Caveat emptor

There may be some truth to the old saw that patients should avoid doctors whose own office plants have died. But how should one choose well among health care providers?

We like simple formulae. An Internet search discloses that Dr. X has four stars next to his name on a list of local specialists and Dr. Y has only three. We probably will feel more comfortable with Dr. X, even though Dr. Y, perhaps a bit more brusque in his personal style, has a great reputation in the medical community and specializes in treating the ailment we are seeking a doctor for.

Don’t believe everything you read. What if Dr. Y hasn’t compared well with Dr. X in some hastily prepared magazine’s ranking system only because Y handles the most difficult cases in his expertise?

It’s not that we lack for health care ranking systems. There are at least 15 highly detailed ones, including compilers such as medical groups, magazines, government agencies and Consumer Reports. Heck, even Angie’s List offers a section for doctors, dentists and other practitioners. Angie also lists hospitals and insurance options.

Don’t doubt for a moment the importance of quality. When it comes to health care, quality and safety remain the paramount considerations for consumers. As a consequence, quality measurement is becoming steadily more sophisticated.

It follows, of course, that providers are not unwilling to publicize to consumers’ results that put them in a favorable light. Who wouldn’t? Attention to measurement has become key for health care institutions, especially those with aggressive competitors struggling with them for market share.

What’s little known to the consumer is how these lists are compiled. One wouldn’t want to rank an award that’s applied for in the mail equally against one that has to be measured and verified by a professional organization with an excellent reputation.

Though the average consumer may not want to become an expert in the habits and foibles of health care, a lively interest in taking responsibility is highly recommended. Until something better comes along, we’ll have to settle for a small dose of common sense as the most useful medicine for making health care choices.

The basis of commercial common law is the Latin phrase caveat emptor, let the buyer beware. Absent a warranty, services are provided on an as-is basis.

Here are five of my personal recommendations, based on my own experiences and unvetted by professional advice. If you are personally unable to follow these recommendations, I advise choosing a single proxy who will advocate for you:

• Cooperate. You are a member of the health care team attending to your health. Respect your fellow members.

• Ask lots of questions. You are entitled to explanations along every link of the healthcare chain. Be an intelligent consumer. Communication is vital.

• Look around. You can tell a lot about your provider’s attention to quality by the way you are treated. Your providers should be rigorously following systematic protocols, should be alert to your condition, and should be attentive to your needs.

• Anticipate teamwork. The best institutions are proud of what they do. They have developed an atmosphere of teamwork that includes everyone from the specialist on his daily rounds to the person who changes the bedsheets.

• Expect empowerment. Quality is a process as well as a result. The best institutions have created an atmosphere where everyone on the care team is constantly learning, expanding their opportunities, and sharing the successes they have achieved.

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