Know Before You Go: Choosing an OB

I say “choosing an OB,” but this could easily be applied to choosing any new practice/new doctor to attend. There’s plenty of literature on the interwebs of what you should do prior to your appointment, but I’ve found very little about choosing practice A over practice B. So call this the “shit list” of shit-to-know-before-you-make-an-appointment-with-the-wrong-doctor.

I should send this list to my past.

1. Insurance. I really hate even needing to list this one because I have a lot of strong opinions about how insurance by all parties dramatically inflates the medical market and it’ll be our system’s downfall yada yada ask me about it over some gluten free muffins and tea sometime. First, you need to understand your plan. Often times your plan will have a network and you’ll spend considerably less if you choose a practice which is “in-network”. These networks seek to ensure that you’re seeing real certified doctors. Please note: “certified” does not mean “good” or “capable.” You still need to get the dirt on this doctor. Next, ask your insurance company if you need any tests or referrals prior to seeing an OB. This could save you a pretty penny down the line. If you are changing practices or if you have questions, it’s best to contact your insurance company first. You don’t want to end up with a pile of bills just because you didn’t notify your insurance provider you were switching practices.

2. Availability.

high_availability

I’m not big on inserting pointless photos, but seeing as this was the first google result for “availability” I just couldn’t resist.

If you’d like to see one care provider regularly and you only have Thursdays off, you’ll need to find a care provider who’s available on Thursdays. This sounds a little obvious, but since physicians schedules can rotate based on the on-call schedules, it’s best to ask when you’re making your first appointment about the long-term availability of the care provider you’ll be seeing.

3. Hospital Privileges. One you might not think of if you’re choosing a doctor other than an OB or a surgeon is at what hospitals can this care provider treat you? The best idea here is to choose the hospital you are most likely to attend in the event of an emergency or your delivery. Then when you find a caregiver that strikes your fancy, ensure that they have privileges at said hospital. In the case of an OB you should choose a hospital with an advanced medical setting and a capable staff.* It’s not always easy to back track this way, but with OB care it’ll be good to know that someone who’s gotten to know you over the past 9 months and understands your wishes will be beside (or below) you to the final push.

  • *If you are moving into a new area and are dizzied by which hospital to pick, look for teaching hospitals that are tied to schools or request to tour your local hospitals, including the delivery wing. Ask specific questions regarding your birth plan preferences, like if you’re interested in water birth or one of those fancy rooms where your whole family can hang out while you deliver a watermelon  Also ask not only what emergency equipment is available, but also what is not. Ask what kinds of emergencies would warrant transfer to another hospital and how long a transfer would take. No expecting mother wants to be in that situation, but it’s best to be prepared.
  • I found that health grades was a great tool to determine which doctors have privileges at my local hospital. They also have pretty accurate statistics-based reviews.

4. Get the Dirt. All of it. The big mistake I made when choosing my OB was only looking at statistics of the doctor at hand. How long they’d practiced, how old they were, where did they have privileges. I never checked the wordy review websites like city search or Rate MDs. Both of these sites have the option of leaving comments when you grade a doctor or practice, and some comments will warn you of doctors (like my horror OB) who have pending malpractice claims or rumors of being ejected from other hospitals. These kinds of things aren’t listed on their practice bio and are rarely on sites like health grades. You’ve really gotta dig through a few websites for all the dirt.

I’m not sure what I was thinking here; I spent days researching reviews on my new mattress.

On the topic of negative comments, remember that it’s common for dissatisfied persons to leave negative reviews and less common for satisfied persons to leave positive reviews. Even so, you should look for key terms with medical professionals like “malpractice”, “killed my (insert-relative-here)”, “demoralizing”, “horrible”, and “beware.” I usually title my worst reviews “run-away” so if you see one like that it’s probably a trustworthy kindred spirit. I wonder if they like pickles and cheese. . .

5. Take a Tour. Many OB practices and Family physicians will allow you to “tour” their offices prior to a decision to become a patient. These practices understand they’re going to be responsible for the care of your offspring and many of them are willing to meet and greet. Call ahead to the office(s) you’re interested in and ask about scheduling a tour or free consultation. Tell them that you’re interested in meeting someone from the practice before scheduling a formal appointment and get your options. Sometimes this will be treated as a consultation appointment and you’ll enter an exam room, but you’ll just discuss the practice, it’s goals, your goals, and if they mesh. At the end of this consultation you may choose to schedule your first appointment.  Some offices will charge for this appointment if you choose to stay with the practice and will consider it a first visit, so be sure to have all of your medical information handy.

Extra Tips

Transferring Medical Records is a Pain.  I’ve found that transferring my records, especially from a crappy practice, is a real pain and can really be a problem. Some practices will inform you immediately that should you require a copy of your medical records you’ll need to pay blah cents per page copied and you have to sign a release and it’ll take a few days to get the records together. That’s not too uncommon, but not all practices warn you up front.Additionally a practice may try to charge you for faxing your records to your new practice, which is a load of bull.

In this situation you hand the reins over to your new kick-ass practice that you just found with all these great tips and you let them open a can of whoop-ass on those sissy girls. Kick back, enjoy some finger sandwiches, and watch those records fly.

Similarly, insurance companies don’t always file your claims correctly, and your medical office won’t always submit your claims correctly. This is another case where you don’t have to fight this battle yourself. If you get a $200-$xxxx bill that’s way over your copay, contact the sender of the bill. If it’s your insurance company ask them to explain why the charge in question wasn’t covered. Sometimes it’s a loophole you didn’t catch when reading through their book of terms and conditions and sometimes it’s a charge gone astray. Likewise, if the medical practice sends you a bill over your copay, they’ve almost certainly filed the claim incorrectly. Call them to bring it to their attention and if necessary, request that the claim be re-filed.

Don’t panic if this kind of thing happens to you. It’s pretty common these days for the claim system to use one computer talking to another computer and if all the jots and tittles don’t line up your claim gets rejected. This is why it’s so important to bring it to a human’s attention. Put the ball back in their court and tell them “this is wrong, please fix it.”

If you’re in an English-speaking country, you might also want to ask them why their claims are in Hebrew. Get it? Jots and Tittles? No? I digress.

Use your Assets. And I don’t mean your rear end. If you know and (medically) trust someone in the medical field, ask for their opinions, advice, and if they have a recommendation for a local caregiver. Often times they won’t personally know a caregiver in your area, but they’ll know someone who knows someone. This is why it’s important to choose someone who you would trust in a medical situation, not just watching your back at the neighborhood poker game. I was referred to my new practice by an associate of a friend of my mom’s, and it ended up being more beneficial than the internet. Still, I’m sure they wouldn’t look as silly in a hat.

Why didn’t you list that in your pretty numbered list up there?
I’ll tell you (She said in the fashion of Tevye). The list above is a solid list of things you need to do before you choose a care provider. I don’t have “ask a friend” on that list because I can’t attest to how well you place your trust in others. You could have really crappy malpracticing friends. And then where would I be? I’d be at the bottom of a subjective, unhelpful list is where I’d be.

So yes, you should consult what assets you have available, but you need to do so with wisdom. I knew I could trust my mother’s friend’s recommendation because she’s an accomplished Nurse Practitioner who has impressive credentials I won’t bore you with. She also recommended a practice that was lauded as the best in my community by a medical journal this past year. I wouldn’t have relied on her recommendation alone without ensuring at least four of the items of that list above were met. You’ve got to take hold of your medical care with vigilance.

tea sammich

All that being said, can we go have some little triangle shaped finger sandwiches? I’ve got them stuck in my mind for some reason. . .

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