Conditions, Health and Wellness

Heart Attack? 10 Must-Ask Questions for Your Doctor

0 Comments 01 December 2010

The care you receive immediately after a heart attack has a huge impact on your overall health and longevity. Dede Bonner, aka “The Question Doctor,” shares the questions you should ask your prospective cardiologist or cardiac surgeon. From her book The 10 Best Questions for Recovering from a Heart Attack

1. Are you board-certified? What are your other medical credentials?

Board certification matters. Board certification assures you that the doctor has passed the board requirements for her specialty. In the United States, medical specialty certification is voluntary. Doctors receive their medical licenses after completing medical school and residency requirements. But this doesn’t apply to medical specialties like cardiology, and only sets the minimum competency requirements to treat patients.

The successful completion of the examinations for board certification demonstrates a doctor’s exceptional expertise and his or her dedication to a rigorous, voluntary commitment to lifelong learning. This is especially important with heart disease, because of the need to stay current with fast-moving research advances in this field. To maintain board certification, doctors must complete specialty training and periodic exams to demonstrate their ongoing competency. Use the search services of the American Board of Medical Specialties 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 for links to your state’s medical board.

Checking on past disciplinary actions and malpractice suits is tougher because most medical professionals don’t readily disclose unclean histories. See ChoiceTrust or HealthGrades, two comprehensive Web sites that charge a small fee for their services. Other sources for checking on prior complaints or disciplinary actions are free at Administrators in Medicine and Health Care Choices.

2. What is your experience with my type of heart disease? How many patients like me did you see during the past twelve months?

Experience matters, too — a lot. The number of years of total medical practice is significant, along with the years of specialized practice a doctor has in treating heart disease.

It’s very important to determine a doctor’s or a surgeon’s prior experience with heart disease, cardiac interventions, or surgeries. One way to determine a doctor’s specialized expertise is to ask, “How many surgeries do you do a month?” or “What percentage of your practice is devoted to treating heart patients?” The higher the number, the better it is for you.

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 question as a percentage of this doctor’s total practice.

A good bedside manner can be very comforting. But don’t choose a doctor based on personality alone. A doctor’s personality should be your secondary — not 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. Be sure to follow through and make the phone calls.

4. Which hospitals are you affiliated with?

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 heart disease center first and then find a top doctor there.

In the second scenario, you will be focused on the facility’s expertise or reputation over an individual doctor’s skills. Either way, ask this follow-up question: “What is the accreditation status of this hospital or medical facility?” Note that if you live in a rural area or choose not to travel for treatments, your choices may be more limited.

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 cardiologist. It’s a fairly reliable indicator that a doctor is considered by her peers to be a leader in this field.

Academic doctors who also practice medicine are likely to be the most well informed about the latest in heart-disease 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 heart disease?

Experts suggest that you look for doctors who have written about heart disease cases similar to yours 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 written for medical professionals and are very technical, you can learn a lot about this doctor’s interests and approach to treating heart disease. Go to PubMed Central for a free archive of medical journal abstracts.

7. What percentage of your patients who are heart attack survivors like me do you refer to a cardiac rehabilitation program?

Your doctor’s answer to this question will reveal two things: (1) You’ll know more about how committed this doctor is to supporting your long-term recovery through the lifestyle changes you’ll need for lifelong good heart health. (2) You want to hear from this doctor that she refers at least 50 percent of her patients to cardiac rehabilitation.

The national average for cardiac rehab referrals is about 50 percent, and you’ll be smart to be part of that statistic. Younger men get more referrals than older women, so be sure to add the phrase “like me” to your question.

8. How will you keep my family involved in care decisions? Do you offer support services and more information about heart disease?

The doctor’s answer to this question will indicate if she is patient centered and family centered. You want a doctor who considers you and your family as unique individuals.

Dr. Timothy J. Gardner, president of the American Heart Association, says, “The patient and his family need to understand that even in the throes of a medical crisis they can still expect the physician to be patient with them and give them the chance to examine all medical options.” George Washington University’s Dr. Christina M. Puchalski adds, “The mark of a good doctor is someone who can treat every patient as an individual and not make hasty conclusions from preconceived notions.”

If you have choices, go to a doctor who emphasizes cardiac rehabilitation and offers referrals to support services, such as specially trained cardiac nurses, physical therapists, nutritionists, and family counselors. The best doctors are also good teachers. As former acting U.S. 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 their 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 if your primary caregiver is directly and personally involved with your recovery after your heart attack.

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 really 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. Also 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 the author of The 10 Best Questions for Recovering from a Heart Attack (Copyright © 2009 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.

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