This article explores a number of steps you can take to make sure the OB/GYN you choose will be good for your needs.
1. Board Certification
The OB/GYN you select should be Board Certified or Board Eligible by the American College of Obstetricians & Gynecologists (ACOG), http://www.acog.org/. This is generally required by hospitals and medical liability insurers, and the absence of this certification is cause for concern.
2. Insurance Type
This is often the biggest deciding factor in affecting patient choice - most patients are limited in selecting OB/GYNs who are within their insurance plan on the basis of cost considerations. The benefit of selecting an OB/GYN in your plan is that your medical costs are generally much lower than if you go "out of network" (selecting a physician who is not a contracted doctor with your insurance company). When selecting a plan it is a good idea to first check to make sure there are a good number of choices for both primary care and OB/GYN specialties. Given the list of OB/GYNs offered by your plan, you can then review the other parameters discussed below to narrow your selection and hopefully find a great OB/GYN!
Sometimes you may not have a choice in selecting your insurance plan. For example, your employer may provide your health plan. If you find that you are unhappy with the plan in this case, it is a good idea to speak to your employer or human resources department and let them know why you are unhappy with the plan. If enough people complain, it is possible your employer will drop a poor performing plan.
If you find that there is a great OB/GYN in your area and he/she is not on your insurance plan, there are still options you can consider. First, check to see if you have a Point of Service Plan (POS) - these types of plans may allow you to go "out of network", however, you will likely have to pay a higher copay or "cost share" (share of the payment owed on the service) - you should check with your plan to determine the rules. If you do not have a POS plan, you could still elect to see your favorite OB/GYN "out of network". This option may not be too costly as you can inquire if your OB/GYN offers a Cash Discounted Price. If you only see your OB/GYN once a year for your Annual Exam, then the cost of this method may be less than a couple of hundred dollars for the yearly visit. You should still retain your existing insurance in case you need more extensive medical care. Another alternative is to purchase a generally less expensive "Catastrophic" coverage plan, which only covers you in case of major medical expenses. The money saved on such a plan often can more than offset your OB/GYN cash visits. Plan selection is a very personal choice and should depend on many factors (including personal health) - please consult your health insurance specialist regarding your options.
3. Word of Mouth
One of the most common ways people choose their OB/GYN is by referral from a trusted friend, relative, or business associate. This may be an excellent way to choose a doctor as you may rely on the experiences of someone you trust. This method assumes that if your trusted source had a great experience, you will also have a similarly great experience. This may or may not work depending on how similar you are to your trusted source (personality and also services/procedures needed). It's always a good idea to use some of the other methods below, since relying solely on this method may overlook important aspects - such as physician philosophy, types of surgeries / procedures commonly performed, and technological expertise (see below).
4. Physician Referral
Another way you may find your OB/GYN is by being referred by another doctor. This may be great or not so great, depending on many factors including: the number of OB/GYNs limited by the plan in which the referring physician has access, referring physician's knowledge of OB/GYNs in the area, cronyism, etc. It is best when referred by a physician to an OB/GYN to also use some of the other methods discussed to validate the referral.
5. Your Own Instincts
One of the best methods of evaluating an OB/GYN is by coming in for a visit. Does the office staff treat you well? Are you made to feel at home? Is the doctor friendly? Does the exam seem professional? Does the OB/GYN address your questions to your satisfaction? Did the OB/GYN spend an appropriate amount of time (not rushed) with you? Does the office environment seem up to date (computers, modern ultrasound, etc.)? Did you have a good experience? If you answer yes to most of these questions, then you have probably found a good OB/GYN. However, it is always good to check the OB/GYN's medical board history to make sure there are no medical disciplinary problems (as listed below).
6. Medical Board History Search
Most States have a website in which to check disciplinary actions taken against the physician by the State's Medical Board. The information may include but is not limited to information on disciplinary action by the Board, disciplinary action by a medical board of another state or federal government agency, if a physician has been convicted of a misdemeanor or felony, hospital disciplinary actions, malpractice judgments, arbitration awards and settlements, This is a great resource since none of the other methods of choosing an OB/GYN may reveal this type of information. A search revealing excessive amounts of disciplinary actions should raise cause for concern. The search should also confirm that the OB/GYN's license is current.
The State of California Medical Board search can be found at the link under Resources below.
7. Technology Used
One quick way to see if an OB/GYN practice is "state-of-the-art" is to ask: does the practice utilize electronic medical records? Although most OB/GYNs currently do not use electronic medical records, those that do show that they are progressive. Electronic medical records offer many benefits - notably, improvements in the quality of patient care. It is important to note that there are many great OB/GYNs that currently rely on paper charts (as the cost of electronic medical records can be prohibitive - especially for small practices). However, OB/GYN practices on the leading edge of medicine use electronic medical records.
More advanced OB/GYN practices may have "state-of-the-art equipment" such as bone density scanners (http://www.thefitscan.com/), urodynamic equipment, Halo breast-pap machines (www.neomatrix.com), and LUMA colposcopy equipment (www.spectrascience.com).
8. Types of Surgeries / Procedures Performed
It's a good idea to ask about the types of procedures and surgeries the physician performs. For example, if you are pregnant or considering having a baby, inquiring about the physician's rate of inductions and C-sections can give you an idea of your chances of having a C-section. Some OB/GYNs are much more open to natural approaches, such as our practice approach of Hypnobirthing: http://www.encinitasobgyn.com/files/Download/Hypno.wmv
By using natural approaches during pregnancy and limiting inductions to mostly those that are medically necessary, the odds of C-Section drop.
Another example is the use of advanced surgical procedures, such as total laparoscopic hysterectomy and vaginal sling surgery. These types of procedures indicate a high level of skill required. Again, this should not be the only factor in determining your choice of OB/GYN but a complement in helping you make your decision.
9. Physician Philosophy
This is a critical factor in choosing an OB/GYN as it will shape your entire experience at the practice. If you are interested in specific types of medicine, like bio-identical hormone replacement therapy or other natural approaches to menopause, then you should make sure the doctor you select supports this. Other popular areas of interest include natural pregnancy (including hypnobirthing), support of alternative health practitioners (such as acupuncturists and chiropractors), and minimally invasive procedures.
10. Physician Personality
You can assess the personality of your doctor on your first appointment by asking plenty of questions. If you are pregnant, you will see your doctor often over a long period of time so you want to make sure your doctor makes you feel comfortable. It's also nice if the practice has more than one doctor so you can rotate between doctors (ask if they mind) and pick the one that best matches your personality. This is also nice if you ever need to have surgery or if you are pregnant, because it's more likely you will be taken care of by one of the practice physicians who you have already met versus an unexpected backup (e.g. hospitalist).
11. Internet Search
This is a good method for locating OB/GYNs in your area. However, avoid the chat rooms, blogs, and online reviews, as they by themselves, may be unreliable. Do review the practice website and verify that the OB/GYNs are Board Certified. Additionally, the site should post images of the physicians and their resumes (e.g. where they went to medical school, medical residency, and the year of completion of their medical programs). Also, the site should show which hospitals the doctors are affiliated.
12. Male vs. Female Doctor
This is a personal preference. If you would like a female OB/GYN and you are pregnant, make sure the entire group can support this preference. For example, if you are pregnant, and you want a female to deliver you, it is important that all the OB/GYNs in your group are female or you may have a male doctor who is on call for the group deliver your baby. This also applies if an assistant is needed for a GYN procedure and you prefer to have a female physician.
13. Medical Research
Physicians that conduct research and have "state of the art" equipment show that they are at the leading edge of medicine. This can also be a big plus for patients who may benefit from that latest clinical trials and other leading edge technology. Always feel free to call prospective practices and ask them if they are conducting any current research projects.
14. Languages Spoken
This may be important if English is not your first language. Feel free to call the office you are interested in and ask if the doctor/s speak additional languages. Language may also be an indication of which doctor you may be culturally more comfortable with as well.
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