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Choosing the right doctor can be difficult. How do you know that you can believe the ratings you see online? Cleveland Clinic is committed to helping you find the right physician for you with ratings you can trust.

In addition to staying in network, you or your doctor may need to get benefit approval or "prior authorization" before you get treatment for certain services for them to be covered. Please check your benefit booklet or your plan's terms if you are unsure.

Forty years ago, Sarah Lubarsky came home from work and realized that her fianc, David, was extremely ill. He was vomiting and slurring his words. So she grabbed her purse and took him by taxi to the nearest hospital, on the Lower East Side of New York City. The minutes slowly passed as they waited to see a doctor.

In addition to the theme of visiting multiple clinicians, several American investigators have constricted the definition of doctor shopping to specifically address the seeking by patients of illicit prescription medications, especially controlled substances. In this regard, Lineberry and Bostwick6 define doctor shopping as patient visits to multiple physicians simply to procure prescriptions. Hall et al7 characterize doctor shopping as obtaining prescriptions for controlled substances from five or more clinicians during the preceding year. Shaffer and Moss8 define doctor shopping as patient consultation with multiple physicians in a short time frame with the explicit intent to deceive them in order to obtain controlled substances.

Physician-related factors. While the majority of studies has focused on patient factors related to doctor shopping, several studies have examined specific physician factors, as well. In this regard, Yeung et al12 determined that extended waiting times contributed to doctor shopping among patients in a Hong Kong community medicine clinic. Feroni et al13 reported that physician attitude, particularly being stringent, stern, or strict, was a factor in doctor shopping among French patients in buprenorphine maintenance programs. In a community sample from the United States, Kasteler et al14 uncovered a number of physician factors related to patient doctor shopping. These factors included inconvenient office hours or locations, undesirable personal qualities of the physician, and insufficient time for communication between the clinician and patient.

Patient-related factors, illness variables. According to the available data, patients doctor-shop for a number of personal reasons, as well. Importantly, these reasons may relate to illness characteristics rather than psychological dysfunction. For example, doctor shopping may be due to symptom persistence,1 a lack of understanding of either the proffered diagnosis or the treatment,2 and/or no improvement in the illness.11 In addition, patients may seek other providers because of the chronicity of the illness or disbelief in either the diagnosis or treatment.10 According to Macpherson et al,3 there appear to be several specific medical diagnoses that are associated with consultations with multiple providers: upper respiratory tract infection, urinary tract infection, and gastroenteritis.3 On a side note, Leung et al15 determined that doctor shopping was associated with failed appointments.

The patent majority of commentaries and empirical studies examining patient factors related to doctor shopping reside in the area of substance misuse/abuse. In this regard, Lineberry and Bostwick6 indicated that doctor shopping is a traditional method for acquiring drugs illicitly. Klienschmidt et al20 reported that many patients in treatment in a drug and alcohol program disclosed that doctor shopping for benzodiazepines was easily accomplished. Pradel21 identified doctor shopping as a concern with French patients in buprenorphine maintenance treatment.

As for empirical studies on doctor shopping and the seeking of illicit drugs, in a Norwegian study, Winther and Bramness22 found relationships between the number of physicians consulted and the prescription of addictive drugs. In this investigation, the two study cohorts consisted of patients consulting with five or more physicians for either 1) addictive drugs or 2) nonaddictive drugs. The percentage of patients in the addictive-drug cohort was 9.5 times higher than the percentage of patients in the nonaddictive cohort. In a patient sample from Hong Kong, Dong et al23 found empirical associations between doctor shopping and benzodiazepine abuse. In examining the prescription drugs most associated with doctor shopping, Wilsey et al24 reported that opioids were most common (12.8%), followed by benzodiazepines (4.2%), stimulants (1.4%), and weight-loss medications (0.9%).

Importantly, not all studies have found relationships between doctor shopping and prescription misuse. For example, in a different study by Wilsey et al,25 using data from the California Prescription Monitoring Program, investigators did not find a relationship between doctor shopping and the abuse of opioids.

A designated doctor (DD) is a doctor or health care provider selected and trained by DWC to resolve questions about an injured employee's medical condition; or a dispute about a work-related injury or illness.

The injured employee, the employee's representative, or insurance carrier, or DWC can request a designated doctor exam. DWC decides if a designated doctor should be appointed to conduct the exam. View video.

PSI Exams administers the designated doctor and maximum medical improvement and impairment rating (MMI/IR) certifying doctor exams at locations across Texas. Contact PSI to schedule an exam or call 855-746-8173.

If you have health insurance, you may need to choose from a list of doctors in your plan's network (doctors that take your insurance plan). Some insurance plans may let you choose a doctor outside your network if you pay more of the cost.

Make a list of the doctors you're interested in. Be sure to think about how easy or difficult it will be to travel to an appointment. Then call their offices to learn more about them. The answers to the following questions may help you make the best decision. ff782bc1db