A few years ago, my husband, Richard, changed his primary care doctor; not because he had a problem with the doctor, but because he felt the front office consistently treated him and other patients poorly.

Some measures of quality care are relatively simple for people to judge for themselves.  You know whether your blood pressure or high cholesterol or diabetes is being controlled or not.  If they’re not, you can find out why and do something about it.  But whether your doctor is a good match for you depends on more than just technical competence.  Factors such as the doctor’s age, gender, communication style, and area of expertise can all help determine whether your doctor meets your particular health needs and personality.

Generalist or Specialist.  Everybody needs a doctor who performs routine health exams and can treat common, everyday problems like the flu and muscle sprains.  Such primary-care doctors—typically a family-practice physician or general internist—should also coordinate and oversee any care you get from specialists for complicated problems, such as cancer or heart disease.

However, some people may want to get their primary care from a physician with special expertise.  For example, older people may want a geriatrician for age-related problems, or women going through a difficult menopause or considering becoming pregnant may opt to use an obstetrician/gynecologist as their primary caregiver.  Someone with diabetes may consider an endocrinologist, or an individual with rheumatoid arthritis may prefer a rheumatologist.  Before you select a specialized physician for your primary care, however, make certain that she or he will perform the more general tasks required of a primary-care doctor.

Young or Old.  Here’s a surprise for you.  A study published last year in the Annals of Internal Medicine indicated that, overall, the more experience a physician has, the worse her or his care becomes.  The study reviewed 59 previous reports on the relationship between physician experience and patient outcomes.  Seventy percent of those studies found that the longer the physician had been practicing, the greater the decline in one or more areas of quality.

So, in general, if your priority is someone familiar with the current evidenced-based standards of care and information, you may want to opt for a younger doctor (this is my preference).

Male or Female. Some research suggests that women prefer female doctors, particularly for screening tests for breast, cervical and colon cancer.  Other research hints that female physicians may do a better job than male ones in providing basic preventive services to both women and men. My personal feeling is that gender doesn’t matter; it’s the attitude and competency of the individual doctor that counts.

Even the perfect doctor isn’t much help if you can’t reach her or him when you need to.  And patients report many roadblocks, ranging from long waits for appointments to not enough time in the office once you get there.  If you think you need urgent—but not emergency—attention, express that clearly to the receptionist.  If you still can’t be seen as soon as you’d like, ask to speak to the doctor directly.  Only a health professional, not the receptionist, can determine how serious your problem really is.  If you still can’t get in, rather than rushing to the emergency room, see if there are any “walk-in” clinics that take your insurance….then I would complain to the doctor and let him know you did not appreciate what happened and ask how it can be avoided the next time…you may or may not get an answer, but at least you have registered you were not happy.

If you’re having consistent difficulty seeing your doctor when you need to, look for a practice that offers “open-access” scheduling, in which a doctor typically leaves part of each day’s schedule un-booked so some same-day appointments can be offered.

If your doctor visits are often rushed, without enough time for in-depth discussion, make the most of the time you do have by preparing a written list of concerns in advance, ranked by importance.  If your doctor interrupts (which happens within 23 seconds, on average, studies show), ask for a chance to finish your concerns or return to the topic later.

If you’re not satisfied with the time your doctor spends with you, look for one who does not discourage e-mail or fax communication, which are efficient, easy ways to address non-emergency matters. I use the fax at times…it actually saves my doctor time and he can answer when he has time.

If your doctor discourages you from reviewing your medical record, like the printed test results from a lab, insist—it’s your legal right.  Checking your medical record allows you to correct mistakes and gives you a sense of your progress in managing your health. Labs have been known to make mistakes. Use a medical dictionary or the computer to help decipher the test results, or ask your doctor to explain terms or abbreviations you don’t understand. Having your records on file at home is also a quick way to bring a new doctor up to date, if you should ever change.

In my opinion, It’s best to have a doctor who is affiliated with a good hospital…it means someone else has approved of her/him.

How does your doctor compare?  According to a survey of 123,000 adults by the U.S. Agency for Healthcare Research and Quality, 41 percent said they almost never saw their health care provider within 15 minutes of a scheduled appointment, and less than half always got an appointment for regular care as soon as they wanted.  59 percent said they always got the help or advice they needed from medical staff when they called during regular office hours (that leaves 13 percent who never or only sometimes got it and 27 percent who said they usually got it.

But Susan Edgman-Levitan, P.A., of Massachusetts General Hospital, who helped develop the survey said, “When it comes to health care, ‘usually’ isn’t good enough.  Not getting seen when you need to be, or not understanding what your doctor says, can lead to serious problems, even if it happens only once—and especially if it happens repeatedly.”