You’ve been seeing your primary care provider and researching remedies for your symptoms online, but you can’t seem to pinpoint exactly what’s causing the issue or how to treat it. Maybe you’re getting more fatigued with exercise than usual, or your knee just isn’t getting better despite home exercises.
At some point, it’s time to call in a specialist. But where do you start?
Between figuring out which specialist to see, who takes your insurance, which online reviews to trust and whether or not you need a referral, there are a lot of factors to consider.
Read on to learn what specialist to look for and how to choose the best one.
Identify Your Specialist Needs
When a lingering health issue persists, the next step is finding the right specialist, which is a health care expert who focuses on a particular part of the body or health condition.
Choosing the right medical specialist can feel overwhelming, especially when multiple experts seem to overlap in what they treat.
“A good rule of thumb is to start with your primary care provider — they’re your medical ‘quarterback,’ trained to look at the whole picture and help you decide which specialist best fits your needs,” says Dr. Annie DePasquale, an Arlington, Virginia-based board-certified family medicine physician and founder and CEO of Collaborating Docs.
In addition, your primary care provider, or PCP, will be able to provide some treatment or relief in the interim. A PCP, for instance, can take a high-resolution photo of that suspicious mole and send it to your dermatologist or prescribe you Zoloft while you’re waiting for a psychiatry appointment.
Understand the role of a medical specialist
Seeing a specialist does not replace the role of your PCP, as they work alongside specialists to help coordinate your care and make sure all the bases are covered.
| Role | Scope | When to see them | Benefits |
| Primary care provider | General health, preventive care, initial diagnosis, coordination and management of chronic conditions | Routine checkups, annual visits, mild to moderate new symptoms, preventive screenings | Keeps the big picture of your health in mind, provides referrals, coordinates your overall care, has all your conditions in mind |
| Specialist | Focused expertise in a specific organ system or condition | Chronic or complex symptoms, advanced diagnostics, procedures, second opinions | Deep knowledge in one focus area, advanced testing and interventions, targeted treatment plans, works alongside PCP |
[READ: Health Questions to Ask Your Doctor]
Match health concerns to specialty types
Here is a quick guide to understanding common medical specialties and their respective treatment areas:
| Specialist | Specialist Focus Area | Potential Concerns |
| Cardiologist | Heart and blood vessels | Chest pain, blood pressure, irregular heartbeat, shortness of breath, fatigue |
| Dermatologist | Hair, skin and nails | Acne, rashes, suspicious moles, hair or nail concerns |
| Endocrinologist | Hormones and glands | Weight changes, diabetes, thyroid concerns, menopause, fatigue |
| OB-GYN | Female reproductive system, pregnancy and hormones | Irregular periods, fertility concerns, pregnancy concerns, menopause |
| Pulmonologist | Lungs and breathing | Cough, asthma, shortness of breath, sleep apnea, snoring |
| Otolaryngologist (ENT) | Ears, nose and throat | Sinus infections, hearing loss, sore throats, vertigo, tonsil concerns, snoring |
| Urologist | Urinary tract and male reproductive system | Urinary concerns, prostate issues, kidney stones |
| Psychiatrist | Mental health and well-being | Depression, anxiety, insomnia |
| Pain management specialist | Pain | Chronic pain, post-surgical pain, mobility concerns |
| Gastroenterologist | Digestive system | Bloating, heartburn, stomachaches, constipation |
| Neurologist | Brain, nerves and spinal cord | Headaches, migraines, dizziness, stroke, numbness, memory and cognition concerns |
| Orthopedist | Bones, joints, muscles, tendons | Injuries, joint pain, arthritis, fractures |
| Rheumatologist | Autoimmune and inflammatory conditions | Chronic pain, arthritis, fatigue, autoimmune disorder concerns |
| Ophthalmologist | Eyes | Eye pain, glaucoma, blurry vision |
| Infectious disease specialist | Infections | Persistent infection, long COVID, travel-related illness |
[READ: How to Best Prepare for a Doctor’s Appointment]
When (and why) you might need a specialist
Although a PCP is a valuable resource for when new problems or symptoms arise, make sure you know the signs of when it’s time to move beyond primary care.
— Persistent or worsening symptoms. If your PCP gave you home care advice, a treatment or a new prescription and your concerns have not resolved, it’s time to discuss specialist care.
— Complex or chronic conditions. Sometimes chronic conditions require more oversight and depth than what a PCP has the ability and schedule to offer.
— Advanced diagnostics or a second opinion. A specialist has the training and technology to provide advanced diagnostics or procedures and has the expertise to offer a second opinion.
[READ: 8 Ways to Get Care When There Are No Primary Care Doctors]
Resources and Strategies for Finding Medical Specialists
You have a few tools and resources at your disposal to find the right medical specialist.
Use referrals, insurance networks and trusted databases
Once you know which specialty you need, the next step is to research.
Before you get too deep into research, check with your insurance. Find out if you need a formal referral order from your PCP. If you do, schedule an appointment with your PCP to request one. After that, check with your insurance to find which specialists are in-network. From there, you can make a list and start comparing to find the best specialist doctor for you.
When evaluating which specialist is the best fit, Annie Rabasca, a nurse program coordinator for the inflammatory bowel disease program at Phoenix Children’s Hospital, recommends that patients or parents start looking at the following:
— Review the provider’s website. Check for provider experience and highlighted patient experiences.
— Review the provider’s education, board certifications and subspecialties. Board certification is a formal recognition of training in a specific area in medicine by an established medical group. It goes beyond medical school and residency. For example, a board-certified cardiologist has met national standards in heart care and is regularly evaluated in competence. A subspecialty is another area of further focus within a specialty. For example, a gastroenterologist may have a subspecialty in inflammatory bowel disease.
— Contact the office staff. Inquire about appointment availability and which provider is best suited for your situation.
— Consult your primary care provider. They are familiar with your history and can recommend trusted specialists, often with established communication channels.
DePasquale also recommends you look at hospital or society affiliations and whether the specialist is fellowship-trained on your specific concern. A fellowship is advanced training that a provider completes after residency.
Assess location, accessibility and practice options
Try to keep location and accessibility at top of mind.
“I try to find a specialist close to the patient’s home to make access easier and increase the likelihood of appointment follow-through,” Rabasca says.
For patients with chronic illnesses, particularly those transitioning to adult care, finding a facility that centralizes services is vital. As Rabasca notes, connecting one of her patients with a local hospital that offered all needed services under one roof was essential to ensure coordinated care and simplified access to medical records.
Evaluate and Compare Potential Specialists
Once you have found potential specialists who are in-network and credentialed, evaluate whether they have any red flags and consider subjective criteria.
Look for red flags
Use this checklist to check for specialist doctor red flags:
— Check professional history. To do this, search your state’s medical board license lookup tool. For example, if you type “Texas medical board license lookup,” it will take you to the official license lookup tool for the Texas Medical Board. There, you can type in provider information and check any concerns or pending disciplinary actions against a provider.
— Check credentials. Use the American Board of Medical Specialties and Certification Matters to verify your specialist’s board certification.
— Check online reviews. Specifically, whether patients felt like the specialist was dismissive of their concerns. That is a red flag.
Patient experience and communication style
When gauging the bedside manner of a specialist, it’s important that you feel you have a level of comfort and trust, says Jean Arndt Audas, a nurse navigator at University of Iowa Health Care in Iowa City.
“You may need to be interacting with this doctor for an extended period of time, and it is important that the you trust that the doctor is acting in your best interest,” she explains.
Audas adds that you should feel like you had ample time for your questions and that everything was explained in a way you could understand. You should always leave a specialist appointment with a next step defined.
“A lack of a plan moving forward will result in anxiety and loss of trust and could be a sign this isn’t the right specialist,” she says.
Make Your Choice and Prepare for the First Appointment
Once you have chosen a specialist and made your appointment, it’s time to prepare for your doctor specialist appointment.
Confirm insurance and cost factors
First, double-check your insurance coverage. Verify the specialist is in-network and that you understand all your out-of-pocket costs. Call the member services line on your insurance card if you are unsure. If you suspect you might need a procedure, such as a mole removal with a dermatologist, ask your insurance if they have any information on that service code and the expected cost for you.
Prepare for your consultation
There are a few quick items you can do prior to your specialist doctor consultation that will make your appointment go as smoothly as possible.
— Compile your medical records. Remind your PCP to fax or send medical records to the specialist. “If you are seen or treated by other specialists, make sure the medical records from those visits have been made available to the specialist before the visit,” Audas says.
— Bring a complete medication list. You can also ask your PCP to print off your medication list for you. Don’t forget to add any vitamins or supplements you are taking.
— Write a list of questions for the specialist doctor. “It’s often difficult to remember what concerns you had leading up to the appointment,” Audas says. Make sure the questions include a timeline for the next steps after the appointment.
— Have a summary of your symptoms and concerns. If you are seeing a neurologist for headaches, have a headache journal available with details on your symptoms, the date, time and what you have tried in the past.
Find the Best Specialist Doctor Near You With U.S. News & World Report
Find the best specialist for you by using the tools you have available. Start by enlisting the help of your primary care provider, who can help you look for the right specialist for your concerns and guide you to a specialist they trust. Ensure your specialist has the right training and certifications and that their license is in good standing. Prepare for your specialist appointment by sending your medical records to the specialist and prepping your list of questions. You will know the specialist is right for you if you feel a sense of safety and trust and you understand the next steps you need to take for your health.
“It may take a few visits to know if a doctor is a good fit for you and your health journey,” Rabasca says.
Check out the U.S. News & World Report specialists index to find the best specialist doctors near you.
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How to Find a Specialist and What to Look for originally appeared on usnews.com
