Services and objectives

Current in the press

Patient in danger

Victim of a medical error

To choose your doctor

To choose your hospital

To deal with your doctor

Take care of you

Inform yourself

Contact us

Questions

Links

To choose your physician

To choose your doctor is very difficult and important, because it is about the most valuable asset you have: your body. As in all professions, there are physicians, between the hands of which, it is hazardous to be, and other doctors who deserve all your confidence. There are very few relationships as important as those which bind a physician with a patient. To find a qualified doctor worthy of your confidence, requires time and effort. It is worth while, since this will give you years of quality life, or you will be able to even sometimes save your life. In addition to a great integrity, several factors and qualities must be joined together so that you will be completely satisfied with your choice. Here the principal parameters among 66 that PatientProtect.com indexed and analyzed.

Communication

The patient-physician relationship should be built on a foundation of communication, trust and mutual respect. You are the most important partner in your medical care. You must feel confident. The physician must listen to you, answer your questions and give you comprehensible explanations. This feeling and confidence are key element. It is with the first contact, during the first consultation, that you will carve out your opinion. You must feeel completely relaxed with your choice of doctor.

Your doctor should welcome your questions. They help him to make a correct diagnosis. The more you communicate with your doctor, the better he will be able to act as your champion. The more you prepare yourself, the more effectively you can communicate.

Be wary of the trendy doctors who impose a commercial vocabulary: they do not speak to you ou like a patient but like customer or consumer. Against wind and tide, behave like a patient, make decisions on what does not have a price, in particular the relationship between doctor and patient, do what is appropriate to you and express a free and critical behaviour.

Availability

In an emergency, how can you reach your physician? Is it easy to get an appointment? Is it always necessary to wait in his waiting room? He should schedule adequate time for a surgery visit to make a diagnosis and answer questions. But remember, even with careful scheduling, appointments can back up, and you may have to wait. Once a patient is in the examination room, it may take longer than expected if the diagnosis is more complicated than could be foreseen. Please be patient: you expect the doctor to take the same care and diligence when it's your turn.

Does he devote you time that he invoices you? Is it easy to obtain a second meeting before an operation or an invasive investigation? Never agree to engage yourself with haste for operation, investigation or hospitalization. Except in a vital emergency, a good doctor must always leave you a long time for consideration, and inform you in two steps, like, inter alia, the Swiss Federal Court jurisprudence.

Diplomas

There exists, for example in Switzerland, the doctor specialist FMH title (of Swiss Medical Association), which attest officially training of a doctor in such or such field. It is about a formation validated with a several years practical experience in hospitals. Does your doctor have one or two FMH titles corresponding to the specialities he practises, and which you need? It is obvious that you will not have unconsciousness to let you operate by a general practitioner or a dermatologist, and that you would not allow a smoth talker to operate you. But are your nephrologist, your diabetologist, your anesthesiologist... really doctors with corresponding FMH title?

By word of mouth

That functions well, on the condition of being able to realize results de visu, which, in medicine, is not always possible by far. It is thus the case in plastic surgery, for much of operations on joints and for example for a varicosis surgical cure, but not for an intrabdominal operation! However, by worth of mouth is not enough to certify professional qualities of a doctor.

Competences

For how much years has this doctor been practising? What reputation does he have? Did he also give you preventive medicine advice? A good doctor is personally concerned with you and your health, not concerned to do something on you. This is why he will give you regularly advices on preventive medicine. Did your first consultation include an anamnesis (personal history), i.e. your personal medical history, a physical examination, and done with respect? Do not have any confidence in a doctor who prescribes you paraclinical examinations (laboratory tests, radiology...), without having initially made your anamnesis and physical examination, physical examination whose extent depends on anamnesis result. Indication and need for a paraclinical examination always depends on the medical condition discovered at the time of anamnesis and physical examination.

Gender of your physician

The gender of your physician is a matter of personal preference, but take note: research shows that, on average, female physicians spend more time with their patients than male doctors do (Courtney McGrath: in Kiplinger's Personal Finance).

Your physician must have only one master: you

A physician is partner in the care of his patients: his duty to the patient comes first. He works for the good of the patient, not that of the government, an insurance company, or a managed health care bureaucrat.

Generally, any physician, officially agreed or not, knows extremely well that he is not a recipient in the contract which binds the policy-holder and the insurer and he is not co-signatory. In fact the physician does have and can have only one master: his patient. No one cannot serve two masters, especially not a physician. An old proverb of Bourrignon in the swiss Jura points out it extremely well: he who serves two masters misleads one of them, very often the two. The acceptance of the presence of an all-powerful third in the relation patient-doctor is the privilege of the veterinary surgeon. Only in this precise situation, the animal is property of its master, itself owner of the veterinary surgeon.

Insist on your rights as a patient. If your physician won'nt agree to your basics rights, you might want to think about finding another doctor.

Access to Medical Records

While the physical medical records belong to the physician's office, you have a right to access and make copies of your medical information. Under special circumstances, a physician may want to withhold a portion of the record that he deems harmful to a patient at a certain stage of treatment, but he should be ready to explain why.

Hospital or private clinic where the physician practise

Does your physician practise in a respected and financially solid hospital? A hospital with financial problems, or subsidized like are almost all public hospitals, is more likely to save on care and qualified personnel recruitment. A hospital, whose majority of nurses and physicians in training, (interns, registrars, residents, senior residents), have only foreign diplomas, probably suffer from big problems. It is consequently unreasonable to trust it. Even its existence should be called in question as fast as possible. If it is your first recourse physician (primary care doctor, family practitioner, general practitioner etc...) which chooses a second physician for you, for example a surgeon, or even imposes this physician to you, (which he should above all not do), he then takes the responsability for this choice and will have to also ensure the consequences of them. Be wary of such a doctor. He could be that he has even a financial interest to advise you in that way. Indeed cases of dichotomy are more and more often reported.

What distinguishes the very qualified physician?

Mastery of complex problems, improvement and update of knowledge, skills with which data are used, analyzed and applied, adaptability to stress, emotional stability, manual skills, quick-wittedness, real clinical flair, constant preoccupation of effectiveness and productivity, and especially very great conscientiousness and solid ethics, these are qualities which distinguish the very qualified physician from average physicians.

Your surgeon should also well be chosen

Each doctor knows that surgeon experience and skill are very significant for an operation success. Too many primary physicians/doctors are simply confident with the surgeon on turn in the near public hospital or, worse, address their patients to the surgeon who pay them, whereas the dichotomy is prohibited by the medical associations ethic codes and, in Switzerland, by the federal Law on the sickness insurance too.

Recommend to the patient a surgeon whose one knows operational qualities remains a medical act of the highest importance. This obvious truth is confirmed by a study led by C B radical Begg and coll.("Variations in morbidity after prostatectomy " NR Eng J. Med. 346: 1138-1144. 2002). The rates of late post-operative complications, in particular the frequency of stenosis or the urinary fistulae and incontinence beyond one year, were correlated with the number of patients operated for this condition in each hospital and with the surgeons experience.

If in this study no significant difference in mortality were noted according to hospital or surgeon, such was not the case for morbidity. Post-operative morbidity was lower in the most experienced hospitals and with the surgeons practising the most interventions of this type. This relation was less clear for incontinence at one year. Beyond these relatively logical figures and almost reassuring, the authors still analyzed post-operative morbidity for the surgeons urologists having greatest operational experience.

The results are at the same time dismaying and logical. There are significant differences in the rates of early post-operative complications and incontinence at one year which can be explained neither by the preoperative state of the patients, neither by the type of hospital, nor by the number of interventions realized by each surgeon. The unfortunate patients from 8 to 13 % of the surgeons have a rate of early and late complications higher than the 99th percentile, while the happy patients from 3 to 14 % of the surgeons have rates of complications in the short and long term lower than the first percentile.

The choice of a surgeon for an intervention such as total prostatectomy for cancer thus rests on criteria relatively easily accessible like operational volume from the hospital or the practising surgeon, but also on a not easily appraisable element for the patients or the primary physicians/doctors: individual results of each surgeon.

Remember this about surgery:

There are benefits

There are choices

There are alternatives.

It is your body.

It is your life.

The final decision is yours.

A particular case: to choose your dentist

Consult what appears in the excellent Quackwatch website of Doctor Stephen Barrett, M.D. Board Chairman, Quackwatch, Inc: http://www.quackwatch.com /, at following page:http://www.quackwatch.com/04ConsumerEducation/dentalchoose.html.