Where Is the Nordstrom of Health Care? The Yelp?

The story of my exhausting search for medical professionals is not an uncommon one. When will we start holding health care to the same standards of customer satisfaction as other service industries?
Be Our Guest | posted by Kelly Emanuel, MPH
Our Struggle Finding a Good Doctor to Treat ADHD

My family moved to a new state last year. For any parent, a big move means a grueling test of executive functions. For the parent of a child with any health condition, it also means an extensive search for new doctors and therapists. In our case, that includes everything from the standard pediatrician and dentist to an occupational therapist, physical therapist, speech-language pathologist, neurologist, and developmental optometrist, just to name a few.

I took “due diligence” seriously and asked everyone I met — my kids' teachers, their school therapists, their case managers, other parents, every pediatrician we saw (we went through a bunch of those, more on that in a minute), and even our special education advocate.

I also spent a lot of time Googling. I read practitioners’ websites. I searched Healthgrades.com for other patients’ reviews, but didn’t find that very helpful. The same goes for my insurance company's list of providers. This list is pretty useless as it includes only the providers in my plan — those who have what the insurance company calls "good outcomes" at an efficient price, a.k.a. low cost to the insurance company.

Finding "the good ones" means evaluating all of the above, plus figuring out who takes our insurance, who knows their stuff, and who’s nearby. Most often, there's a trade-off made, and I'm reminded often of the old Meat Loaf song, "Two Out of Three Ain’t Bad.” Anything above and beyond, like good bedside manner, is a bonus. I'll sacrifice manners for getting the help we need, though there has been more than one occasion when I wonder why a certain doctor or therapist even decided to go into pediatric work at all.

We are pretty well established now - though not without a few incidents. I had a few emotionally charged exchanges with the first four pediatricians we considered. Our current one is still not ideal, but we’re trying to make it work. I have learned the hard way that pediatricians’ primary concern is keeping kids alive. Finding a pediatrician who understands my kids’ chronic challenges and the exceptions that are needed for kids with special needs is harder than you might think – I’m still in search of my own Holy Grail.

In my experience, too many doctors don't want to take on new patients who don't follow their one-size-fits-all protocols. They don’t look at the individual and they’d prefer if you don’t ask any questions – particularly about the medications they want to prescribe. I endured more than a few eye rolls when I questioned (and refused) certain prescriptions. Most recently, I declined to use a really strong antibiotic, Bactrim, as the first course of action for one of my kids. We have a family history of sulfa allergies and this kid had what appeared to be just the start of an infection. He relented and gave me a different antibiotic. After the results of some additional tests came back negative, the doctor called and asked us to discontinue the antibiotic altogether.

Above all, I go with my gut. We left an occupational therapy practice that many other parents adore and swear by. I just didn't like how the place was run. My kids didn't seem to be making progress and they didn't develop a good rapport with the therapists. It didn't matter that they had state-of-the-art sensory equipment and could talk a good talk. It didn't work for us, so we found another place.

Since I’m handing over my kid (and my money), I hate that choosing a practitioner remains a roll of the dice. You don't know what you're in for until you walk through the door. I would love to know as much as possible about the person with whom I'm entrusting my family's health. And I would love to be able to get my money back for poor service. Customer satisfaction: What a novel concept in healthcare. How is it that every other service industry has managed to achieve this? Maybe one day…

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