How to Choose the Right Physician - How to Tell Us if You Don't

Choosing the Right Doctor

Choosing the right doctor is a very important decision. Yet, many people take more time to compare the quality and price of their next car than they do to select a physician.

Today, many people have primary care physicians who serve most of their needs and can refer them to specialists when necessary. Primary care physicians generally include internists, family practitioners, pediatricians and, in some instances, obstetricians and gynecologists.

How do you select a primary care physician, and how do you know if the specialists he or she suggests are the right doctors for you? Here are some things to consider when selecting a physician:

  • Ask friends and relatives for recommendations. If you are moving and changing physicians, ask your current physician if he or she can refer you to someone in your new community.
  • Check with area hospitals. Many of them offer referral services.
  • Check with your county medical society. They will give you the names of several physicians.
  • Ask your insurance company, health maintenance organization or managed care plan if they have a panel of physicians from which you should select.

Once you have the names of several physicians, you can do some additional checking to help you make a final decision.

Is the physician licensed?

To find out if the physician is currently licensed and registered in New York State, contact the State Education Department, Division of Professional Licensing Services, Cultural Education Center, Albany NY 12230. Phone: 518-474-3817 and ask for public information. Web site: www.op.nysed.gov . The State Education Department can also tell you where a physician attended medical school.

How can I learn about my physician's education?

The New York Patient Health Information and Quality Improvement Act of 2000 made it possible for all citizens of New York to get information about physicians (doctors) through the State Physician Profile website www.nydoctorprofile.com

Certain information is required to be available on all physicians. Such information includes

  • Information about the doctor's medical education
  • Information about translation services at the doctor's office
  • Information about legal actions taken against the doctor

To see all the information that is available for each doctor, search on any doctor's name.

Optional Information

Doctors can also give extra information (optional information) about their practices. Each doctor is invited to add:

  • The practice name, address and phone number of all offices
  • The names of other doctors in a practice group
  • A list of the articles or research papers the doctor has published
  • A list of professional and community service activities or awards
  • A list of the health plans the doctor works with
  • A personal statement about any information in the doctor's profile

Is the physician board-certified?

Many doctors become board certified in a specialty. This means that they complete specialty training and pass formal examinations. While no guarantee of excellence, board certification is one way the average consumer can be certain of a physician's training. Many primary care physicians also are board-certified in specialty areas. To find out if your physician is board-certified, access the American Board of Medical Specialties web site at www.abms.org or call 1-866-275-2267 Patients who would like to check the certification status of a DO can visit the American Osteopathic Association (AOA) Web site at www.osteopathic.org or call the Member Service Center at 1-800-621-1773, option 1 on the menu.

How does the office operate?

Check a physician's office hours and locations, payment requirements, emergency and after-hours coverage, and the availability of telephone consultations and house calls. Find out at what hospitals the physician has admitting privileges.

What about the physician's malpractice record?

Information on a physician's malpractice record can be obtained by checking the State Physician Profile website www.nydoctorprofile.com or checking with the County Clerk's office.

Has the physician been disciplined?

To learn if a physician has been disciplined, call OPMC at 1- 800- 663- 6114, or access the medical conduct Web site at www.nyhealth.gov/professionals/doctors/conduct/. Select "Search for a Disciplined Physician" on the left side of the page for information about disciplinary actions imposed on an individual physician. Effective November 3, 2008, both the charges filed against a physician and the Board's Determination and Order regarding all charges will be made public. Pending or dismissed complaints are not public information.

Reporting a Problem with Your Physician

The vast majority of New York's licensed physicians, physician assistants and specialists assistants* are dedicated, caring and capable professionals working to protect and improve the health of their patients.

* Throughout this discussion, the term "physician" includes physician assistant, specialist assistant and unlicensed resident physician.

The Office of Professional Medical Conduct (OPMC) and the Board for Professional Medical Conduct (the board) are responsible for investigating and adjudicating complaints against physicians, physician assistants, and specialist assistants. Each year OPMC investigates thousands of complaints received from the public and from health care professionals and institutions. Each year, the board disciplines hundreds of physicians.

If you believe your physician, physician assistant, or specialist assistant has acted improperly, you MUST file a written report. You may send a letter or complete a complaint form. Your complaint should include the full name and address of the licensee, when the problems occurred and all other relevant information. To protect your confidentiality, OPMC does not accept complaints either by facsimile (fax) or electronic mail. Please send complaints to:

New York State Department of Health
Office of Professional Medical Conduct
433 River Street, Suite 1000
Troy, New York 12180- 2299

If you want a complaint form, or have questions, call OPMC's toll- free number, 1- 800- 663- 6114. Your complaint will be kept confidential.

Complaints against other professionals, such as dentists, nurses, chiropractors, podiatrists, optometrists and psychologists, are the responsibility of the State Education Department and should be sent to:

Office of Professional Discipline
NYS Education Department
475 Park Ave. South, 2nd Floor
New York, NY 10016-6901

What to Report

If you feel that your doctor has practiced negligently or incompetently, or has engaged in illegal or unethical practices, he/she may have committed professional misconduct, and should be reported.

Physicians may be charged with misconduct for:

  • Being impaired by alcohol, drugs, physical or mental disability.
  • Abandoning or neglecting a patient in need of immediate care.
  • Promoting the sale of services, goods, appliances, or drugs in a manner that exploits the patient.
  • Refusing to provide medical care due to race, creed, color, or national origin.
  • Guaranteeing a cure.
  • Performing professional services not authorized by the patient.
  • Willfully harassing, abusing or intimidating a patient.
  • Ordering excessive tests or treatments.
  • Failing to make patient records and X rays available to the patient or another physician on request.
  • Permitting unlicensed persons to perform activities which require a license.
  • Practicing the profession with a suspended or inactive license.
  • Revealing personally identifiable facts, data or information without consent of the patient, except as authorized or required by law.

For a complete list of the definitions of misconduct see Education Law Section 6530 and 6531.

To access the above-referenced sections of Education Law:

  • Visit the NYS Senate Web site at http://public.leginfo.state.ny.us/menuf.cgi
  • Select the link for "Laws of New York."
  • Select law EDN Education
  • Scroll to Article 131-A Definitions of Professional Misconduct Applicable to Physicians, Physician's Assistants and Specialist's Assistants

What NOT to Report

Complaints regarding fees are not generally under the jurisdiction of the board unless they represent fraud. For example, it would be considered fraud if the physician charged for tests or services that were not provided. You may feel a physician charged too much for the services you received, but that does not form the basis of a misconduct action.

Complaints about a physician's communication skills, attitude, or "bedside manner" are also not generally under the jurisdiction of the board. Nor does the board have any authority over such office practice issues as long waiting times or rude staff. While the board does not condone rude or uncaring behavior, such actions do not, by themselves, constitute misconduct.

How the Process Works

  • Written complaints are reviewed by OPMC investigative and medical staff.
  • Complaints that raise possible misconduct issues are assigned to investigators. OPMC medical coordinators provide clinical guidance. Typically, complainants, doctors, and others involved are interviewed. Interviews may be conducted over the telephone or may be in person. Complainants' identities are kept confidential, although a physician may deduce the source of a complaint from the available information.
  • If appropriate, complaints that raise issues outside OPMC's jurisdiction are referred to the appropriate agency. Complainants are notified of that action by letter. If a physician was contacted, he or she is also notified by letter.
  • If an investigation uncovers sufficient evidence to suggest misconduct, the case is presented to an investigation committee consisting of two physicians and one lay person drawn from the board. The committee can recommend to the Director any of the following: a hearing, additional investigation, a dismissal of the matter, or non-disciplinary warnings or consultations.
  • If the investigation committee determines that the physician poses an imminent danger to the public health, it may recommend to the state health commissioner that the physician's license be summarily suspended.
  • If the investigation committee finds evidence suggesting misconduct or if the commissioner orders a summary suspension, charges are filed against the physician and a hearing is scheduled.
  • If sufficient evidence suggesting misconduct is not found, the investigation is terminated and the case is closed. A record of the investigation remains in OPMC files for possible future reference. Complainants and physicians are notified by letter.
  • Cases ordered to hearing go before another committee of the board— also consisting of two physicians and a lay member— which hears and reviews evidence from both sides. The physician and the state are usually represented by counsel who introduce evidence and call and question witnesses. Typically, the physician testifies at the hearing as well. An adverse inference may be drawn against a physician who does not testify. The committee rules on the case and determines if a penalty is warranted.
  • The hearing committee decision may be appealed by either side to an Administrative Review Board composed of three physician and two lay members of the board.

Penalties

The board has the authority to take actions against a physician's license. A physician's license can be revoked or suspended. The board can also limit a physician's license; issue a censure and reprimand; order education or retraining; levy a fine; or require community service.

Some Things You Should Know

  • Effective November 3, 2008, both the charges filed against a physician and the Board's Determination and Order regarding all charges will be made public. Pursuant to state law, information on previously closed complaints, dismissed actions and on-going investigations is not available to the public. Investigative files are confidential and are not disclosed to complainants or physicians.
  • Because medical conduct investigations are complex, it often takes months to resolve complaints; issues that go to hearing typically take longer.
  • The board cannot direct a physician to reimburse a patient, change a diagnosis or alter an opinion.
  • Action taken by the board is an administrative procedure and is different from a malpractice action. Malpractice cases are heard in civil court and seek financial awards for patients or families who claim wrong-doing by a physician. The board does not initiate malpractice actions.

How to Reach Us

For complaints and information about other professionals:

Office of Professional Discipline
NYS Education Department
475 Park Ave. South, 2nd Floor
New York, NY 10016-6901
Phone: 800-442-8106

Web site address: www.op.nysed.gov/opd.htm

For license information:

  • By email: op4info@mail.nysed.gov
  • Call: (518) 474-3817 (TDD/TTY: 518-473-1426)
  • Fax: (518) 474-1449 or
  • Contact the specific State board for the profession.