There are number of reasons a person might switch doctors.
A move — especially a long distance one — may make it necessary. Or the doctor may no longer be covered under a patient’s health insurance. “Their insurance plan may have changed,” says Dr. John Meigs, Jr., a family physician in Centreville, Alabama, and board chair of the American Academy of Family Physicians. “A lot of the insurance plans these days have a limited network.” Or the physician may leave the patient’s plan, and it could be difficult (or impossible) for the patient to pay the higher out-of-network physician fees, depending on the difference. In other cases, the doctor may simply not be a good fit for that person.
Whatever the case, clinicians and patient advocates say the transition from one doctor to another is an important time to cross t’s and dot i’s, so that care isn’t interrupted. “Transitions of care are a lot of times when people fall through the cracks,” Meigs says. This can be a time when medical information, including bits and pieces of an individual’s past medical history, are lost; or a prescription for medications a person needs to continue taking may lapse.
[See: Which Practitioner Do I See, and When?]
That’s why, if you had a good relationship with the doctor you’re leaving, experts suggest enlisting that physician’s help, or at least the physician’s office — to the extent possible — to make a smooth transition. If instead you made a clean break, that’s OK, too. Either way, you’ll just want to keep some things in mind as you make the change:
Don’t leave your medical history behind.
“Medical records need to be transferred,” says Dr. Kate Cronan, a pediatric emergency medicine physician at Nemours Alfred I. duPont Hospital for Children in Wilmington, Delaware, and medical editor for KidsHealth.org.
If you opt to tell your doctor you’re leaving (which isn’t required, should you not feel comfortable doing so), then you can also ask that medical records be transferred to the new doctor to get this process started at the time of your last visit.
“If they opt not to tell the doctor — say it’s not a good ending or they have other reasons, they can call … the doctor’s office — and ask to have the medical records transferred,” Cronan says. She notes that patients will have to sign paperwork to have the records (paper or electronic) released under the 1996 federal Health Insurance Portability and Accountability Act, or HIPAA. “But they’ll have the records transferred,” she assures.
Still, experts add, it’s important to shepherd the process as all medical records aren’t created equal. Besides hang-ups like the incompatibility of different electronic medical record systems, what’s entered into the record — the accuracy of that information from diagnoses to treatment to a patient’s medical history — will, of course, affect what the next health provider gets out of it. Also, records are often overwhelmingly voluminous. “I can get hundreds and hundreds of pages of documents and I can’t find any useful information,” says Dr. Lucy Hornstein, a family physician in private practice in Phoenixville, Pennsylvania, who has written on the topic of switching doctors. “I tell people, a patient who can reliably tell me their history is way more valuable than all these pages of electronic records.”
That’s not to say experts advise trying to go from memory — since clinicians point out that often patients forget or fail to relay pertinent information, from a medication they’re taking to a past procedure. “A single cogent summary put together by the previous doctor can be helpful,” Hornstein says, adding that it’s also important to share recent test results, like an EKG, and other labs, as well as immunization records.
Patients with a more complicated medical history should provide more extensive information that goes back further, as needed, experts advise; and make sure your record includes a detailed family health history.
[See: How Hospitals Are Using Technology to Become More Patient-Centered.]
Take your medications — to the new doctor.
“I actually prefer if my clients collect their medications in a bag and bring it with them,” says AnnMarie Quintaglie McIlwain, CEO of Patient Advocators in Summit, New Jersey. Having them all in one place can help give the new doctor a clearer picture of exactly what a patient is taking and the dosages, the patient advocate says. This can precipitate deeper discussion about medications the patient will continue on and perhaps some that can be dialed back or even eventually stopped. If you don’t opt to bring your medications in to see your new doctor, at the very least experts recommend having a comprehensive medication list that includes not just prescriptions, but any over-the-counter medication along with herbal remedies or supplements you take.
Make sure, too, that you have the prescriptions you need before you leave a doctor to see new one. “You need to be clear what medications you’re on,” Meigs says. If you’re moving, for example, “are you going to run out of medicine before you can get an appointment with your new physician?” That’s something you don’t want to figure out while in transition. “Make sure you’re clear about what medicine you’re on and why you’re taking it and will you need refills before you can get established with your new physician?” he adds.
Be prepared to avoid common hassles.
The last thing you want to do is decide on a new doctor — and then find out after an appointment that the physician is out of your insurance network, and you can’t afford to keep seeing him or her. So, unless you’re able and planning to pay in cash (say, for a concierge practice), check your insurance network in advance to make sure the doctor is in it; and doubly confirm this with the doctor’s office. Of course, coverage is always subject to change, but this will greatly reduce unpleasant coverage surprises.
Bring your insurance card to the new doctor’s office, Quintaglie McIlwain says, and of course, a form of ID (in case you sometimes travel really light). She recommends additionally taking with you a list of other doctors you’re seeing, and their contact information. Especially if you’re changing primary care doctors, this will help in coordinating care.
Think about the big picture.
Quintaglie McIlwain also suggests coming prepared with health goals. “I want my clients to think about ‘what it is I’m trying to get out of this. Why am I with this new doctor, and what am I hoping to accomplish today?'” she says. “Odds are you won’t achieve what it is that you really want to achieve, if you haven’t taken the time to think about it.”
The point is to put yourself in a position to make the most of what’s usually limited time with the doctor.
Focus on establishing a relationship with your new doctor.
On your way out? If you’re on solid terms with your soon-to-be-former doctor, there’s plenty of reason to involve the physician’s office in the transition process. But if you’re leaving because it just didn’t work out, or the doctor wasn’t a good fit for you, don’t waste time and energy trying to explain yourself — and certainly don’t stick around because you feel bad. “You should not refrain from changing physicians for fear of upsetting or making your old doctor angry” or anything like that, Hornstein says. What’s more, if a patient decides to leave a practice, the physician should be professional about it, experts say, and not make an issue over that or otherwise try to change the patient’s mind.
[See: When to Fire Your Doctor.]
The patient should, in turn, put his or her energy into developing ties with the new doctor. “Go ahead and make an appointment. Start establishing that relationship. Don’t wait until there’s a medical emergency or you’re ill,” Meigs encourages. “It always works better if you and the physician know each other.”
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How to Ease the Transition to a New Doctor originally appeared on usnews.com
