By Dick Broom
“First, my providers have to be clinically
competent and know what they’re talking
about,” she says. “Second, they need
to have both the ability and the desire
to communicate with the patient on the
patient’s level. And, third, they have to be
accessible when you need them.”
That’s not only what Williams wants,
it’s what she says every patient deserves.
Williams isn’t your typical health care
consumer. She has more than 20 years of
experience in health care, first in nursing
and now in administration. As administrative
director of practice management for
FirstHealth of the Carolinas, she oversees
the operation of several of the FirstHealth
Family Care Centers.
“I want my primary care
providers to have the knowledge,
experience and expertise
to take care of just about
all my needs and, at the same
time, to know when to refer
me to a specialist,” Williams
says. “They need to be on
the cutting edge, and they
need to have confidence in
That all sounds good, but
how do you know if a particular
doctor practices top-notch medicine?
Williams suggests doing an Internet
search to find out, at the very least,
what degrees and certifications the physician
has. If a doctor is board certified
in his or her specialty, that indicates a
high level of knowledge. The Web site
of the North Carolina Medical Board (www.ncmedboard.org), which licenses
physicians to practice in the state, has
information about their qualifications
and whether they are in good standing
with the Medical Board.
Asking relatives, friends and neighbors
which primary care providers they recommend
is perhaps the best way to find one
who is a good match for you and your
Robert Townsend, D.O.
“Word of mouth is a great resource,”
says Robert Townsend, D.O., a family
practice physician with the FirstHealth
Family Care Center in Raeford. “Talking
with friends who have had success with someone is a good way of finding out how competent that doctor is.”
But you won’t really know whether a doctor is right for you until you take the medical equivalent of a test drive.
“Schedule an appointment and talk
with the doctor about your health
status and medical concerns,” Dr.
Townsend says. “You will be able to
tell a lot from the way they address
your complaints. You can usually tell
if they know what they’re talking about.”
If you have any doubt, don’t hesitate
to ask about the physician’s
experience in dealing with
whatever your particular
health problem might be.
While physicians have
different styles, nearly all
of them are well educated,
well trained and competent,
so most people
recommend their physician to friends and neighbors based on other considerations.
Touber Vang, M.D.
“For most people, it’s more of a personality
issue than a medical issue,” says
Touber Vang, M.D., the family practice
physician at Mid Carolina Family
Medicine in Troy. “People gravitate
toward people they like. My residency
director used to say that you can teach
somebody medicine, but you can’t teach
good personality or bedside manner. It’s
something you either have or you don’t.”
It is essential that you choose a primary
care physician with whom you feel
comfortable, says Bill Edwards, CEO of
Pinehurst Medical Clinic, which includes a number of internal medicine physicians who provide primary care.
“Someone might be the smartest
physician in the world, but if you don’t
feel comfortable with him or her from a
personality standpoint, then it’s probably a good idea to choose another primary care
physician,” he says.
Having a good rapport with the physician’s nurse and other staff members is also important, he says.
Patients tend to be happiest with primary
care physicians who take the time to listen
to them, answer their questions and explain things to them in language they can understand.
“I always encourage patients to
let me know if I haven’t explained
something clearly enough for
them to go out and explain it to
somebody else,” Dr. Vang says.
|J.K. Daniel, M.D., of FirstHealth Family
Care Center-Richmond Family Medicine
encourages patients to prepare and periodically
update their personal health
profile because, he says, “Your health
changes as you age.”
J.K. Daniel, M.D., a family
practice physician with
FirstHealth Family Care Center-
Richmond Family Medicine in
Rockingham, agrees that communication
is essential for a good doctor-patient relationship. But, he says, the communication has to be two-way.
“I tell my patients it’s a ‘we’ process, and
they need to do their part,” he says.
That means being open with the doctor
about all of your problems and concerns,
learning as much as you can about your medical conditions, asking questions and giving the doctor feedback.
“If you don’t feel I’m giving you the time
or attention you need, please tell me,” Dr.
Daniel says. “If you have a problem with
check-in, or you have to wait a long time
to see me, or if anything else impedes your
experience in my office, I want to know about it.”
Williams says it is unacceptable for a
patient to leave a doctor’s office feeling uncertain or confused.
“The last words out of the doctor’s mouth
before the patient leaves should be, ‘Have I
answered all your questions?’”
she says. “That’s a really big push for us in our clinics.”
According to Dr.
between doctors and patients
builds trust, which is necessary
for a good relationship
and, ultimately, for good
medical care. The more he
knows about a patient, he says, the better he is able to meet their needs.
“Everything that a patient comes to me
for has an emotional and spiritual as well as a
physical component,” Dr. Townsend says. “If
I’m not addressing all of those aspects of the
disease, then I’m not doing a good job of taking care of the whole problem.”
Available and accessible
In overseeing the Family Care Centers,
Williams tries to make sure that FirstHealth’s primary care providers are available to see patients whenever they are needed. She insists that they be accessible.
“That means a doctor will break up
his day to see a patient who really needs
to be seen,” she says. “It means that if
you go to the office in a panic, you don’t
get that look that says, ‘We don’t take
walk-ins.’ It means that when you call
the office, you can talk to a nurse who
works directly with the physician and can
get your question or concern addressed.
You’re not diverted to someone who
can’t help you.”
That doesn’t mean patients never have
to wait when they come for an appointment. In fact, good doctors often have so many patients that waiting is inevitable.
“Doctors who are really thorough and
spend a lot of time with their patients
may cause other patients to have to wait
longer,” Dr. Vang says. “If you’re a person
who doesn’t like to wait, then you
might want to go to someone who can get you in and out faster.”
Williams says she doesn’t mind waiting,
as long as the office staff lets her know the reason for the wait and how long it will be.
“I recognize that there are emergencies
and other circumstances that are beyond
the physician’s control, and physicians
sometimes run late because they spend
as much time as needed with patients,”
she says. “That’s all right, because I know
that when I get in there, I’m going to be
given the same courtesy and my needs are going to be met.”
Some physicians practice on their own,
while others are part of a group practice.
Edwards says patients should find out
who will see them if their primary care
physician isn’t available, who will take
care of them if they have to go to the
hospital, and what procedures are in place for getting in touch with their physician in case of an emergency.
Often, if patients can’t get in to see
their doctor when they have an urgent
problem or if they can’t get their questions
answered over the phone, they
blame the doctor’s staff. But the responsibility ultimately lies with the doctor, Williams says.
“Accessibility has to come from the
provider,” she says. “If any of our providers
tries to build a wall around himself, I
readily pick up on that and immediately take steps to break it down.”
One way patients can
help their doctors help
them is by creating a
personal health profile.
Physicians say it should
include your past medical
and surgical history, family history, current
medical conditions and any medications
you are taking.
“When somebody comes in with a
complete history, it helps me evaluate
whatever is going on with them at the
time,” says Robert Townsend, D.O., of the
FirstHealth Family Care Center in Raeford.
Dr. Townsend recommends keeping
your health profile with you because you
never know when it might be needed.
“If you go to an Emergency Department
for acute care, having a record like that
with you, especially a list of the medications
you are taking, can be invaluable to
someone deciding on a treatment plan for
you,” he says.
According to J.K. Daniel, M.D., of
FirstHealth Family Care Center-Richmond
Family Medicine, a health profile should
include the patient’s “social history”
including whether he or she smokes or
drinks and, if so, how much. Dr. Daniel
says it also should include the patient’s
occupational history: “Do you work where
there are certain hazards, such as in the
military or in a mill where you inhale a lot
A health profile can include healthrelated
goals, such as giving up smoking or
losing weight, and it should be periodically
updated, he says.
“Your health changes as you age,” he
says, “and you can have different problems
and concerns at 45 or 65 than you
did at 25.”
| Health care
Gone are the days when nearly everyone
thought of their doctor as all wise and all
knowing in matters of health. Gone, too,
are patients who are passive, unquestioning
recipients of care.
Nowadays, most doctors want their
patients to be well-informed partners in
The Internet has made it much easier for
people to learn about their medical conditions
and treatment options. Hospitals,
medical schools and government agencies
provide a wealth of health information
online. The Web sites of non-profit organizations such as the American Heart Association
and American Cancer Society have factual, easy-to-understand information about specific
Many people are now using these online resources before going to their doctor, according
to Robert Townsend, D.O., with the FirstHealth Family Care Center in Raeford.
“Oh, yeah,” Dr. Townsend says with a chuckle. “While it’s good for patients to educate
themselves, you’ve got to be careful. I mean, there’s a reason why it takes a minimum of
seven years for somebody to get through medical school and residency training. Patients
often get a little bit of information but don’t understand how to put it into the overall
picture of their health care.”
According to Dr. Townsend, both WebMD and Familypractice.org, the Web site of the
American Academy of Family Physicians, are good sources of reliable consumer information.
J.K. Daniel, M.D., of FirstHealth Family Care Center-Richmond Family Medicine in
Rockingham, also recommends WebMD.
“I encourage my patients to look up information on a Web site, print it out and bring
it in,” Dr. Daniel says. “I’m happy to go over it with them. Doctors have a thousand things
going on, so if something new came out just yesterday, I might not be aware of it. So bring
it to my attention, and I’ll research it myself and tell you whether it applies to your situation.”
Saul Salvador, M.D., a hospitalist physician at FirstHealth Moore Regional Hospital, recommends
the Mayo Clinic’s Web site for “good explanations and illustrations of how various
procedures are done.” FirstHealth’s Web site, www.firsthealth.org, also offers a userfriendly
“e-Health Library” link.
The more informed patients are, the better off they are, Dr. Salvador says. “For one
thing, they can give a more confident ‘yes’ or ‘no’ to a certain procedure or other treatment
option,” he says.
Prescription drug advertising on television and in magazines—a relatively recent phenomenon—
has raised people’s awareness of certain medical problems, educated them
about potential treatments and made them more assertive in their relationship with their
doctor. All of that is mostly good, physicians say, but ads can give people false hope.
“I sometimes have to explain to patients why a particular medication they have seen
advertised isn’t the best choice for them,” says Touber Vang, M.D., of Mid Carolina Family
Medicine in Troy. “It might not be appropriate for them medically, or it might cost a lot
more than another drug that would work just as well, or their insurance might not cover it.
“But as long as a drug meets the criteria for what the patient needs and there aren’t
any contra-indications for it, and if cost isn’t an issue for them, then I have no problem