Doctor shopping to improve your health!

Doctor shopping is the act of seeking out multiple doctors for treatment of the same condition at around the same time. 

The doctor shopping I’m referring to in this post is doing research on physicians in advance of appointments, and carefully selecting the correct doctor to meet your needs – and changing doctors if the first one you see fails to provide helpful treatment.

Another common usage of the term “doctor shopping”, is drug-seeking behavior on the part of people with addictions, where they visit different doctors for the same symptoms until one prescribes the drug of choice. 

If you or anybody you know seems to keep seeing different doctors to feed an addiction rather than treat symptoms, the problem may not be with the doctors.

I have frequently found myself needing to do some deeper research and occasionally go doctor shopping in order for my condition to be correctly treated. 

If you are seeing multiple doctors, your goal should be to find one in that specialty who respects you and your situation, understands your condition, and is best able to help you manage your symptoms. 

Once you find that doctor, you should not need to continue shopping, unless you need an additional specialist.

Get information from multiple sources!

If you are trusting doctor’s website information, please stop doing that.  Any website for any individual or organization likely will slant information in their favor.  

It only makes sense.

If they are paying for it, they want it to portray them in the best possible light.  

If you want to know about what a doctor(or organization) says they can do, look at their site, but if you want an evaluation of how well they do something, you need to use independent sources.  

Sadly, there is no information widely available about a doctor’s misdiagnosis rate or patient success history. 

Instead, you need to use cruder metrics, like what previous patient experiences were like. 

To know what prior patients of the doctors have to say, Healthgrades is one of several good resources.  

You should be able to find more with a quick google search such as ‘doctor review sites’.  

Also, most insurance companies have a similar system, but only for their members(and participating doctors).  

To look at that, just log onto your insurance company’s site and run a search for your doctor. You should see a rating(1-5 stars, 5 being best), and what other patients have said of her or him.  Generally, only doctors covered by that provider will be listed.

Also be aware that some patients do not distinguish between the doctor and the doctor’s office or practice.  Many insurance companies also write their questions with a bias towards office-based information rather than about the individual doctor

If you are getting severely mixed opinions, study the comments carefully – it may be that some patients are focused on their interaction with the doctor, while others are focused on challenges the office presented. 

I talk about evaluating your doctor and their office in another post that may shed some light on those considerations. 

Remember though, this is all opinion-based. Just like any other rating and review site, the fewer reviews the less reliable the information, and it is always possible for at least some of the reviews to be fake.  

Also, remember that human nature being what it is, people are much more likely to recount exceptional experiences, so their worst or best doctor experiences are likely to be shared, not their average ones. Still, the opinion of many consumers is one of the better metrics available.  

History of malpractice

To dig more into a doctor’s history, you can search for a history of malpractice suits.  Do a google search for “medical licensing board” with your state’s name. From there it should be relatively easy to find the directory and search up the doctor you are interested in.  That information should include the average number of malpractice suits for their discipline for a realistic comparison.

In this case, being below average is a good thing. Bear in mind that this information does not always cross state lines with the doctor, so if your doctor’s time in your state doesn’t line up with their age or work history(most doctors publish a simple CV on their pages), you may want to check in other states as well.  Try surrounding states, or the state where they went to med school or had other ties to.  

Where do you look?

Any time you need somebody with a very detailed knowledge of your condition or symptoms(to properly diagnose you), you want to do research on all(or at least several) of your available options. 

There definitely can be some very good specialists running their own practice, but you may want to especially look for areas where highly focused and curious medical professionals are likely to gather.

If there is a teaching hospital or university-affiliated hospital in your area, or another well-known group that specializes in your symptoms or condition, they may be a good place to look into.  The Mayo Clinic, Sloan-Kettering, or the Cleveland Clinic are all good examples.  They have a reputation for being among the best in their fields.

If you have a primary care physician or specialist who you trust deeply, talk to them about recommendations of doctors of treatment groups that may be your best fit.

Ask the experts!

Those of us with chronic or disabling conditions often spend a lot of time doing research on conditions and treatments.  You can also ask around in any social group around your condition(such as a Facebook group or Pinterest board) or a nonprofit that focuses on your condition(these often begin as volunteer groups) to see what specialists(both types of specialists and individual professionals) they may mention.

You can also search for medical papers or journals about your condition to see either what people or what locations focus on your specific condition or symptom set.  Google Scholar may be a resource for this, and you also may find papers mentioned in the above-mentioned groups.

Again, focus on getting good information from relatively neutral parties – use the hospital or group’s website to find the doctor’s names and a bit of their history or biography, but then look that doctor up in an unrelated site to see what others say.

Search through the nonprofit sites or disability forums to find hospitals or medical groups that may be helpful to you, or individual specialists.  The more doctors you’ve hit walls with, the more important it is to find an expert in your precise condition or set of symptoms.

Doctor’s area of interest/expertise

When you are looking for your primary care physician, this will generally not be an issue, but when you are looking into specialists it becomes very important to make sure that their area of expertise lines up with your diagnosis or symptoms. 

If your condition was easily diagnosed or has a well-known treatment process, the area of interest or expertise is pretty much a non-issue unless the treatment is very invasive(such as surgery). 

If you are undiagnosed or concerned about a misdiagnosis, or if you are going to have a potentially dangerous procedure done, you want to make absolutely sure that you are in the best possible hands.

I have experienced this personally, as it took visits to multiple neurologists(and two psychiatrists) for me to be properly diagnosed with conversion disorder(now properly called Functional Neurological Disorder). 

The first neurologist I saw told me that I appeared to be having some form of anxiety reaction, and put me on anti-anxiety medication. While not technically incorrect, she didn’t go far enough!

The second neurologist I saw focused primarily on epilepsy and seizures, so he gave me anti-seizure medication(that had no effect on me or my symptoms) and when my symptoms came back had me tested for epilepsy by trying to induce seizures. 

While I was in the hospital under his care, I also saw a psychiatrist who thought I was overly anxious and put me on an anti-convulsant that sometimes controls anxiety.

One of that neurologist’s colleagues looked me over and suggested that maybe I had a movement disorder, and connected me with Columbia Presbyterian which has a Center for Parkinson’s and other Movement Disorders. 

The neurologist there watched my movements and had a conversation about my experiences, and tentatively diagnosed me with conversion disorder without a single additional test(he saw that the tests for epilepsy and my MRI had not indicated any issues).

He explained how my movements were different from tics and other more standard movement symptoms(including seizures), and that the only reason he couldn’t say for certain was that it is considered a psychological condition, and so I needed a psychiatrist to confirm the diagnosis(this is no longer part of the FND diagnosis process). 

Until I went to a neurologist who specialized in movement disorders, no other neurologist or psychiatrist I saw could identify my condition.

They were all working off of a similar set of information, but all of the others missed the clues that the movement disorder specialist had immediately recognized. 

It’s important to be aware that your diagnosis is really the doctor’s best guess, or theory, or your condition. Your doctor’s experiences guide their diagnoses, which is why finding the right doctor is so vital for proper diagnosis.

Insurance coverage

Some of this will be insurance-dependent, so assuming you have health insurance, you’re going to want to find out what hospitals/groups/specialists are in-network for you and look at those first. 

If you do not have insurance, you may want to call around and see where you might be eligible for Charity Care or see if you are eligible for Medicare or Medicaid.

Seeing an okay doctor is better than seeing no doctor, but the more challenging your diagnosis is or your treatments are, the more important it is to find the right type of expert.

What if you don’t know what you have?

There are conditions that doctors can’t make heads or tails of.  If you’ve seen multiple doctors and each one has been thoroughly confused, you want to hunt for a good diagnostician. 

Search the larger hospitals and teaching hospitals to look for one.  Find a field that seems to be the best match for your symptom history, and ask for recommendations or referrals from the most helpful doctors you have seen.

Even if you aren’t asking for help in the completely right field, the specialist with a reputation as a diagnostician will often prescribe a test previous experts hadn’t thought of, or double-check something that another doctor might have considered close enough to normal.

Al’s relatively common blood disorder(pernicious anemia) was discovered by his endocrinologist, who was the only person he saw who double-checked his B-12 levels. 

They had been on the low side of ‘normal’ the only other time it had been checked, so she ran another test, and discovered the level was so low it was unmeasurable. 

If we hadn’t tried a second endocrinologist after the first couldn’t find the source of his problem, who knows how long it would have taken to get the correct diagnosis!

Warning signs that it’s time to go doctor shopping

• If the first doctor you see seems to have a pet diagnosis
• You have a diagnosis of exclusion (translation: I can’t think of anything else) or idiopathic (translation: I don’t know why this happened) expression of a condition.  Primary and essential are also words to be wary of, especially if you aren’t in the standard population to have the condition or symptom.
• Suggestions that you ‘didn’t grow properly’ or ‘there’s no discernable cause’
• The narrative of the condition does not align with your lived experience!  I had people suggest, for example, that maybe my movement symptoms were a result of a chemical spill.  The chemical spill was years after my initial movement symptoms.
• Their diagnosis can only be treated by their patented and expensive treatment program.  It is possible and common for locations to have a reputation for the ‘best’ service or the ‘most advanced’ treatment.  But that’s not the same as ‘only provider’.  If there aren’t other treatment locations/options, I would have serious reservations about being treated, and at least seek a second opinion that has no affiliation with the first.
• You will want to get a second(and possibly third) opinion if surgery or other radical procedures are mentioned.  This doesn’t mean the first doctor is wrong, but if the treatment may put your life at risk, you want to be sure that you trust the specialist.  Seeing the second doctor and getting a similar statement can help confirm that it’s the right treatment.  It also introduces you to a second professional in the field who you may have a better rapport with, or give you a better appreciation of the first doctor.  If you get two very different opinions/treatment suggestions, seek out at least one more – you want to know that you are taking the right action, especially when the risk is significant.

Conclusion: Doctor shopping can improve your health!

As you can see, there’s a lot of research you can do before stepping into your doctor’s office to weed out the bad ones and increase your chances of finding a doctor who can help you with your condition.

If when you see the doctor you feel dismissed, ignored, or not listened to, your best bet is to find a doctor who will respect and help you.  If you see a doctor with a strong bias, they are less likely to be able to realistically evaluate your condition.

Use your research to decrease your risk of finding a doctor ignorant of your symptoms or condition, and to make sure that the doctor you see doesn’t have a history of bad decisions.  Stay within your insurance network to start, but consider going out of network or adjusting your insurance if your diagnosis or treatment proves more challenging.

You deserve to feel that your doctor listens well and cares about your health (or at least about solving the puzzle you represent).  If you feel ignored, or feel that the pieces don’t line up, it’s a good time to see who your other options might be!