Finding "The Best" Care

Getting the Best Care - November 7, 2012

When you receive a diagnosis of cancer or other major illness, one of the first decisions you'll need to make is where to have treatment. Usually your primary care physician or a hospital physician will refer you to a specialist within their network. Then you will have to decide if you want to be treated by that physician or seek out a different one. You may find yourself flooded with advice and suggestions from well-meaning friends, family members and colleagues, who will tell you about a certain doctor or treatment center that is "one of the best" out there.

With so many choices, it's difficult to know how to choose a physician and treatment plan. To the average person, it's not clear what makes one physician or facility better than another. How do you know where to get "the best" care?

In researching treatment options when my husband was sick, I learned some things about the different types of hospitals and facilities available. In my opinion no physician or facility is really "the best;" what's more important is to find the right match for the patient. While one hospital or facility may have achieved better results in treating a particular disease, that facility may not be the best fit for a particular patient. What might be truly great for one patient would be a bad fit for another. My husband was treated at more than one facility throughout the course of his treatment. These are some things I learned during that process.

Generally, patients at teaching hospitals tend to get more aggressive and cutting-edge care. They have more access to clinical trials, but in a more fractured, less warm environment. Teaching hospitals have a stronger tendency to follow protocols and less of a tendency to get creative, but also less of an influence by pharmaceutical companies, since their mission is fundamentally data-driven rather than profit-centered. The physicians at teaching hospital generally do research in addition to their clinical duties, so they often only see patients one day a week, which makes getting appointments with them very challenging. Navigating the bureaucracy in a teaching hospital can also be difficult. Statistically, though, patients often have better results when they are treated at a teaching hospital.

Many times patients who are treated at a community hospital or other non-teaching hospital can have a personalized, warmer treatment experience. Many facilities have the same cutting-edge equipment and technology as teaching hospitals; some, of course, do not. Physicians at non-teaching hospitals focus mainly on treating patients, but they are usually less specialized than their counterparts at a teaching hospital. A patient at a non-teaching hospital can generally expect to have easier access to tests and physicians and experience a more customer service oriented atmosphere. The staff has more room for creativity and customization, as they are not as bound by research protocols and gathering data.

Obviously you want to be treated at a facility that is highly ranked and has good success rates. However in my opinion going to a facility with the best survival rates or other statistical measure is not necessarily the best choice for some patients. If the patient doesn't feel comfortable and connected with the physicians and nurses at a particular facility, or if traveling there is difficult, or if the philosophy of care isn't a good match for the patient and the patient's family, then that facility will not provide the best possible care for that patient.

My husband was treated at one of the largest teaching hospitals in the world and also at a smaller community hospital. He benefited greatly from both facilities and at different times during the course of his treatment each facility was "the best" for him. When you set out to choose the best facility for the patient in your life, my advice is to stay focused, always, on that person's specific needs.