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From: john@ur-tut.UUCP (John Gurian)
Newsgroups: net.med
Subject: Re: finding a good doctor
Message-ID: <37@ur-tut.UUCP>
Date: Sun, 9-Mar-86 16:27:00 EST
Article-I.D.: ur-tut.37
Posted: Sun Mar  9 16:27:00 1986
Date-Received: Wed, 12-Mar-86 04:17:27 EST
References: <121@drutx.UUCP> <1623@brl-smoke.ARPA>
Organization: University of Rochester School of Medicine
Lines: 41

> Among the list of needed doctors given in the referenced article was a
> good internist.  One followup message suggested a 'shotgun' approach to
> finding a 'family doctor.'  My experience with 'family doctors' is that
> they're fine for dealing with sore throats and simple ailments but that
> they often wait too long to refer to a specialist when something is
> REALLY serious.  

Like any other specialty, you can get good and bad family practictioners.
It would be worthwhile to check and make sure that the family doc has
been board-certified in family practice (i.e. has done a 3 year residency
and takes recertification exams every 7 years).  Again, this is never a
guarantee, although it is worthwhile to note that FP's are the only ones
that need to take recertification exams (others are planning it, I think).
A good FP can treat the minor stuff, but can recognize serious stuff and
make the referal.  My own personal bias is that FP's are overly maligned
in many cases - there a quacks in every field.  I also think that FP's
have a little more exposure to psych training, and being a firm believer
in the biopsychosocial model of disease, this can only be a good thing.
It can be a great help to have one doctor that knows EVERYTHING about
a patient and the patient's lifestyle.

> I strongly suggest that the respondent begin her search with a good
> internist.  If your local area (Denver, was it?) has a reputable medical
> school_cum_hospital complex, begin there.  Identify the younger men and
> women practicing internal medicine and select from among them.  A
> competent internist can best refer you to the gyn and other specialists
> whom you might need.  His/her affiliation with a good med center helps
> assure that you get excellent referrals.

While this is certainly valid advice, in my opinion it perpetuates a myth
that the researchers at a med school are gods, and the guys in private
practice in the community, actually delivering medicine to the bulk of the
population, are screw-ups.  Certainly there are screw-ups in private 
practice.  Just as certainly, there are screw-ups on the faculty of
prestigious medical schools, and affiliation with a school provides no
guarantees.

-- 

-- John Gurian
-- !{harvard,seismo,topaz}!rochester!ur-tut!john