How does one find a qualified physician?

by Edward R. Annis, M.D.

Our people are mobile; and every year untold numbers change their residence, often at great distance from where they had called home for many years. Once established in a new location they quickly determine immediate needs, such as where to buy gas and groceries, but before long, especially among older citizens, there is a recognized need to know where to find a doctor when problems arise.

How does one find a qualified physician? Innumerable satisfied patients attest to the fact that time spent in finding a good doctor is rewarded many fold when faced with illness or accident. The avenues most frequently followed are those resulting from conversations with family, business associates in a new office or newly established neighbors in a residential community.

One is especially fortunate to hear repeated approval of a family physician whose reputation has been earned by his or her dedication to the art as well as the science of medicine. Such physicians listen and talk to their patients. When requested and authorized by patients, they listen and they talk to parents, to spouses, to friends. They explain what the problem is, what, in their opinion, is needed and why. They also explain a patient's options when different approaches may be made in handling especially difficult problems. They include their patients in the decision-making process, at times and of necessity emphasizing the limitation of a doctor's abilities to reach perfect results in all cases.

Most family physicians possessed with these qualifications belong to the American Academy of Family Physicians. As members of this professional body they are constantly involved in continuous medical education, to keep aware of the rapid advances in science and technology which could benefit their patients. These physicians develop a true doctor-patient relationship and are well equipped to refer their patients when they require the services of specialist or sub- specialist in the many areas of medical practice.

Most of today's doctors are Board-eligible or Board-certified in their areas of expertise. After four years of college and four more years of medical school, to become Board-eligible requires a minimum of three years of further concentrated study. Some specialties, such as neurosurgery, require longer periods of residency training, usually from six to ten years including time spent in research. Having completed their residency training doctors become eligible for examinations which attest to their earned qualifications. Many newly trained physicians, while Board eligible, defer taking the examination to become Board-certified until after they have established their practice.

Many well-qualified physicians are not Board-certified and can be consulted with confidence when referral comes from responsible sources. Many of these were among those who recognized the need and helped establish the boards in the first place. Board certification alone does not guarantee a first-rate physician, but it does guarantee that the physician had at least the minimal education and training necessary to become a competent practitioner.

Remember that the telephone book is helpful in providing an address and phone number, but it is not the best place to search for a doctor. It is not illegal for physicians to practice in any specialty they choose, with or without training in that field. They may also legally list themselves in the yellow pages as self-designated specialists in any field.

If someone is in need of a physician before or in the absence of referral from satisfied patients or from another doctor, they can call the office of the local medical society and request the names of qualified physicians who are Board-eligible or Board-certified in their field of practice. Never be hesitant about asking for a physician's credentials.

At times people who have never established a relationship with a family physician require the services of a specialist, such as an orthopedic surgeon for fractures, an otologist for hearing difficulties, or an ophthalmologist for eye troubles. Here again there are means of determining a doctor's qualifications. Is he or she Board-eligible or Board-certified and a member of the specialty societies where ideas and progress are shared with other specialist?

The past few years have produced a rapid increase in new knowledge and new scientific tools for diagnosis and treatment. Good examples are the CAT scan and Magnetic Resonance Imaging. These new diagnostic implements have the remarkable capability of providing dramatic cross-sections of all sections of the body. Frequently they make it possible for precise diagnosis without surgery or other invasions of the body. They have provided the neurosurgeon with the means of early detection of brain disease and brain injuries which have resulted in the saving of many lives. Other examples are the different types of lasers which are expanding the ability to replace the surgeon's scalpel. For a number of years qualified ophthalmologists have demonstrated the value of lasers in many ways, such as destroying malignant tumors of the eye and welding back detached retinas to restore and preserve sight.

It has been estimated that the half-life of medical knowledge is seven years. That means that one half of what we know to be true today was not known just seven years ago. It also reminds us to keep alert, because within the next seven years what we know today will be improved upon or replaced by new knowledge and even better tools and skills.

Because all of this is true, those physicians desirous of maintaining their skills in new areas of demonstrated value have organized new professional organizations which concentrate on the education and sharing of ideas with their colleagues.

Two recent developments have been in keeping with this trend: namely, the American College of Eye Surgeons and the American Board of Eye Surgery. The American College of Eye Surgeons is a voluntary organization of physicians who are Board eligible or already certified as specialist by the American Board of Ophthalmology. Among these are researchers, teachers and well-qualified surgeons. These physicians agree to stay in the forefront, to be informed, to keep current, to share ideas with their colleagues, and to educate young physicians in the proper use of the rapidly developing valuable diagnostic and therapeutic tools for eye surgery.

The American Board of Eye Surgery, like other Boards attesting to qualification in different fields of medicine, will concentrate its efforts in establishing the high standards and means of evaluating quality and competency in eye surgery. The American Board of eye Surgery will stimulate the recognition and use of surgical procedures and skills of demonstrated value while stimulating continuing education for today's practicing surgeons as well as the young people who will carry on in the tomorrows.

Continuing medical education has always been important to most physicians who never cease to be students. Theirs is a never-ending search to do things better. They subscribe and read medical journals by the score. They listen to audio cassettes in their automobiles and use and re- use videocassettes on their VCR's. They attend scientific lectures, conferences, conventions, and meet regularly with their hospital staffs to discuss progress, complications and good results while evaluating new ideas to better serve their patients. Both the American College of Eye Surgeons and the American Board of Eye Surgery are structured to deal with an information explosion which has characterized eye surgery during the past decade.

No one will be grandfathered in to the American Board of Eye Surgery. To become Board- certified all must provide their credentials, agree to be examined and to be observed by their peers to demonstrate their judgment and technical skills.

A nationally known, well-respected testing service has spent many months in structuring a certification program and already a number of eye surgeons have been evaluated. Increasing numbers are volunteering to be tested so as to earn the designation of Board certification, an achievement for which they can be proud and a designation which has been helpful to the profession at large as well as to the public they serve.

Those people who are fortunate in having a close doctor-patient relationship with a family physician can be guided to capable specialists when the need arises. When problems obviously require the knowledge and skills of certain specialists, they can be assured and confident that doctors who put forth a continued search for excellence are numbered among the members of those organizations dedicated to provide the best care that modern medicine can provide.

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