How to pick the best provider for you and your family.

By Andrea Wright-Agustin

I once read an editorial claiming that most people put more effort into finding a good restaurant than finding a good provider. I believe it. In fact, I’m guilty of it.

When choosing a restaurant for a special occasion, I’ll ask friends for suggestions, read reviews, and browse menus online. When I recently needed to see a specialist, I quickly chose the first doctor on the list who was accepting new patients and didn’t think twice about it.

That editorial really got me thinking. We trust providers to help keep us healthy and well. And yet, we sometimes pick them blindly. With such a big responsibility, we should know who we’re trusting with our health. I have strict standards when it comes to pleasing my taste buds; I should give my mind and body the same respect.

Many people are lucky to have long-standing relationships with providers they know and admire. For those new to the Islands, in a new health plan, in need of a specialist or a second opinion, or who simply want to explore other options, establishing a relationship with a primary care provider (PCP) should be a priority.

Start by checking your health plan’s website or brochures for a list of participating providers. You can also ask friends and family for referrals – many have great providers who they’re happy to recommend. And your PCP doesn’t necessarily have to be a doctor; most health plans will let you choose an advanced practice registered nurse or certain specialists. If you need a specialist, ask your PCP for recommendations.

Of course, you want your PCP to provide great care. But other factors might sway your decision, too. Here are some questions to consider when choosing a provider or health center.

Credibility

• Is the provider certified by a specialty board?
• Does the provider have staff privileges at a nearby hospital?
• Which hospital(s) does the provider use? Would you feel comfortable being treated there?

Comfort

• Who covers for the provider when they’re away? Are you comfortable being seen by the designated covering physician?
• If you’re picking a provider for a specific condition, how often do they treat cases similar to yours?
• Do you prefer a male or female provider? Does age matter? What about ethnicity or languages spoken?
• Is the office staff friendly and courteous?

Convenience

• Where is the practice located? Is it easy to get there? Is there ample parking? Is it accessible by public transportation?
• How long do you have to wait for an appointment? Can you be seen on the same day if you have an urgent need?
• Where should you call if you have a problem after hours?
• If you call with a question, does a doctor or nurse return your call promptly?
• Can you email them with questions?

Preference

• Is the provider part of a patient-centered medical home?
• Does the provider frequently refer patients to specialists or do they manage the majority of care themselves?
• Will the provider treat your entire family?
• Where are X-rays and lab tests performed – in the office or at an outside laboratory?
• Does the provider perform surgery? Do they provide prenatal care and deliver babies?

Insurance

• Does the provider or health center participate in your plan’s network?
• What are the fees for services?
• Does the office process claims or must you pay up front and file claims yourself?
• Does the office use electronic medical records?

If you find a provider you’re interested in, call for a consultation appointment to ask questions. You may have to pay for the appointment, but it can be a valuable way to gather information.

Most importantly, don’t wait until you or your family members need a provider to choose one. When a medical issue arises and you need a provider in a hurry, it’s best to have a PCP who is familiar with you and your family’s medical history. Establish a relationship with a PCP now so you’ll be ready.