Healthcare providers--how do you choose?

Annegriet

I had an interesting conversation with a friend about choosing healthcare providers. I used to not care whether a doctor was a man or woman. I care more now. As I get older, I sometimes feel that older women understand my issues a little better. Do you guys think about the sex of your doctor? What about therapists? It's a female dominated profession. I am wondering in the case of therapy, if hearing the perspective of the opposite sex might be better? Just a little musing this morning.

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Uptown Gal

Not sure it has an answer. The best Dr., I ever had was a female...but the worst was too. In my work I move around a lot for times, and have had

to have Drs., in different places quite often. In my last place before my

present I had a woman and was really, really pleased for most of the reasons

you stated. When I moved here I chose another woman. She is worthless..

if you ask her a question, she repeats the question and her mind kind of

wanders off and never really answers.

Having a hard time changing during the Pandemic, so have to keep her for

awhile, I guess. Her rating is very low...but so far the Hospital (a large outfit)

hasn't done anything about her. Hoping I won't have any serious medical

problems until I can do something positive about it.


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eld6161

I do feel more comfortable with women doctors and have been lucky to find good ones.

That said I don’t go out of my way to always make sure my providers are women. My dentist is not, my MRI tech isn’t and my neurosurgeon was picked because of his ratings.

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LoneJack Zn 6a, KC

I had the same male primary care doctor from my teens until he retired about 15 years ago and then I moved over to his son who is a few years younger than I am after that. My DW went to high school with the son.

The only female doctor I've ever gone to is my current Rheumatologist. She's a very good doctor and cute to boot :-)

eld6161 - I think all neursurgeons are a little 'different' in the head than normal folk. At least the 4 that me and DW have had over the years were. Must have something to do with poking around in peoples brains.

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tvq1

Both the worst and the best doctors I've had have been women. The worst: I'd ask her a question, and 75% of the time her answer was "I don't know". Not "I don't know, but I'll find out", just "I don't know". Finally, I decided I was better off Googling my questions, and I changed to my current PCP, who is actually a Nurse Practitioner. She is great!

I don't choose on the basis of gender, but rather by recommendations from friends and family. For specialists, I rely on my PCP to guide me.

One thing I think is important to remember: While a lovely personality is nice, you're not looking for a new best friend. Willingness to listen, experience and knowledge are more important.

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foodonastump

Butt or balls I‘m more comfortable with male for some reason, but aside from that I really don’t care. I look at a combination of professional profile, board certification preferred, and patient reviews.


ETA - And age. I prefer neither young nor old.

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stacey_mb

I have a female doctor and while not perfect (was slow in investigating my hypothyroidism), I like her very much. I continue to see her even though her office location keeps moving farther away. I like her unhurried approach and her willingness to listen and respond. She also is mostly on time with her appointments, which I value. Edited to add: At this point, I feel more comfortable with a female doctor. My dentist is a male, however, and I chose him because of a recommendation and his wonderful rating.

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jrb451

At this point in my life I want a doctor that's younger than I am and will still be practicing when I need their services the most. I was with my first pcp for 35 years before he retired. I had to start over with another one. It's taken a few years to get to where I feel like he knows me and my heath needs.

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Fun2BHere

Gender isn't a factor in my choice of doctors except for my OB-Gyn because women typically have smaller hands, thus a tad less invasive IYKWIM.


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ccrunneroklahoma

I do seek out female doctors who also have excellent recommendations from my friends or seem to be very qualified in their fields. Over the past decade my gynecologist, dermatologist, endocrinologist, and dentist have all been women. When my male internist retired a year ago I decided on a female physician in the same practice who specialized in geriatric medicine and women’s health. She is much younger than me so hopefully I won’t need to find another one for a very long time.

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bleusblue2

My doctor of twentyfive years was a woman. When I looked for a new doctor I didn't consider anything but the recommendation of patients. So I've found a good doctor who is a male. I like him but I will admit though that I'd prefer a good woman doctor.

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Bookwoman

I would start with the best teaching hospitals around, then look at where the doctor did her/his training (especially residency), and also ask friends in the medical profession for their recommendations. My doctors, other than our children's pediatrician, have all been male, but I wouldn't care one way or another. Expertise, responsiveness, and someone with whom I can have some rapport are more important to me than gender.

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Elmer J Fudd

I've found personal referrals to be of limited value because often the referee isn't able to assess factors that may be important to me. Affiliations may matter (and background does too, to an extent) but it does come down to the individual and the patient's comfort and confidence in dealing with them. The best doctors seem to like to teach part-time, and all seem to have great personalities and sincere caring feelings for their patients. Those are important factors for me.

We had a primary care doc for about 10 years and he retired about 10 years ago. I thought - the old wise practitioner, working in a small office with partners of about the same age, couldn't be bested.

WRONG! We'd been using specialists from our local excellent medical school faculty for many years (all of whom without exception have been outstanding) so we decided to sign up for primary care with them too. My 68 year old male doc was replaced by a 30 year old female who can run rings around him. She's more current, more organized, more comprehensive, an out of the box thinker - in short, really awesome. I had more of a personal relationship with the older guy but heck, a doctor is a care provider, not a friend. I've got a much better care provider and should have left the kindly but limited older doc sooner than when I had to. Gender doesn't matter a stitch to me, I'm looking for the best care available, not for a romantic relationship.

There's some irony that some who have a heightened sensitivity to unequal gender treatment and biases would prefer a physician solely because of the doc's gender. Do as I say not as I do?

Bookwoman, note that a "teaching hospital" and a "medical school faculty practice" are not the same thing. There are plenty of community hospital here, there and everywhere that are "teaching hospitals" because they may have a limited number of residents in a limited number of practice areas and the program directors may be nothing better than local hacks. All hospitals of any size (except the very smallest) take residents because they're cheap labor - salaries are mostly covered by the federal government through Medicare nationwide. There are many sub-par "teaching hospitals" so care is indicated.

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nicole___

My dentist was on vacation, so I saw this other guy. He wanted to replace ALL my fillings. Said amalgams were dangerous, leaking mercury. Scammer! I called him out, his assist left the room...ran...really. My current dentist is female. She's excellent!

Yes, I think about the sex of my Doctor. The worst Dr. I ever had was a male gyn. I saw him because two people recommended him. I prefer a woman nurse practitioner for a gyn, now. My ophthalmologist is a man. Both are very good!

My husband "had" an EXCELLENT nurse practitioner, she's out on leave. The next one sucks.

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Bookwoman

Yes Elmer, you're quite right; I was too broad in what I wrote. Around here we have an abundance of medical schools and excellent hospitals affiliated with them, but I realize that's not the case for everyone.

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eld6161

You really have to be your own advocate. And educate yourself on what is out there.

That said, of course it is the doctor’s call.

I know that if you want to be operated on, you can always find a doctor to do it.

My SIL insisted on getting another hip operation because someone told her if you have one done than you should get the other one. The original doctor wouldn’t do it. Finally found one that agreed and put it through as quality of life as she claimed to be in pain.



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Elmer J Fudd

"My back doctor does want to operate but I just want oxy so I’m not happy with him"


Is this a serious comment?


If you're having back problems, why not see another doctor? If I understand your comment, I hope it's not true that you make regular use of opioids. That's a bad choice.

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maifleur03

I too am in the my almost best and worst doctors have been women. I have retired, out lived, or moved away most of my doctors. Two years ago I was assigned from the practice a doctor who while probably not stupid lacked two rocks in his head to beat together. I finally ditched him after he had me sent some medication that if I had just taken it as suggested when I called the office would have made me quite ill. First thing I did was go to my insurance company site and use their list of doctors to find one in this area but not in that practice. Made an appointment knowing that if there was an immediate problem such as dismissal or something odd about the new office I would leave and try again.


Personal recommendations especially for health depend on what an individual wants and expects. Each person has different criteria. A suggestion for couples who wish to see the same doctor pay attention to how the doctor treats each of you. Some doctors sadly will treat women as if any problem is either depression or some other negligent problem.

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maifleur03

If you only want Oxy you are a drug addict even if you will not admit it to yourself.

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foodonastump

I didn’t expect nor do I appreciate the ignorant judgment. Posts deleted.

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amylou321

Hmmmm. I do not have a primary care doctor. I go to urgent care if I need care. My dermatologist was a referral from the urgent care doctor. And I was satisfied with his service, so he remained my dermatologist since. My gynecologist was assigned to me when I called the same practice my sister used and asked if they were accepting new patients. This was when I was 18 and knew I needed one for standard lady care. He was a brand new doc out of med school and I was one of his very first patients. I like him very much. He is friendly yet professional, thorough but not pushy and I feel comfortable with him. A lot of women I know would never EVER consider a man for a gynecologist, thinking that somehow a woman would be a better choice given they have the same parts. I also know women who do not now the very basic makeup of their own body or how to practice proper care or hygiene ( i knew a woman who bathed in bleach. BLEACH!!! Because she thought it was good for her, um, "ladyhood") soooo......

The doctor I saw for weight loss was a man. I also liked him very much. He was recommended to me by a truck driver who lost a bunch of weight and when questioned, gave up his secret....

My eye doctor is a man and I have been with him since I was 13 with no issue. My dentist is a man now because he bought out my former dentists practice when she retired. Also no issue with him or her before him.

I guess I do not really choose specialists, I go where I am referred. Or that has been my method so far. If I am satisfied, I stay, if not, I ask for a different referral from the original doc.

Come to think of it, I do not think I have ever received care from a woman doctor, only nurse practitioners, which I was happy with. But I remember at least 3 different medical students in with my doctors, all women. One, whose first name was Cherry, was in with my dermatologist to observe a mole removal. One was with my gynecologist, and one was with the surgeon I was referred to to get a boobotomy (biopsy). So maybe in the future I will end up in their care.

Gender is not a factor in whether or not I am happy with a doctor.

My grandmother refused to see women doctors. Absolutely refused. If the only specialist she needed in her area was a woman, she would drive hours to see a man. I do not know why. I could not think of a single reason that would be acceptable to me, so I never asked.

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Ded tired

Some docs, I prefer a woman. My urologist is male and honestly it would be easier to talk to a doctor who has a similar anatomy and knows what I mean when I describe some symptoms. My dermatology, pcp, and gynecologist are all women.


As for age, I agree there is a sweet spot — old enough to have experience but young enough to outlast me.

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Kathsgrdn

The first doctor I had when moving here was a total jerk and it was obvious he hated women. I quit going to him. Years later he was in the papers for narcotic offenses related to his office. He always talked to my husband at the time much differently than me.

I really like my current doctor, another man, but one that actually listens to me. There are a couple NP or PA that work in his office that I see when I'm sick and he isn't available. They're women and I like them okay. There is one man, who I really don't like, though. He's a jerk, was a jerk to my daughter during one of her visits too.

I look to see if they're going to brush off your concerns or explain your options or why you shouldn't be worried about something. I think I just lucked out on my doctor. He was new to the clinic I was already going to, didn't really have a doctor and happened to get in to see him one day.

I had a good gyn but she moved to Florida...um a long time ago. I haven't replaced her and was going to find somewhere to go when the pandemic hit.

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bleusblue2

Elmer J Fudd

EXCERPT

"There's some irony that some who have a heightened sensitivity to unequal gender treatment and biases would prefer a physician solely because of the doc's gender. Do as I say not as I do?"

~~~~

Elmer -- that's an unfair comment about any woman or man who prefers a doctor of their own gender. I felt more comfortable with my doctor who was a woman -- she was an excellent doctor. My new doctor seems to be just fine but it is a fact that there is a drop in comfort level when it comes to certain areas. That's how I feel about it. That has nothing to do his expertise or anything else. I loved the very matter of fact and knowledgeable the woman doctor could address intimate symptoms. There was no distance between us.

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foodonastump

“I had a good gyn but she moved to Florida...um a long time ago. I haven't replaced her and was going to find somewhere to go when the pandemic hit.”


Kaths - My wife took a long pause and it didn’t end up so well. Please put on a mask and go.

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katlan

I have had male doctors all my life. Our first pediatrician for our kids was male. He was an ass! He talked down to me when our kids were sick and I asked questions. He actually said to me one time "are you questioning me?!" in his most condescending, incredulous voice. Yeah, kicked him to the curb.

I prefer a female dr. at this point in my life. I have had 4 different drs. at the practice I go to, the first 3 left eventually for bigger practices, understandable.

My dentist is male, he took over when our previous male dentist retired. Eye dr. is/was husband and wife team who are transitioning to part-time moving toward retirement. They have a young woman working there now who is very good.

For general health, physicals and more female related care, I want a female dr. A Good female dr.

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Elmer J Fudd

bleusblue, I've no doubt your feelings are sincere but I'm surprised you don't recognize that your expressed views seem a bit contradictory. That was my earlier comment. If you believe in complete equality of genders, as I do, the gender of a physician shouldn't matter. Not that the gender is any indication of competence, of course it isn't. If you had a problem of concern and needed to see a gynecologist and you had the choice of just two - either a highly regarded male or a so-so female, which would you choose? I hope it would be the male given the circumstances.

Coincidently, I had an important but non-urgent doctor appointment this past week week that I'd waited a month for. A busy specialist I'd been recommended to. A woman with an impressive record and reputation.

Without getting too specific or graphic, the exam after our initial conversation (that included discussion of intimate matters) required me to strip from the waist down and pull up my shirt. She said something like "I hope it's okay with you, I'm going to have to touch and move around your private parts". I said "Please do whatever you need to do, you're a doctor". She said "Thank you, some men can be sensitive". I replied "I'm not".

It hardly matters to me that we have different equipment down under. I saw her for the quality of her training, of her professional practice and learning from that, and from her ability to draw on all of that and judgement to treat me. That we have different personal experiences or sensations because of gender differences matters not a wit. Assess medical doctors by their skill, their caring attitude and their manner, not by their gender.

PS - the outcome is that all is well and the problem seems to not be what it might have been. I'm fine, relieved, and very grateful to have access to such a great physician.

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chisue

I hadn't throught too much about the fact that my hospitals are 'teaching hospitals' until I had a serious bleed following a colon resection. (A 5 - 10% occurence.) I had to be re-hospitalized for days. They'd have to operate again if the bleed recurred and my hemoglobin didn't come up. A very young woman doctor stopped by my room twice as often as any other MD. She seemed overly solicitous. Guess who was 'learning' during my surgery?

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foodonastump

Elmer - You bring up an interesting point but I don’t think it’s as cut and dried as you make it. I think it’s important for an individual to feel comfortable with their doctor, and I don’t think a woman should be shamed into pretending to feel comfortable with a man, or vice versa. This is not making a judgment on the quality of care but the emotional comfort of the patient. And we know that the psychological affects the physical. But having said that, it of course opens up the door to other preferences which we might not be as comfortable discussing. What if a white woman feels more comfortable with a white gyn. Is that excusable?

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Elmer J Fudd

"What if a white woman feels more comfortable with a white gyn. Is that excusable?"

People should feel however they want to feel but someone who recognizes that they have such a bias would be a hypocrite, in my opinion, to tout themselves as being colorblind and a supporter of complete equality of people in all respects. When their conduct is influenced by choices involving the race, gender, or ethnic origin of other people.

My incident discussed above was with a specialist. My primary care physician also happens to be a woman and a woman of color. She's awesome. When she first became my doctor and I had my first physical exam with her, she was more cautious (bordering on slightly solicitous) before performing the manual prostrate exam than I was to receive it. If you're a male, you know what that involves - it's very personal and not pleasant. But important to do.

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bleusblue2

Elmer J Fudd

bleusblue, I've no doubt your feelings are sincere but I'm surprised you don't recognize that your expressed views seem a bit contradictory. That was my earlier comment. If you believe in complete equality of genders, as I do, the gender of a physician shouldn't matter. Not that the gender is any indication of competence, of course it isn't. If you had a problem of concern and needed to see a gynecologist and you had the choice of just two - either a highly regarded male or a so-so female, which would you choose? I hope it would be the male given the circumstances.

~~~~

Not contradictory. No man or woman is prevented from becoming a doctor because I feel comfortable with a female doctor. I am not campaigning to keep genders separate. My current doctor is male. I have stripped down and had my private parts examined by this male doctor. He's a doctor. Fine. Why do you bring as a comparison, the choice between a "so-so female" and a good male doctor. I am not talking about competence. I wrote this:

"So I've found a good doctor who is a male. I like him but I will admit though that I'd prefer a good woman doctor."

FOA makes a good point that we should feel comfortable with our doctor and then wonders diverts to wondering if this might equate with a white woman preferring a white obgyn!

And back to your comment -- "If you believe in complete equality of genders" -- who in the world said that I do not! Why nitpick on such an obvious non issue?

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Elmer J Fudd

If you would choose a doctor known to be less competent strictly because that doctor was a woman, then to me you are not gender-blind. How could you suggest it to be otherwise?

My original comment was that for someone to express support and concern for gender equality and then not practice it with personal choices was hypocritical. Make whatever choices you want, it doesn't matter to me. Be honest with yourself how what choices you make suggest to others what your own personal attitudes may be.

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bleusblue2

Elmer J Fudd

If you would choose a doctor known to be less competent strictly because that doctor was a woman, then to me you are not gender-blind. How could you suggest it to be otherwise?

My original comment was that for someone to express support and concern for gender equality and then not practice it with personal choices was hypocritical. Make whatever choices you want, it doesn't matter to me. Be honest with yourself how what choices you make suggest to others what your own personal attitudes may be.

~~~~~~

"If you would choose a doctor known to be less competent strictly because that doctor was a woman,"

"So I've found a good doctor who is a male. I like him but I will admit though that I'd prefer a good woman doctor."

Good grief. Are you just dropping in here or are you READING what was written.



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foodonastump

(Deleted since the portion referencing me was edited out.)

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Olychick

There is no way a man can fully understand any woman's preference for a woman doctor, particularly a gynecologist, and should stop trying to pretend that they can/do. And women shouldn't feel like they need to justify it or explain it to any man.

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foodonastump

There’s no way a woman can understand how well a man is capable of understanding women. 😂

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heritagehd07

The most important factors to me are feeling comfortable with the doctor, they are being honest with me and providing clear information.

If I'm not comfortable with a doctor I am less likely to seek care.

Generally I find most MD's in my area to be mediocre to average. This may be a factor of how hospital physicians are managed.

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HamiltonGardener

I love my current doctor. She is perfect in every way.

Unfortunately, she has decided to retire this year and will be bringing in a new doctor as her replacement.

I must admit that I am worried about not having that “understanding” if she brings in a male doctor or younger female doctor. It’s nice to have someone who has been through similar experiences. Does a 30 year old really understand your hot flashes from personal experience? Does a male doctor understand that description you are trying to give him?

I had a biopsy done by a male obgyn who was less than delicate...then when I told him it was painful, he told me it “wasn’t that bad”... like I was being a baby. My female doctor was much more sympathetic.


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chisue

The majority of students in medical school in 2019 were women -- by half a percentage point.

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maifleur03

Having had many doctors both male and female I refuse to be treated as a slab of cold meat just because the doctor is of the approved for my sex doctor. Not all doctors are equal and if you are looking only at what is between the legs and expect to be treated as a functioning human being you are looking at the wrong area in selecting a doctor. The same goes for young vs old. If you take a parent or spouse to the doctor and the patient is ignored that doctor is wrong for that patient and if it is your doctor they are wrong for you.

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floral_uk z.8/9 SW UK

The situation here is very different. We have one general practitioner with whom we are registered but we can ask to see any GP at their shared practice. Nobody has personal specialists. If one is required your GP will refer you. You don’t refer yourself. I get an impression of over medicalisation from all these specialists on tap.


In fact it’s so long since I went to a doctor I don’t even remember who I’m registered with. But if I need attention I’ll call the practice and get it. Routine checks are carried out by practice nurses. The doctors deal with people who are actually ill.

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Elmer J Fudd

floral, are you an NHS patient?


We have several sets of friends in the UK, indigenous sods they are ;-). What they've told me is that the NHS is great so long as one is well and not needing other than basic health care. Cost containment is partially achieved by long queues for appointments and procedures, services by sub-physician staff and required referrals for specialists. Both couples have private insurance and avoid the NHS as much as possible.


I don't doubt that many in the US are overtreated but the alternative doesn't need to be being undertreated. Take yourself to a physician and have a wellness visit if that's permitted. An ounce of prevention is worth a pound of cure.


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jmm1837

Because I've moved around a lot, I've had plenty of experience with male and female doctors and dentists. I want medical practitioners who are science based, willing to listen, and good at explaining. I don't find those qualities to be gender-based.

When we moved here, a good friend highly recommended a (male) dentist. As it happened, I broke a tooth shortly after arrival and begged him to see me. on an emergency basis. He did a wonderful job in saving the tooth and replacing the crown. He's been my dentist ever since, and hands down the best one I've ever had. The two dentists I had before him were both female, and good, but this one is better.

There's a good sized medical practice near my house, with 10 or 11 GPs, half of them women. They also have "registrars, " junior doctors doing a 6 month rotation in the practice as they work towards their full GP licence. I saw (male) registrars the first few times, then opted for an appointment with a female doctor (she specialised in women's and child health). All things being equal (by which I mean, just as bleusbleu did, if two doctors are equally qualified) I do prefer a woman GP: my personal experience has been that they are a little more sensitive when it comes to gynaecological issues. And yes, she's excellent.

My orthopaedic surgeon is male, the plastic surgeon who handled my carpal tunnel is female, and my gastroenterologist is male. I also saw a neurosurgeon for back problems twice: male. He ran more tests than I've had in my entire life, and concluded that neither surgery nor prescription medication was necessary. Since then I've been in the clutches of a gaggle of physics and (until Covid) was doing regular hydrotherapy with the physios (word is, we get back to hydro next week). He was absolutely right: the odd twinge aside, my back is pretty good these days.

I was referred to all of these specialists (not the physios) by my GP: I thought that was standard practice everywhere.

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lily316

I have never in my life had a female doctor. My daughter only will have a female. It just worked out that way for me and I picked younger men thinking they'd outlive me and my first two didn't. I had one for 20 years and had a good relationship with him. He got cancer but recovered and moved 100 miles away. My second was a family friend who I was very fond of and I had for ten years. He's still here but left the practice and started his own boutique practice which is $2500 a year out of pocket. No insurance. So for the last ten years, I've had a younger guy who's not my favorite person in what world. It is what it is.

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Elmer J Fudd

jmm, my experience with health insurance is as a patient and consumer, not as an insurance industry person. The majority of Americans have health insurance (though many do not) and for most, it's paid for in whole or in part by an employer. The "in whole" was more common when costs were lower, cost sharing with the covered employee is more common now. A brief description of the two basic kinds of insurance plans:

-An HMO (health maintenance organization) plan. These are usually the less expensive plans to purchase. They typically require having a primary care doc, require that the primary care doc provide a referral to consult with a specialist, and typically have a fixed list of doctors that must be used. Other docs, including those one may have used before starting with this kind of coverage or a specific company, may be outside of the "plan" and thus services may not be covered.

Individuals having these kinds of plans can experience similar problems as may be encountered with other systems where go-slow and limit care practices can serve to contain costs. As with, for example, the NHS in the UK or governmental programs in other countries. There can be incentives for GPs to NOT provide specialist referrals. There can be long waits for appointments and procedures.

-A PPO, a Preferred Provider Organization. Having a primary care doc may not be required, the patient is free to go to specialists when they wish to (or with consultation but without needing a referral with their primary care doc), and most (but not all) docs are covered either as preferred providers (a higher percentage of the cost is covered) or as out of network providers still covered but perhaps with a higher cost share to be paid by the patient.

PS, you said that you prefer having a female GP to deal with gynecological issues. I believe most women in the US who have PPO coverage would have among their doctor team one trained in and limiting their practice to gynecology. A frequent tandem training path for med school graduates leads to a tandem practice called obstetrics/gynecology. Some who have done this training path practice both medical areas, some just do one and not the other.


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jmm1837

Elvis - I'm not sure why there would be an incentive for a GP not to refer a patient to a specialist. That has certainly not been my experience, either in Canada or Australia. Admittedly, the GP is not going to waste the time of a specialist when it isn't necessary, but I've never encountered an issue with getting a referral for something significant. And I don't need a specialist gynaecologist for routine tests and smears: that again is a waste of the specialist's time when my GP should be capable of doing the necessary.

As for go-slows, there are backlogs in Canada, Australia and the UK for elective procedures. That is not true for acute conditions. That's one of the reasons all these countries have outcomes at least as good as the US does, at lower costs. They prioritise resources by need, not ability to pay.

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chisue

@mdln -- Your scenario would be more likely if the young woman gal wasn't so *anxious*. It was personal.

Thanks for the 'better outcome' article. I suspect the average female brain 'takes in' more from a situation than the closely focused, 'check list' male brain.


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maifleur03

jmm unless Elvis has changed names I did not see the comment you are referring to but I have a problem with the electrical impulses in my heart found when I had a stress test. I did have a heart cath. Showed no blockage only a second pulmonary vein leading to my heart and for some reason the person who did the cath was concerned because he did not find the normal amount of fat in the veins leading to my heart. That was all. I have my suspicions as to why the problem was dropped.

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jmm1837

Sorry, I meant Elmer, not Elvis (I had just booked my husband an appointment with his ophthalmologist, whose name actually is Elvis ;)

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Elmer J Fudd

maifleur, I think Elvis was used instead of Elmer. I get mistaken for a younger Elvis all the time, I must resemble his very handsome looks.


Call me anything you want, just don't call me late to dinner.

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Elmer J Fudd

"I'm not sure why there would be an incentive for a GP not to refer a patient to a specialist."

The US system is different from what you've experienced in Canada and Australia so you can trust me, it's too often the case. In brief, medical groups that participate with HMOs receive capitation payments, $X per patient covered by a primary care doc. When a patient needs to see a specialist, the group is out of pocket for the cost. Thus encouraging the PCP to do as much as possible themselves (including things afield from their core competences that they shouldn't be doing). Oftentimes, PCPs who refer too much to specialists can be subject to internal criticism.

An experience - about 25 years ago, when my employer was in the process of adapting to changes in the medical insurance world, we spent 2 years unwillingly in an HMO. During this period, my wife had a sports injury to her knee. She went to the PCP (the required first stop) who ordered an xray (a ridiculous step for a knee where many injuriies aren't visible in xrays) that determined nothing was broken (!). He ordered physical therapy. Two weeks passed, my wife's knee gets more painful. She calls the PCP and asks for a referral to an orthopedic surgeon. "Finish your PT and lets see how it is" was the reply. We dropped that and went directly to an independent orthopedic practice known to work on all of the college and pro athletes in our area. We saw one of the knee guys, who in 10 seconds of physical examination, said "you have a torn ACL, you knee is moving in ways it shouldn't". She had what at the time was expensive surgery and recovered to be as good as new.

I submitted the bills to the insurance company and asked they be paid. They replied that because the care was given outside of the HMO system and without a referral, nothing would be covered. I sent a letter on a lawyer friend's letterhead (I wrote it, he signed it) giving them two choices - either reimburse the costs in full, or be sued for the full costs plus personal injury damages resulting from their malpractice and the misdiagnosis of the PCP. Funny thing, I head back from them in less than a week with a request that I resubmit all the bills and that they would be paid in full. We afterwards changed the PCP assigned to us and at the end of the year exited the HMO as fast as we could.

A relative had a similar experience with a local HMO that's unique, Kaiser Permanente. It's a combo insurance company and captive full spectrum medical practice that's been in existence a long time, since the 1940s. His car was rear-ended at a pretty high speed in an auto accident. His Kaiser PCP examined him, said he had no need to see a surgeon, and prescribed physical therapy. Several weeks went by, the pain got worse. I suggested he go externally to a back/neck doctor. Upon exam and testing, he was found to have cracked bones in his upper neck requiring surgery to fuse them. He had the work done and submitted the bills to Kaiser. They refused to pay, I suggested the approach I'd used as per above, and they ultimately paid the costs.

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Elmer J Fudd

"As for go-slows, there are backlogs in Canada, Australia and the UK for elective procedures."

For just elective procedures? Here's a story from Australia:

I have a relative who lives in Australia, in a populated area. My relative has a friend who had two kids with medical problems that needed surgery. One was diagnosed as having a torn rotator cuff from a fall. Because the arm wasn't being held tightly in the socket, this poor kid was suffering sometimes weekly dislocations, that were very painful. In the Australian Medicare system, her surgery was scheduled for 5 months out.

The other kid was continually sick with chronic ear/sinus/throat infections and besides being miserable from so much illness, was missing a lot of school. It was decided the kid should have a tonsillectomy. That was scheduled for 3 months out.

I don't consider these to be "elective procedures". Do you?

Growing tired of the continual illness and discomfort of their kids, this family pulled together the money to have these two different procedures done in the private parallel system in Australia. Yes, I know, it's often the same doctors, but the access is quicker. Both were done within 2 weeks. Fortunately, medical costs are much lower there than here and while it was a lot of money, they could afford to pay for it from savings.

My relative has told me that broadly speaking, access to basic medical care is good and PCPs are available. BUT, when anything more is needed, it can be difficult or a wait or often the specialists are not always as capable as would be found in the US. Coincidently, this person needs a drug that isn't on the current Australian national formulary and their doctor has had to submit a petition for a waiver to have it approved. That's pending at the moment.

Yes, my relative has private insurance and doesn't generally need to deal with the Medicare system.

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Lindsey_CA

I don't remember ever going to the doctor as a child, except to get routine vaccinations. As an adult, I've always had PPO insurance.

Having said that... I don't care if any of my doctors are male or female, as long as they are qualified and competent. The only "must" is that they must be board certified in their field of practice.

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