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Top-rated California doctors

Consumer Reports can help you find the right doctor for you and your family

Published: January 21, 2015 06:00 AM

We expect a lot from our doctors. They should be competent, of course, skilled in their craft, and able to help us stay healthy. But we want to like them, too, according to a recent survey of 22,030 Consumer Reports subscribers who live in California.

We asked them to think about physicians they visited during the previous year and assess them on seven personality measures. At the top of the list: being a good listener. “That makes sense,” says Marvin M. Lipman, M.D., chief medical adviser to Consumer Reports. “Good care depends on good communication, but unfortunately, too many doctors still think that means they do the talking and patients do the listening.” (Read more about the importance of being treated with respect by health care professionals.)

That can lead to serious problems if, for example, you fail to follow through on medical advice that you don’t understand or agree with, or if it leads to the wrong diagnosis and the wrong treatment.

Other traits that stood out in the survey also highlighted the importance of a good bedside manner: providing trustworthy advice, being warm and caring, making you feel calm and at ease, and having a sense of humor.

But trying to find a doctor who listens to you and who seems to understand you isn’t always easy. And even if you’re lucky enough to find such a physician, you may have to look for another if, for example, you move, your doctor retires, or your health insurance changes. (Read more about how to choose a doctor.)

To help you find a doctor who’s right for you and your family, for the second year in a row we’ve teamed with the California Healthcare Performance Information System—a nonprofit collaborative of health insurance plans, health care providers, businesses, and consumers—to rate California physicians.

The group surveyed more than 52,000 people in California and culled key information about their experiences with their doctors. From that, we were able to create Ratings for more than 170 physician groups across the state. Together, the groups provide about 90 percent of the health care received by Californians insured through private, commercial plans.

Use these Ratings to compare physician groups across California, based on survey data collected by the California Healthcare Performance Information System.

What we found

The findings provide valuable information about how well physicians communicate with patients, coordinate medical care, and provide timely access to routine and urgent care, as well as how patients rate their care overall. The survey also asked patients about their experiences with the office staff.

We found that high-scoring groups are more common in some areas than in others. For instance, more than one in four physician groups in the Bay Area earned a score of  70 or higher for overall care, compared with just one out of 24 in Riverside and San Bernadino counties and one out of 23 in Eastern Los Angeles.

Overall, patients gave their doctors high marks when it came to being treated with respect: 84 percent said their doctors always showed respect for what they had to say. But only 55 percent said their doctors knew about the care they received from other health care providers, only 37 percent said their doctors always saw them within 15 minutes of their appointment time, and only 26 percent said their doctors asked whether they felt sad or depressed.

To see how your doctor’s group performed in the survey, use the Ratings. Below, we highlight some findings from the survey. Also, we’ve included questions from it to help you assess your relationship with your doctor, and we offer advice on how to improve it, if necessary.

Rate your doctor

In the following sections, we include some of the most important questions asked in the survey. Most of them match up with the measures in the Ratings chart. The questions are divided into four categories:

  • Communication
  • Coordinating your care
  • Working with the office staff
  • Getting timely care.

Use the questions below to rate your doctor. Then check the Ratings to see how your experience compares with those of other patients in the same group, as well as how your doctor’s group stacks up against other groups across the state.

Communication

Clear and honest communication with your doctor and other health care providers can help you stay healthy and, if you get sick, recover faster. In fact, patients who take an active role in the doctor-patient relationship by asking questions, stating symptoms clearly, and interrupting when necessary have better outcomes, research suggests. The ideal is shared decision-making: cooperation between an informed patient and the doctor.

1. How often did your doctor explain things to you in a way that was easy to understand?

Respondents who said "Always": 80 percent

What to do: Write down what your doctor tells you. Then in your own words, repeat his instructions, so you can confirm that you’ve understood them. If something is unclear, speak up. If there are complicated instructions that must be followed every day, ask your doctor to write them down. Last, consider having a friend or relative accompany you to your appointment so that there’s an extra set of ears.

2. How often did your doctor listen carefully to you?

Respondents who said "Always": 80 percent

What to do: Don’t hesitate to repeat your problem if you’re not sure that you doctor heard you. If you would like your doctor to make more eye contact, stop talking, or sit when she talks with you, say so. Read more about how to make your doctor listen.

3. How often did your doctor show respect for what you had to say?

Respondents who said "Always": 84 percent

What to do: You might be concerned about a treatment’s side effects, and your doctor might focus on its benefits. Let your doctor know what’s important to you. If you don’t think your opinions are being respected or considered, speak up.

4. How often did your doctor spend enough time with you?

Respondents who said "Always": 75 percent

What to do: Because doctors are busy, visits can feel rushed. To make the most of your time, jot down questions and concerns in advance, listing the most important ones first. Ask whether other providers on staff can help you with the less pressing questions. If you want to raise a new health concern during your visit, mention that when you make the appointment so that more time can be scheduled for you. According to research, when visits aren’t rushed, doctors are less likely to write unnecessary prescriptions and more likely to spend time talking about preventive care and self-help measures.

5. How often did your doctor give you easy-to-understand information about your health questions and concerns?

Respondents who said "Always": 75 percent

What to do: Don’t be shy. If you don’t understand something, ask your doctor to explain it in different words, use a picture or diagram to make it clearer, or just slow down. If you still have concerns when you get home, call and ask for a follow-up appointment, perhaps on the phone or with a nurse practitioner or a physician assistant. He or she might be able to spend more time with you.

6. How often did your doctor seem to know the important information about your medical history?

Respondents who said "Always": 70 percent

What to do: Before your appointment, make a list of the drugs (and any supplements) you regularly take; any surgeries or procedures you’ve had; and important aspects of your personal and family medical history, including chronic diseases. And take the list to your visit. If your doctor doesn’t ask about those things, bring them up. Chances are your physician will include the information in an electronic health record. Ask whether you can access that information through a secure website, or health portal, when you are home so that you can review it. Read more about how to safely and effectively use patient portals.)

Coordinating your care

Your doctor should be familiar with all of the care you get, from other health care providers in the same group and from providers outside of the group. That helps prevent duplicated tests or prescriptions and drug interactions, and ensures that you get the information you need about follow-up care from all of the doctors you see.

7. How often did your doctor seem informed and up-to-date about the care you received from specialists?

Respondents who said "Always": 55 percent

What to do: Make sure your doctor knows about the care you’ve gotten from specialists and other providers, including chiropractors, alternative health care practitioners such as acupuncturists and herbalists, and other physicians. Explain why you saw them, what happened during the visit, and which treatments or drugs were prescribed. You should make sure that those providers communicate with your primary care doctor, too. Ask for copies of letters or reports that the specialist plans to send to your primary care provider. Electronic health records can help providers share information, but patients also need to be in the loop.

8. When your doctor ordered a blood test, X-ray, or other test, how often did someone from the office follow up to give you those results?

Respondents who said "Always": 63 percent

What to do: Find out when your test results will be ready. If you haven’t received them by then, call the doctor’s office. Also, ask whether you’ll get the test results by phone or letter, or online with a secure patient portal. If you don’t know whether your group has a patient portal, ask. Last, request a written copy of your test results and file it with your other health information.

Working with the office staff

Your interactions with your doctor’s office staff, including nurse practitioners and physician assistants, as well as the receptionist and the person who handles billing and insurance, are as important as your experience with the doctor. Most California patients gave their doctor’s staff high marks, but our Ratings show that there’s plenty of room for improvement.

9. How often were clerks and receptionists at your doctor’s office as helpful as you thought they should be?

Respondents who said "Always": 62 percent

What to do: Let the staff know—politely but firmly—that you’d like them to be more helpful. If you don’t get the assistance you need, reach out to the office manager or doctor.

10. How often did the clerks and receptionists treat you with courtesy and respect?

Respondents who said "Always": 77 percent

What to do: If you have a disagreement or other unpleasant interaction with a staff member, tell your doctor or the office manager. Remain calm and polite when describing the situation, but be direct. Will an apology make you feel better, or will it be so difficult to interact with the staff member in the future that you prefer to see a different provider? Make your feelings known.

How California's top practice did it

 


Sutter Gould Medical Foundation, in California’s Central Valley, earned a 77 in these Ratings, the top score in the state. Its 330 physicians, nurse practitioners, physician assistants, psychologists, and other health care providers care for some 250,000 primarily working-class patients in San Joaquin, Stanislaus, and Merced counties.


Despite its size, patient experience comes first. “We are in the people business,” says chief medical officer Steven Mitnick, M.D. “We spend a lot of energy making sure we give patients what they need.”


Trying to schedule an appointment on a patient’s preferred date is a priority, as is moving patients from waiting room to exam room quickly. Good communication is also encouraged. “We train our staff in a communication technique called AIDET,” Mitnick says. It stands for Acknowledge the patient; Introduce yourself; Duration (say how long the patient will have to wait); Explanation (tell the patient what is going to happen); and Thank the patient.


Supervisors observe each employee periodically “to make sure they are using the technique consistently and not just when they think about it,” Mitnick says. To track how staff is doing on various measures, patients are regularly surveyed, and doctors and support staff receive monthly results so that they can improve as needed.


Electronic health records can reduce unnecessary testing, improving efficiency and care. “Any physician who sees any patient within our organization has a record of every note, lab test, and X-ray done on a patient,” Mitnick says. “The physician always has the most up-to-date information, so he can do the best decision-making.”


Getting timely care

Scheduling an appointment for routine care shouldn’t take weeks. If you have a pressing medical question, your doctor or someone in the office should be able to squeeze you in or to at least take a phone call. And when you show up for an appointment, you shouldn’t have to endure long delays.

11. When you phoned your doctor’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?

Respondents who said "Always": 60 percent

What to do: If you want an appointment on short notice but can’t be seen by your doctor, ask whether another physician can see you instead. Or ask whether the nurse practitioner or physician assistant on staff has an opening. Those professionals can handle many common medical problems.

12. When you made an appointment for a checkup or routine care with your doctor, how often did you get an appointment as soon as you needed?

Respondents who said "Always": 64 percent

What to do: Schedule appointments for routine care or follow-up visits as soon as possible—weeks or months in advance. If you’ll be late or you need to cancel, call right away. The scheduler might be able to move up someone else or to take another patient.

13. When you phoned your doctor’s office during regular office hours, how often did you get an answer to your medical question that same day?

Respondents who said "Always": 58 percent

What to do: If you have an urgent question, let the office staff know how important it is. If your question can wait, it makes sense to use the group’s secure online health portal, if available, to send it in writing.

14. When you phoned your doctor’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed?

Respondents who said "Always:" 59 percent

What to do: Health concerns can crop up after regular business hours, so make sure you know how unexpected problems are handled. Some nearby groups may team up to offer expanded hours for urgent care. Larger groups might keep staff on duty evenings and weekends for patients who can’t come during business hours.

15. How often did you see your doctor within 15 minutes of your appointment time (include time spent in the waiting room and the exam room)?

Respondents who said "Always": 37 percent

What to do: Be sure you check in when you arrive so that the staff knows you’re there. Ask whether the doctor is running on schedule; if he isn’t, let a staff member know how long you can wait before you have to leave. If long waits become the rule rather the exception, find another group.

Health care reform in California, one year later

 


California’s health care landscape has shifted dramatically since the expansion of the Affordable Care Act in October 2013. About 3.4 million people who did not have health insurance before now do, thanks in part to Covered California (the state’s health insurance Marketplace) and an expanded Medicaid program (Medi-Cal). As a result, more people than ever are looking for primary care doctors. Here are some other ways that the ACA has affected California:


• People without any health insurance:  Down 50 percent, from 22 percent before open enrollment for Covered California to 11 percent by June 2014.


• People insured through Covered California who receive a subsidy to help pay for health insurance: 90 percent.


• Newly insured Californians who say their plan offers good value: 73 percent.


Read more about health insurance and health care reform.


Sources: Henry J. Kaiser Family Foundation, the Commonwealth Fund, and Covered California.


Talking prevention

Top-notch health care is as much about preventing disease as it is about treating it. Eating right and exercising regularly are the cornerstones of good health. But your mental well-being is important, too. Here are the state averages for four survey questions that address how well California physician groups perform in those categories:

16. Did you and your doctor talk about a healthy diet and healthy eating habits?

Respondents who said "Yes": 57 percent

What to do: Let your doctor know whether you’re concerned about your weight or diet. And don’t be offended if she mentions it. Diseases related to unhealthy eating and excess weight—including heart disease, certain cancers, stroke, high blood pressure, osteoarthritis, osteoporosis, and type 2 diabetes—are among the leading causes of disability and death. Ask about support, such as a referral to a nutritionist or a registered dietitian.

17. Did you and your doctor talk about the exercise and physical activity you get?

Respondents who said "Yes": 67 percent

What to do: Request advice that’s tailored to your needs. For example, if you have arthritis, you might benefit from exercises that differ from those recommended for someone who has diabetes or who wants to lose weight. You and your doctor should discuss what makes the most sense for you. He or she might be able to recommend community resources, such as gyms or fitness programs, near you. If necessary, ask for a referral to a physical therapist.

18. Did anyone in your doctor’s office ask you whether there was a period of time when you felt sad, empty, or depressed?

Respondents who said "Yes": 26 percent

What to do: Responses to a few simple questions about emotional health can be surprisingly helpful in identifying people who are at risk of depression, according to research. Each year about 15 million Americans experience serious depression, which is debilitating and can worsen other diseases and conditions. If you have experienced a prolonged period of sadness or depression and your doctor doesn’t ask about it, bring it up.

19. Did you and anyone in your doctor’s office talk about things in your life that worry you or cause you stress?

Respondents who said "Yes": 30 percent

What to do: Most of us don’t take stress seriously, but it can be as bad for your heart as excess weight, lack of exercise, and smoking. It can also contribute to diseases such as type 2 diabetes, chronic pain, and depression. And it can weaken your immune system, raising your risk of infection, and can result in unhealthy behaviors, such as excessive eating and drinking. Tell your doctor about the stresses in your life, such as long hours at work, family troubles, or financial problems.

Use these Ratings to compare physician groups across California, based on survey data collected by the California Healthcare Performance Information System.

Where to go for more information on doctors

 


California residents can use the Ratings to find information on more than 170 physician groups and to identify practices that score high on measures such as communication, follow-up care, and wait times for appointments.


Consumer Reports also rates hospitals and heart surgery groups on several safety, performance, and patient experience measures. But it can help to gather information from other sources, too, including those listed below.


AMA DoctorFinder. Basic information on more than 814,000 physicians in the U.S. You get information on specialty training, board certification, and more. But there is no information on patient outcomes, disciplinary actions, or communication skills.


California Office of the Patient Advocate. Rates 212 California physician groups on how often they provide recommended care for asthma, cancer screening, chlamydia screening, diabetes, heart disease, and pediatric care.


Healthgrades.com Comprehensive, easy-to-use site that allows searches by name, procedure, specialty, or condition. Includes info on education, affiliated hospitals (and ratings on the hospital itself), sanctions, malpractice claims and board actions, office locations, and insurance plans. Ratings on topics such as patient satisfaction and wait time are based on patient feedback, which can be limited.


Medical Board of California. Search by name to see whether a physician or other health care professional is licensed, whether any patient complaints have been filed, and whether any disciplinary actions have been taken. You can also use the site to lodge a complaint against a doctor.


National Committee for Quality Assurance. Information on doctors who meet standards in measures such as care for heart disease, diabetes, and back pain. NCQA verifies a doctor’s licensing, but other data are self-reported.


Physician Compare. Information from the federal Centers for Medicare and Medicaid Services on health care providers who accept Medicare. Provides information on board certification, education, and group and hospital affiliations.


ProPublica. The organization’s Treatment Tracker and Prescriber Checkup tools compare doctors on how often they use certain treatments and prescribe certain drugs. And its Dollars for Docs tool shows how much doctors are paid by drug companies, indicating possible conflicts of interest.


RateMDs.com. Search for doctors by name, sex, ZIP code, state, and specialty. Includes information on training as well as patient ratings on staff, punctuality, helpfulness, and knowledge. It has links to medical board records where you can get information on disciplinary actions. Ratings are based on patient reviews.


Click on the map at right to find Ratings of hospitals nationwide. The Ratings include include information on our surgery Ratings, our hospital Safety Score, as well as some information on performance for more than 4,000 hospitals.

 


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