These days when people call my neurology practice in New York’s Hudson Valley, the first three things they want to know are: Does the office participate in my insurance plan? Are the hours a good fit for my schedule? And, of course, how long will I have to wait?
All are important questions. But if that’s the only information you look for, chances are you will miss what’s really critical: finding a highly qualified doctor who puts your best interests first.
I’m no longer surprised, but I do confess to disappointment when I hear new patients say they picked me “from the book”—an action that seems to me to be about as reckless as driving blindfolded. It’s always best to do some research first, such as checking out the physician’s credentials and looking for board certification.
Then, once you show up for your appointment, you should continue to look for important clues about whether you’re at the right place—or should walk back out the door.
Here are six red flags to watch out for.
The front desk doesn’t know you’re alive
The reception desk is your gateway to appointments, medical records, prescriptions, and myriad other needs that will come up over time. The demeanor of the people behind that desk should be professional, helpful, and attentive.
If you are not greeted by staff soon after you arrive, and no one lets you know that your doctor will be running late, or how long that wait will be, it’s discourteous.
Ditto for medical personnel who have a bad attitude about answering your questions and assisting you with your referrals, prescription changes or renewals, test results, or anything else you need.
While the doctor herself may not be responsible for hiring and firing, especially at a large institution, poor staff behavior means human resources is asleep at the wheel, and your future experience at another department may be at risk as well.
We all have bad days, but if you find a pattern over time, or find yourself dreading to call the office, that may affect your care and you should speak to your doctor about it.
A drug company rep got there before you
If you look around the waiting room and find pharmaceutical logos on pens and clipboards, post-its and writing pads, or on posters and other display items, it’s a sure indication that drug company representatives have been there.
They may have brought the staff a free lunch, left new medication samples with the doctor, and made a pitch for the latest brand drug or device on the market.
While many doctors claim that these small gifts do not influence their prescription choices, others argue that they can cloud objectivity.
That’s why more and more doctors are restricting access to drug reps. In 2016, less than half of doctors regularly met with pharmaceutical salespeople compared to 80% in 2008.
If you see signs that your doctor is accepting freebies from pharma companies, and you get a prescription for a related brand-name drug, as one of my savvy patients did with another physician, raise your concerns with the doctor. If your doctor dismisses you, which is what happened to my patient, it may be time to get another opinion.
Your privacy isn’t properly protected
The majority of doctors’ offices are very responsible about adhering to the Health Insurance Portability and Accountability Act (HIPAA), which limits who has access to your health records. Still, breaches happen with some frequency, affecting nearly 5. 6 million patient records last year according to Protenus, which tracks disclosed infractions affecting the healthcare industry.
The standard HIPAA release form that patients sign explicitly spells out how your doctor can use and share your health information.
The rules include: We may not speak about patients in public places like elevators or share information with other patients or family members. We can’t leave charts in places like examining rooms where other patients may read them, or leave our computer screens positioned where they can be viewed by others. We can’t use clipboards with patient sign-ins that are left for others to see.
There’s more: Paper patient documents must be shredded, not left around waiting rooms after a visit. We cannot post photos of you on social media or discuss your case over text messages unless they are encrypted on both ends.
What do you do if you see your doctor’s office isn’t following the rules? The first step, if something like this happens, is to bring it to the office manager or doctor’s attention. They know how important protecting your privacy is—and ought to receptive to cleaning up their act if they’ve been lax.
The doctor is selling something
It used to be unthinkable for a physician to promote products and sell them to patients. But in the last few years there has been a growth in the number of doctors looking to enhance their incomes, and a dietary supplement market that is looking to increase its “practitioner channel’’—that is, the number of doctors selling their products.
Indeed, I have heard countless stories from patients who say their doctor sold them vitamins, botanicals, minerals and other dietary supplements touted to promote weight loss, enhance cognition or improve libido.
That kind of activity turns the doctor into a salesperson, often disregards evidence-based medicine, and takes advantage of a patient’s vulnerabilities.
The AMA warns, “Physician sale of health-related products raises ethical concerns about financial conflict of interest, risks placing undue pressure on the patient, threatens to erode patient trust, undermine the primary obligation of physicians to serve the interests of their patients before their own, and demean the profession of medicine.”
If your physician tries to sell you a product, it may be time to get a second opinion—or just leave.
Those diplomas seem a little iffy
I’ve had some patients jest that they don’t trust a doctor whose diplomas are all lined up and straight and others who have said the same thing about those that are crooked.
Joking aside, a practitioner’s office gives you a glimpse into the chronology of the doctor’s education and may tell you whether he or she is board-certified, on the medical staff of a university, has gone on to attain sub-specialty training, or has received any awards or honors.
An even better way to check your doctor’s credentials: Go to your state’s licensing board website and look the doctor up. For example, in New York, you can look up a doctor’s education and practice information, history of malpractice, or professional misconduct and criminal convictions.
The office fails the white glove test
It seems obvious. But all too often you’re so focused on your health issues that you miss signs of neglect to the most basic housekeeping details—details that can critically affect your care.
A dirty lab coat or dusty shelves suggest a less than optimal attention to cleanliness. Sloppy desks and chart racks are a setup for misplaced notes and phone messages.
Our offices today are a mixture of old school paper and digital solutions. Both need to be kept in order for you to get the right care.