctors and you'd better go back to “go” and start all over again.

From Chapter 12: Thirteen "Diseases" That Can Kill You:
"An undertaker's dozen"

Making telephone diagnoses.

All the bad habits of sloppy medical practice converge in the still-too-common practice of diagnosing illness by phone and prescribing drugs without seeing the patient. There are rare occasions when a patient may benefit from a telephone diagnosis. For example, when a patient's illness is well known to his doctor, a telephone diagnosis may save an unnecessary office visit. But in the vast majority of cases, diagnoses over the telephone border on malpractice. If your doctor makes a habit of such a practice, you should dismiss him immediately.

If you have paid attention to what I have been saying, the reason for my harsh criticism of telephone diagnoses should be immediately evident. It can't be done! Fancy telephonic audio-visual communications which link electrocardiographic tracings and paramedical personnel to experts in medical emergency centers are a different situation entirely, and I am not referring to this. What I call telephone diagnosing is that practice, typical of a busy, harried or sloppy doctor who, rather than spend time examining his patients, merely guesses at the cause of their trouble without seeing them and, on the strength of this guess and reliance on the laws of chance, prescribes a medicine and tells them to call back in a day or two if they feel worse. This is not responsible medical practice and indicates a callous attitude.