I often get asked advice from non-physician friends about what doctor I'd recommend they choose as a primary care physician or specialist. This is a common theme at backyard picnics, receptions, fundraisers, and chance encounters at the grocery store.

It goes something like this, " Hi Jan, gosh I haven't seen you since a couple of years ago when our kids graduated from high school. Wasn't that a great ceremony? Wow, those peaches look good! Hey, I've been meaning to ask you...see, my insurance has changed and I have to pick a new primary care doctor and so I'm wondering who you'd recommend?"

I figure the "Golden Rule" is a good place to start with most things in life and I always end-up recommending docs I'd be willing to see myself, as if I were the one needing care. So I'm going to shed some light on just how it is that I (and most other doctors) choose other doctors.

But to start, what do we value? I don't think doctors are different from anyone else, we want doctors we can talk to and whose judgment we trust. A recent survey from the American Board of Medical Specialties reports that Americans rate communication skills and bedside manner as the most important aspect of choosing a doctor. Second in importance comes board certification – but it turns out that for the most part, John and Jane Q. Public don’t know what that means, and often confuse it with a license to practice medicine.

So here's the big difference; a license to practice medicine doesn't require board certification. I'm not kidding about this. Licensure requires passing all 3 steps of the United States Medical Licensure Exam (USMLE), one year of training beyond medical school in an accredited training program (sometimes called an internship), and being deemed a member in good standing of the profession by that state's medical licensing board. Board certification (and I can see why this gets confusing) requires all of that AND completion of an entire residency in an accredited training program (an additional 2-6 years beyond internship) devoted to a medical specialty, plus passage of the certifying exam administered by that medical specialty board.

Licensure is required of all physicians who wish to practice medicine and deliver care to patients, but board certification is not; it's voluntary and yet is one very important standard by which physicians judge one another. Not to be board certified is an exception rather than the rule, and you should make sure your physician is board certified. If you're not sure, you can find-out (free of charge) by going to http://www.abms.org .

I want to revisit the catch-all phrase "bedside manner" and talk about other aspects of how I choose (or recommend) a doctor, but I'll save those musings for another day. My peaches are getting soft.

Jan