Finding the Best Medical Professionals Using the Internet in Six Steps

Image of Medical Professionals Research Spreadsheet

Introduction

This topic is close to my heart. There are those I love who really really need to get medical attention but have been frustrated by the ineptitude of some medical professionals. I’m writing this for you – yes, I really mean you! Pretty Please???

I’m also writing this to you, passing traveler on the information highway, because I want to see you find the medical care you need as well. I know you may be frustrated by multiple negative experiences, but I hope you’ll try using the method I outline below – I have been repeatedly satisfied with the results.

1. Finding Medical Professionals Covered By Your Health Insurance

The first step is to pull up your health insurance website and find the directory of providers covered by your insurance.[1] Here are links to those directories of providers on several of the largest health care insurer’s websites:

To get accurate results you’ll need to enter information about the health insurance plan you have (see your health insurance card) as well as the geographical locale in which you live. You should see a list of providers once you have provided the necessary information. Found it? Great!

2. Creating a List of Medical Professionals

Your next step is to create a list of medical professionals covering the sort of care you require. At this point I recommend creating the list without concern for who will be best or worst – instead, look at how close they are geographically to where you live.

I find that it’s best to add all of these individuals to a spreadsheet, and I’d recommend using Microsoft Excel,[3] Google Sheets, or AirTable. I’ve created a list provider spreadsheet template/example you can use.

Image of Medical Professionals Research Spreadsheet

In the first row you can place your column headings, which describes what will go in that part of the listing. I recommend starting with Provider Name, Distance (from your location), and Location (city).

Once all of the potential medical providers are listed in the spreadsheet, we are ready to move on to the next step…

3. Adding Health Professional Reviews to Your Spreadsheet

The next step is to go to a search engine (Google and Bing both work well) and to type in the title and then name of one of the providers followed by the city they are located in. This helps ensure that you get results for the correct practitioner – oftentimes multiple providers share the same name – even unusual ones!

In the image below you can see the results I received when entering “dr michael looney delmar” into Google. Notice how there are stars next to some of the results? These are the ratings the people on these review sites have given Dr. Looney–just like a product review on Amazon! You can visit the sites to see more details, but usually what we need is available right on the search results page. We are looking for the name of the review site, the rating the provider received, and the number of reviews the average is based on.

Image of Google Search Results

Now the spreadsheet you’ve created will need additional columns- two for each health review site we want to use. I have found the following to be among the most helpful review sites:

  • Healthgrades
  • Vitals 
  • Zocdoc – The nice thing about this one is that you can set up appointments through the web and there tend to be numerous reviews for doctors who participate in Zocdoc.
  • RateMDs
  • UCompareHealthCare
  • Wellness
  • PatientFusion – Good resource, but reviews seem to be largely limited to practitioners who use PatientFusion.
  • WebMD – They got into the game quite late, and while I expect them to continue to grow in quality, it’s hit or miss whether there are reviews of any given practitioner.

Here is a screenshot of the example spreadsheet I mentioned previously:

Image of Medical Professionals Research Spreadsheet

Note what I’ve done:

  1. I’ve shrunk the size of each column relating to the review sites as small as I can. This allows us to see all/most of the relevant rating info at once instead of needing to scroll right and left.
  2. I’ve shrunk the names to fit within the columns by using an abbreviation.
  3. I’ve created a column on the far left that explains the abbreviations I’ve used, for example, HG means HealthGrades.
  4. For each review listed on the Google Search results, I added the rating to the first column for that review site and then the number of reviews to the second column for the same review site.
  5. I also created another column that covers sites that I’ve found don’t usually have reviews of practitioners, but when they do can be a helpful source of information – in this case Facebook and Yelp.

I usually look at the first 2-3 pages of results to see what review sites/ratings show up. You’ll note that a number of the review sites columns are empty – this is because the review site/rating did not appear in the search results I’m seeing. That is perfectly okay!

You’ll then repeat this process for each provider on your list.

4. Picking the Best Medical Providers from Our Spreadsheet

Once we have our spreadsheet filled in we can begin to analyze the list of providers. Look for those with the highest scores across the most sites and from the most people. Soon you should have a few stand-out choices. If you don’t come up with any good choices, you can go back to the health insurance site and look at other providers further away. I know that isn’t what you want, and in most cases you shouldn’t need to, but it does happen sometimes – especially if you live in rural areas.

A couple tips on choosing the best providers:

  • I like to bold scores / number of reviews that are particularly high, this helps certain providers to stand out – especially if they have good reviews across several sites.
  • I like to italicize reviews that are particularly low, especially if they come from a high number of reviews. Again, the providers who have consistently poor scores across sites should begin to stick out as well.
  • While searching you may notice news articles or other helpful sites outside of review sites about a given provider, these can be of significant value.
  • Because you are looking at the consistently highest rated providers you may run into a few who have full schedules or for some other reason can’t see you, that’s okay, just move to the next person on your list.

5. Additional Things to Consider When Choosing Healthcare Providers

  • Don’t abandon the tried and true ways of finding a provider – talking to friends, family, co-workers, and neighbors! Their advice can be golden and you can then validate their recommendations by adding them to your list. You may find there is significant overlap between who people local to you recommend and who seems the best based on online reviews.
  • Don’t forget to talk to any medical providers you currently have that you do like. They are often more than willing to make referrals to other providers who can meet your needs. Once again, you can validate the recommendations by adding them to the spreadsheet and comparing them to the providers you have looked at on your own. Hopefully you’ll see significant overlap!
  • Remember that we humans tend to review services we feel strongly about – positively or negatively. Just because a doctor has some bad reviews doesn’t mean they are a bad provider overall. This is why I recommend looking across multiple review sites. In general, the more data you have, the more accurate the results (which providers are best) will be.
  • In my experience, some professions have generally lower scores than other professions. For example, you may find pediatricians who have 5 stars on multiple sites from multiple reviewers, whereas for psychiatrists or oncologists you might find that the highest scores are 4’s. There are various reasons for this, one being that some professions deal with more intractable problems than others.
  • Just because the reviews say so, doesn’t mean the medical provider is perfect or infallible. Use your own best discernment to determine whether the provider is a good fit for you.
  • Some really good practitioners are eccentric or abrasive. You have to decide if their particular type of eccentricity / abrasiveness is something you are comfortable with. For me, I don’t mind a practitioner who lacks social graces and is a bit abrupt at times, but this may not work for you – and that is okay.

6. Getting the Care You Need at the Appointment

Some medical professionals will walk you through the care process from beginning to end. Others will do so only if you specifically point out to them the issue you are having. Yet others will be effective in their particular niche but won’t provide any sort of overall support when multiple providers are involved. I think all of these types of providers can be good providers – but the way you approach them needs to be different. Don’t assume that the doctor knows what you need or want, tell them the information you believe is relevant (try to be as concise and specific as possible).

If the provider recommends a medication or treatment and there is another you’d prefer, tell them so, and ask them if that would be okay or if there are specific reasons they are recommending one course of treatment over another. Providers oftentimes have a “go to” treatment/medication that they have seen success with, but if you mention another treatment of equal quality, they’ll oftentimes be willing to start you off on that medication/treatment.

Don’t be afraid to leave a provider that you feel is not meeting your needs, or who is not willing to work with you to get those needs met in some practical way–even if other people have had a good experience with that provider. Sometimes things just don’t work out, and that’s okay–but it shouldn’t hold you back from receiving the care you deserve.

Your Thoughts?!

What are your thoughts on this article and process? How do you find quality medical care providers? Is there anything unclear in the article? I look forward to your feedback!

  1. [1]If you don’t know the website of your healthcare provider type it into a search engine like Google or DuckDuckGo and it should appear in the results.
  2. [2]Requires you to login to your online account. Come on UHC!
  3. [3]If you don’t have a copy of Excel available, you can use the free online version.

My Experience with Healthcare.gov

I’m a geek – so of course I wanted to test out the healthcare.gov site immediately after it launched – and failed. First I wasn’t able to connect to the site and eventually when I did connect to the site it would let me go through the profile process but once it attempted to verify my identity it would drop me into purgatory and leave me there – forever and ever and ever (literally, I could leave the site and come back days later and I’d still be stuck there).

Screenshot of Healthcare.gov upper front page.
Screenshot of Healthcare.gov upper front page.

I tried a couple times creating, deleting, recreating, on various days and over various months – no luck. Finally I decided to call the phone number and admit that I, an IT guy, couldn’t get the site to work for me. The phone was picked up fairly rapidly and I was led somewhat painfully through providing all the information I had already provided numerous times via the site. At the end I was given an application ID number which the representative informed me I should “enter on the site” and it would show my enrollment – but that sometimes it took up to 24 hours for the change to happen on the site.

I grimaced at the 24 hour statement. While I was on the phone I attempted to pull up the application and of course it didn’t work. I had a pretty good feeling that if it didn’t work then it wasn’t going to work in 24 hours – and I was correct. The next day it still couldn’t find my application ID and weeks and even a month or two later it still could not find the application ID.

People have been noting how few younger people have been signing up through healthcare.gov and I wonder – does the system, for whatever reason, have problems with younger individuals? I don’t mean that it is intentionally discriminatory, but that the data about older individuals is more readily available, organized differently, etc. For example, it may be that older individuals already are “known entities” to the system b/c they have utilized services like Medicare. Just a thought.

Today I tried again…I successfully walked through the process from start to finish. I still don’t like the site design (it is using funky and complex functionality to display the forms, which I found to be jerky in transitioning…) and the site still managed to leave me with a few “what do I do now?” moments…

But it is all done, I’ve signed up for the Keystone Health Plan East HMO Silver Proactive. Cost is less than $230/mo. (unless the premium changes, which I have heard happens…). This may be a decent jump for young folks in good health compared to pre-Obamacare, but for me it is a huge drop. Since I have pre-existing conditions Keystone would have charged me around $600-$700/mo. for health insurance…which was just impossible for me (and thus I have been without health insurance for over a year now).

Ohh, but the real reason I wanted to tell you about this is b/c something bad happens if you don’t have health insurance by the end of March…which I think most people know (I know a fine…and I think “open enrollment” closes which means you can’t get healthcare until the next “open enrollment” occurs – which might not be for a few months), but perhaps more important – if you want to have coverage as of April 1st you need to be enrolled in a plan by March 15th. If you are registered after March 15th, your insurance policy won’t “start” until May 1st!

Why the Healthcare.gov fiasco SHOULD teach us to Open Source Government Application Development.

We Spent How Much?!

According to The Daily Beast the United States Government has spent $118 million to build Healthcare.gov and another $56 million in fixing it…and based on the fact that the site isn’t expected to be fully patched for some time yet I wouldn’t be surprised if the total cost in “fixing” exceeds that of building the system in the first place.

Image courtesy of OpenClipart.org and Iwan Gabovitch
Image courtesy of OpenClipart.org and Iwan Gabovitch

I’m not going to take a position on the Affordable Care Act (ACA) – I try to avoid speaking publicly on controversial issues…but I would like to suggest a lesson we can learn from the ACA that I don’t think will be (very) controversial across party lines – that the Government should utilize open source in the development of applications as a standard rule.

Now, I’m not particularly interested in arguing that every government project should be open source – I’ll be happy if 95-99% of them are. I understand that some people rightly or wrongly believe that using open source in sensitive areas could cause security risks. I’ll let Kevin Clough and perhaps Richard Stallman[1] argue that point.[2] But for the vast majority of projects (Healthcare.gov for example) I can see no reason why the development should not be open source and believe there would be significant advantages to such a course of action.

Lets take a look at the specific ways in which open source development could have reduced or eliminated the issues involved in the Healthcare.gov launch:

Transparency

The government (not just one department, but its entirety – e.g. the white house and congress) and the public could much more readily have seen that issues were arising, deadlines were slipping, etc.  and made necessary adjustments.

It is a constant problem within organizations that individuals at higher levels make decisions without the proper knowledge base upon which to make such decisions. This can result in unrealistic timelines and even if the timelines are realistic, if unexpected issues arise and there is slippage, there is a temptation to “gloss over” the setbacks and “hope” that the timeline can still be met.

This oftentimes results in extreme pressure on those actually working on the application as they are pressured to produce more, quicker – which, especially in the case of programming – is unwise. The more you pressure programmers the more likely they are to make mistakes, to take shortcuts and the more hours you demand of them the less productive they will become and, again, the number of bugs will grow exponentially.

Bug Fixes

Open Source software is oftentimes very stable and secure because of the number of eyes looking over the code. Further, individuals who are amateurs can make small contributions that allow the programmers to development on system architecture and bigger issues instead of stomping out bugs and making aesthetic improvements.

It would make sense for the Government to take a similar approach to Microsoft, Google, and Yahoo! on this front – each offers cash rewards for the discovery of issues. This is a relatively inexpensive way to get folks to pour in their energies – and individuals receive (for them) a significant compensation (hundreds to thousands of dollars – depending on the issue discovered).

Load Testing

The failure to properly load test the Healthcare.gov site is shocking. An open source project still needs robust methods of load testing performed by the core team – but it also benefits from other individuals and organizations implementing the application and discovering bottlenecks.

An open source, distributed team, also could have easily simulated the significant load that the site experienced upon launch – exposing the load issues early enough for remediation.

Code Reuse

When a project is open source the code can be reused by others for all sorts of purposes. The code to this project would certainly have applications in other government projects as well as the private sector. Reuse of code can significantly streamline development timeframes and even if someone in an entirely uses a portion of code for an entirely different project in a different industry – they will oftentimes contribute their version of the function (with enhancements/bug fixes) back to the original project (resulting in better, more flexible, secure, and robust code).

Cost

I really am just spitballing here – but I have a hard time believing that the development of an open source system to perform the Healthcare.gov functions would have cost anywhere near the costs expended thus far upon this closed source system. I’d guess that $10 million could have completed the project in a more robust and timely manner via open source.

Lesson Learned?

Please, let us take a lesson from this fiasco. We want more affordable healthcare – we can start by not wasting millions developing an application as a closed system which lacks robustness and stability.

I know some areas of the Government are already working with open source (and that is great) – but this needs to be a greater emphasis. Perhaps (I don’t know) there should even be some legislation that makes the (required) standard for new applications be open source and any applications which are desired as closed source systems should require review by a panel to determine if there is actual, substantial reasons for developing in a closed source system.

[Apparently I’m not the only one to think OSS could have made a huge difference. See this article by Christina Farr over at VentureBeat. Not directly related, but still interesting is Dylan Tweney’s article “Healthcare.gov costs show that feds have literally no idea how to build a big web site” also on VentureBeat. Another article comes from NBC News staff writer Gil Aegerter and can be found here.]

[11/4: Good article from Matt Asay entitled, “Sorry, Open Source Isn’t the Panacea for Healthcare.gov” on ReadWrite.]

  1. [1]Though Stallman would argue for free software rather than open source, but I leave that semantics argument, however important it may be, aside for the time being to focus on an area in which a relatively minor change in procedure (moving to open source development) could make a significant change in cost and efficiency.
  2. [2]There are some excellent arguments on how and why open source technology can be more secure than closed source technology. Specifically, the additional security in closed source systems usually isn’t b/c the systems are actually more secure but a function of “security by obscurity” – in other words, security holes exist, no one knows about them (including those who wrote the software). But I digress…