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How to pick the best doctor.

How to pick the best doctor. And Get the most economical care. ADVERTISING. TV RADIO NEWSPAPERS MAGAZINES PROGRAMS MAIL COMMERCIAL RELATIONSHIP. YELLOW PAGES. Alphabetical listing Specialty listing Bold face font Large ads. REFERRAL. Physician Family member Friend or neighbor

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How to pick the best doctor.

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  1. How to pick the best doctor. And Get the most economical care.

  2. ADVERTISING • TV • RADIO • NEWSPAPERS • MAGAZINES • PROGRAMS • MAIL • COMMERCIAL RELATIONSHIP

  3. YELLOW PAGES • Alphabetical listing • Specialty listing • Bold face font • Large ads

  4. REFERRAL • Physician • Family member • Friend or neighbor • Support group

  5. WHAT DO YOU WANT ?

  6. Primary Care • Family practice • General practice • Internal Medicine • Gynecology • Pediatrics • Gerontology

  7. Subspecialties • When to see a sub specialist

  8. American Boardswww.abms.org • Only 24 recognized • Allergy and Immunology • Anesthesiology • Colon and Rectal Surgery • Dermatology • Emergency Medicine • Family practice

  9. American Boards • Only 24 recognized • Medical Genetics • Internal Medicine • Neurological Surgery • Nuclear Medicine • Obstetrics and Gynecology • Ophthalmology

  10. American Boards • Only 24 recognized • Orthopedic Surgery • Otolaryngology • Pathology • Pediatrics • Physical Medicine and Rehabilitation • Plastic Surgery

  11. American Boards • Only 24 recognized • Preventive Medicine • Psychiatry and Neurology • Radiology • Surgery • Thoracic Surgery • Urology

  12. VERIFY CREDENTIALS • Texas State Board of Medical Examiners • www.tsbme.state.tx.us • Federation of State Medical Boards • www.docinfo.org • American Board of Medical Specialties • www.abms.org • links to each specialty board

  13. TSBME REPORT Description:  EFFECTIVE 12-18-02 AN AGREED ORDER WAS ENTERED REVOKING THE PHYSICIAN'S LICENSE, HOWEVER, THE REVOCATION WAS STAYED AND THE PHYSICIAN WAS PLACED ON PROBATION FOR TEN YEARS UNDER CERTAIN TERMS AND CONDITIONS. IN ADDITION, AN ADMINISTRATIVE PENALTY IN THE AMOUNT OF $25,000 WAS ASSESSED. ACTION DUE TO UNPROFESSIONAL OR DISHONORABLE CONDUCT THAT IS LIKELY TO DECEIVE OR DEFRAUD THE PUBLIC OR INJURE THE PUBLIC, AND VIOLATION OF PREVIOUS ORDER OF THE BOARD.  

  14. TSBME REPORT Description:  11-6-02 A TEMPORARY SUSPENSION ORDER WAS ENTERED TEMPORARILY SUSPENDING THE PHYSICIAN'S LICENSE DUE TO EVIDENCE AND INFORMATION THAT THE PHYSICIAN'S CONTINUATION IN THE PRACTICE OF MEDICINE WOULD CONSTITUTE A CONTINUING THREAT TO PUBLIC HEALTH AND WELFARE. THE ALLEGATIONS RELATED TO THE APPLICATION FOR TEMPORARY SUSPENSION ARE TO BE THE SUBJECT OF A DISCIPLINARY HEARING AS SOON AS CAN BE ACCOMPLISHED UNDER THE ADMINISTRATIVE PROCEDURE ACT. IT IS FURTHER ORDERED THAT THE TEMPORARY SUSPENSION ORDER SHALL REMAIN IN FULL FORCE AND EFFECT UNTIL SUCH TIME AS IT IS SUPERSEDED BY A SUBSEQUENT ORDER OF THE BOARD.

  15. TSBME REPORT Description:  AN AGREED ORDER WAS ENTERED ON 5-17-02 SUSPENDING THE PHYSICIAN'S LICENSE; HOWEVER, THE SUSPENSION WAS STAYED AND THE PHYSICIAN WAS PLACED ON PROBATION FOR SEVEN YEARS UNDER CERTAIN TERMS AND CONDITIONS. ACTION DUE TO THE FOLLOWING: INABILITY TO PRACTICE MEDICINE WITH REASONABLE SKILL AND SAFETY TO PATIENTS BECAUSE OF ILLNESS, DRUNKENNESS, EXCESSIVE USE OF DRUGS, NARCOTICS, CHEMICALS, OR ANOTHER SUBSTANCE, OR AS A RESULT OF ANY MENTAL OR PHYSICAL CONDITION; AND

  16. TSBME REPORT Self-Reported Disciplinary Action by Other State Medical Board: Description: I SURRENDED MY CALFORNIA LIC.

  17. LOCATION • Near home • Near hospital • Near medical center • Near major highway

  18. Hospital Affiliation

  19. TRUST • Character • Personality • Ease of communication • Community activities

  20. OFFICE HOURS • Appointment only ? • Drop in ? • Urgent or emergent work in ? • Who answers phone ? • Machine ? Listen to message.

  21. 24/7 Coverage • Solo practitioner • Who do you sign out to? • Group Practice • How do you handle night and weekend call ? • How do you handle emergencies ? • Can I have your home and cell phone number ?

  22. PREVENTION • Little or no cost compared to treatment

  23. AUTOMOBILE ACCIDENTSSTATS • 6-7,000,000 PERYEAR • 3,200,000 INJURIES • 40,000 DEATHS • Half alcohol related • At a BA of 0.8 – risk of accident 20x

  24. ACCIDENT CAUSES • Talking with other passengers 81% • Playing with radio or CD 66% • Eating or drinking 49% • Using cell phone 25% • Fatal accidents • Alcohol 50% • Fatigue 50%

  25. Prevent “Accidents” • Bathroom Slippery surfaces Handrails Shower seats GRF electric outlets

  26. Prevent “Accidents” • Kitchen Sharp knives Hot pans Flammables Slippery surfaces GRF electric outlets

  27. LIFESTYLE • Exercise • Weight control • NO SMOKING • One alcoholic beverage per day • Attentive and lawful driving • Medication effects

  28. LEARN ABOUT YOUR DISEASE • Medical Information Web Sites nih.gov medical.nettop20.com webmd.com drkoop.com • Library • Support groups • Handouts from doctor

  29. CLUES • History Past illnesses and operations Family history of disease Medications ( Rx or OTC) Allergies &/or side effects Social history Lifestyle

  30. PHYSICAL EXAM First visit Thorough, undressed, head to foot Follow-up Focused

  31. Lab and imaging • Don’t be afraid to ask, Are these studies covered by my insurance ? Are the studies necessary to make a diagnosis or to determine treatment ? Is there a less expensive alternative ?

  32. PRESCRIPTION MEDS • Brand name vs. generic • OTC alternative • Shop pharmacies (talk to pharmacist) Walgreen's CVS Grocery stores, HEB, Randall's, etc. Costco, Sam’s On-line (Canadian)

  33. Shop for your Medicines • Call several pharmacies • Inconsistent pricing • Ask if there is a generic • Ask if there is a larger pill that can be broken • Check on-line (e-pharmacy.com) • Consider Canada • ??? Mexico???

  34. Examples • Diovan 160/25 (brand name – no generic) 30 day supply Walgreen’s $81.99 CVS $79.59 Hall & Hall $85.44 Sam’s $64.54 Costco $68.54 HEB $72.49 U S On-Line $37.58 Canada $39.79

  35. Difference Highest to Lowest • For 1 year for 1 medicine (brand name) $584

  36. Examples Brand vs. GenericTenormin 50 mg Atenolol 50 mg Walgreen’s $46.49 $10.39 CVS $45.49 $9.99 Hall & Hall $56.16 $35.03 Sam’s $40.84 $3.97 Costco $42.19 $3.89 HEB $49.65 $10.46 U S On-Line $32.13 $7.99 Canada $30.00 $15.00

  37. Difference Highest to Lowest For 1 years medicine (brand name) $ 317.55 For 1 years medicine (generic) $ 135.00 For 1 years medicine (highest brand to lowest generic) $635.10

  38. Over the Counter Alternative • Anti-inflammatory 1 years supply $950 • Ibuprofen 1 years supply $50

  39. Key Points • Switch to a less expensive but equally effective medication • Stopping non-essential medicines or use them only as needed • Splitting pills • Using office samples • Use Govt. or private Patient assistance programs • Shop around

  40. INSURANCE • Group (through employer) • Group (through association) • Government Medicare Medicaid CHIPS VA

  41. INSURANCE • HMO • PPO • Workmen’s comp. • Auto insurance • Homeowners insurance • Travel insurance • Foreign travel • Individual

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