Even if you prefer to stay with a family doctor for ongoing Alzheimer’s care, you owe it to yourself to seek at least a second opinion from an Alzheimer’s specialist. These 10 questions from Dede Bonner, Ph.D., aka “The Question Doctor,” will help you with that important task. From The 10 Best Questions for Living with Alzheimer’s

1. Are you board certified? What are your other medical credentials?
Board certification matters.

Board certification assures you that the doctor has passed the requirements of certification for her specialty. In the United States, medical specialty certification is voluntary. Doctors receive their medical licenses after completing medical school. But to be a specialist like a neurologist, the doctor does additional training called a residency. After completing the residency training, a doctor can apply for certification by a specialty board.

Successful completion of the examinations to complete board certification demonstrates a doctor’s exceptional expertise and her dedication to a rigorous, voluntary commitment to lifelong learning. This is especially important with Alzheimer’s disease because doctors need to stay current with the fast- moving research advances in this field. To maintain board certification, doctors must complete yearly training and take periodic exams to demonstrate their ongoing competency. Use the search services of the American Board of Medical Specialties (http://www.abms.org) to check for a specific doctor’s certification.

A valid state license is also very important. Go to the American Medical Association’s Web site (http://www.ama-assn.org/) and click on your state for specific information about a doctor you are considering. Links to state boards are available at http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure/state-medical-boards.shtml.

Checking on past disciplinary actions and malpractice suits is tougher because most medical professionals don’t readily disclose unclean histories. See ChoiceTrust (https://www.choicetrust.com) or HealthGrades (http://www.healthgrades.com), two comprehensive Web sites that charge a small fee for their searchable services. Other sources for checking on prior complaints or disciplinary actions are free at Administrators in Medicine (http://docboard.org) and Health Care Choices (http://www.healthcarechoices.org).

2. What is your experience with Alzheimer’s patients? How many Alzheimer’s patients did you see during the past twelve months?
Experience matters, too. The number of years of total medical practice is significant, along with the years of specialized practice a doctor has in treating Alzheimer’s disease.

It’s very important to determine a doctor’s prior experience with Alzheimer’s. One way to determine a doctor’s specialized expertise is to ask this follow-up question: “What percentage of your practice is devoted to treating Alzheimer’s patients?” The higher the better. You also want to ask, “How many total times have you treated Alzheimer’s disease?” (Alzheimer’s disease was rarely diagnosed correctly before the mid-1980s.)

If you live in a rural community or have limited access to specialized care centers, doctors will naturally have lower yearly numbers. In this case, ask this Best Question as a percentage of this doctor’s total practice, like, “What percentage of your patients are Alzheimer’s cases?” in addition to getting a total number.

A good bedside manner can be very comforting. But don’t choose a doctor based on his personality alone. A doctor’s personality should be your secondary — not the primary — consideration in making your choice.

3. May I speak to at least one of your patients to see how he or she made out in these same circumstances?
This Best Question was suggested by former Surgeon General Dr. C. Everett Koop. He believes it’s very important to follow through on patient referrals.

Asking for a referral is more common than you might think. Chapter 2 [of The 10 Best Questions for Living with Alzheimer’s] gives you specific Best Questions for getting highly reliable referrals.

4. Which hospitals are you affiliated with?
Although early stage Alzheimer’s patients rarely need hospitalization (except for treating other medical conditions), this answer could be very important later.

You have two choices. You can choose your doctor first and then go with the hospital where she has admitting privileges. Or you can choose the hospital or Alzheimer’s facility first and then find a top doctor there.

In the second scenario you are focused on the facility’s expertise or reputation first over an individual doctor’s skills. Either way, ask this follow-up question; “What is the accreditation status of this medical facility?” See The Joint Commission’s Web site (www.jointcommission.org/) for more on accreditation.

5. Are you affiliated with any medical schools?
A teaching affiliation with a prestigious medical school is the gold standard when looking for a top specialist. It’s a fairly reliable indicator that a doctor is considered by her peers to be a leader in the Alzheimer’s field.

Academic doctors who also practice medicine are likely to be the most well informed about the latest in Alzheimer’s research, diagnostic tools, and treatments and they will keep current through frequent contacts with their medical colleagues.

6. Are you involved with any ongoing research projects or clinical trials on Alzheimer’s disease?
Experts suggest that you look for doctors who have written about AD and whose work is often cited in medical journals.

If a doctor you are considering has been published, ask for copies of those articles. Even if the articles are full of jargon or boring, you can learn a lot about this doctor’s interests and approach to treating Alzheimer’s. Go to PubMed Central (http://www.pubmedcentral.nih.gov) for a free archive of medical journal abstracts.

7. Are you part of a team that holds regular meetings to discuss patients’ cases and treatments?
Doctors often emphasize how important a multidisciplinary team behind the scenes is for ensuring quality patient care, accurate diagnoses, and effective treatment plans. More heads are better than one in making accurate and well-informed diagnoses and providing better patient care.

Doctors practicing in teaching hospitals or large Alzheimer’s centers are more likely to be part of a team. Not having this team approach isn’t necessarily a deal breaker, but it’s good if you can get it.

8. How will you keep my family involved in care decisions? Do you offer support services and more information about Alzheimer’s disease?
The doctor’s answer to this question will give you a great insight into how patient centered and family centered she really is. You want a doctor who considers you and your family as unique individuals.

If you have choices, go to a doctor who offers support services, such as specially trained geriatric nurses, physical therapists, nutritionists, and family counselors. At later stages you’ll have these other needs for which a family-centered specialist can be a godsend.

The best doctors are also good teachers at heart. As retired acting Surgeon General Rear Admiral Dr. Kenneth P. Moritsugu comments, “When the doctor seeks to educate the patient, they are not merely engaging in a two-way conversation. Rather, the doctor is taking it beyond the conversation in order to teach the patient about medical options and how to take control of his or her own health and well-being.”

9. Please describe your preferences for communicating with your patients.
Communication obstacles rank high on patients’ list of complaints. Most people highly value how well a doctor communicates with both the patient and his family, especially since Alzheimer’s primary caregivers are so directly and personally involved with the patient’s well-being.

10. Who covers for you when you aren’t available or are on vacation?
This is another question that most patients don’t think to ask until they can’t reach their doctor when they need to.

Be sure that your doctor tells you how she will communicate with you if unanticipated problems come up or when she’s unavailable or on vacation. A follow-up question is to ask how (calls or e-mails) and when (best times of day) she can be reached.

ABOUT THE AUTHOR
Dede Bonner, Ph.D., aka “The Question Doctor” and author of The 10 Best Questions for Living with Alzheimer’s (Copyright © 2008 by 10 Best Questions LLC), specializes in creative breakthrough and money-saving Best Questions for corporate clients and CEOs. She is on the graduate business faculty of Curtin University in Perth, Western Australia, and is an internationally acclaimed expert in questioning skills and management. A former political analyst for the federal government, Dr. Bonner is the owner of New Century Management, Inc, and 10 Best Questions, LLC. She has a doctorate of education in executive leadership.

MORE ARTICLES BY THE AUTHOR

• 10 Questions to Ask if Your Spouse Has Been Diagnosed with Alzheimer’s Disease
• How Do I Find Help for My Parent With Alzheimer’s Disease?: The 10 Most Important Questions to Ask
• How to Spot a Bad Nursing Home: The 10 Questions You Should Ask
• When Should Dad Go to a Nursing Home?
• How to Talk About Your Fibromyalgia Diagnosis With Those You Love

LEARN MORE

• Read the Introduction to The 10 Best Questions for Living with Alzheimer’s
• See the book’s Table of Contents
• Browse more books by Dede Bonner, Ph.D., “The Question Doctor”