When doctors move on
Top 5 considerations if your physician leaves the practice
by Katherine Shaw
Laura Kolaczkowski was fastidious in putting her multiple sclerosis care team together. Diagnosed in 2008 by her family physician in Dayton, Ohio, she made the decision to travel an hour and a half from her home to the comprehensive Multiple Sclerosis Center at Ohio State University. On her first visit, she was seen by Dr. Aaron Boster, then an assistant professor of neurology who later became director of the center. She perceived him as smart, proactive and insightful, so she decided to keep him as her neurologist.
When she compiled the rest of her MS care team, she set the bar similarly high. “I ask a lot of questions, and it is important that I have practitioners who are responsive and patient-centric,” Kolaczkowski explains.
Since that first visit, she and Dr. Boster have built a strong relationship based on trust and understanding, and he has seen Kolaczkowski through attacks, remissions, various courses of treatment and clinical trials. So when Dr. Boster decided to leave Ohio State in 2014 and move his practice across town to OhioHealth’s new Neuroscience Center, Kolaczkowski was not pleased.
“It was distressing initially. We’ve built a trust relationship so that I know if I have a problem I can depend on him to respond.”
For many people with MS, as for Kolaczkowski, that ongoing relationship with a neurologist or primary care physician (PCP) is an important factor. After all, given the variability of MS, with its subtleties and nuances, it’s good to have someone who is with you for the long haul—someone who knows you and knows your history.
Making an informed decision
Doctors are now more likely than ever to change practices a number of times during their careers. “There is unprecedented demand for physicians, due in part to an aging population,” and in part to insurance reform, notes Jim Stone, president of The Medicus Firm, a national physician recruiting consultancy. As a result, he adds, “physicians have many choices of practice opportunities.” A 2014 study by Medicus found that 73 percent of practicing physicians receive at least three employment solicitations a week.
If your neurologist or PCP has moved his practice across town—or farther—what do you do? Beyond experiencing any feelings of abandonment, hurt and anger, the bottom line will be determining whether it’s best to follow your doctor or find a new one. Dr. Boster recommends using the following five strategies to help you decide:
- Verify your coverage. If you’re insured, this alone could be the determining factor. Your plan may specify which practices are “in network”—and your doctor’s new practice may not be.
- Ask when and why. Have a frank discussion with your doctor, acknowledging the feelings you are having about her move, and talking through the pros and cons of staying with her. Your doctor may be moving for a better role in the hospital system or better benefits—or she may think the new practice will offer her patients better care. Find out how she thinks the move will affect you; for example, her new office may be able to provide more support services under one roof. But be aware that contractually, she may be limited in what she can say. If your doctor is building a new practice, verify timing so you know when the practice will be up and running.
- Do a relationship review. Do you have a good rapport with your physician? Feel you’re in capable hands? That you’re being heard? That your doctor spends ample time with you? If you answer yes, you have some very good reasons for following your doctor. Be sure to also consider the relationship you have with any other team members at his office, such as the social worker, nurse or other healthcare providers.
- Sweat the small stuff. Can you get appointments in a timely manner? Get prescription refills quickly? Are wait times short? Sometimes something as simple as an adjacent parking garage or free valet service can make all the difference. Sometimes the convenience of having neurology, physical and occupational therapy, and MRI services all in one building, combined with the ability to schedule back-to-back appointments, saves time and minimizes stress.
- Shop around. If you are on the fence about whether to follow your doctor, try out a different physician. A second, or even third, opinion never hurts. Then you can make an informed decision about whether to stay or go.
Access to care—now and into the future
If you find yourself in a situation where your doctor is leaving, and you don’t know whom to see in his or her place, contact the National MS Society. Call 1-800-344-4867 and an MS Navigator will try to help connect you with resources, including other MS healthcare providers, in your area.
But not all areas of the country are well-served. In some regions, such as rural areas with small populations, there simply aren’t many (or any) MS specialists within a convenient commute. “We recognize that there are gaps,” says Kathleen Costello, an MS nurse practitioner and vice president of Healthcare Access in the Advocacy, Services and Research Department at the Society. “As a result, we are funding the next generation of MS specialists through individual and institutional clinical fellowships.”
In July 2016, there will be 17 clinical fellow physicians nationwide participating in specialized training and education in MS care. In order to fulfill the Society’s Access to High Quality MS Healthcare Principles, which stipulate that all people with MS should have access to high-quality, affordable care focused on the best possible outcomes, “we are also looking at strategies to improve access in underserved geographical areas and in special populations such as pediatric MS, as well as pursuing collaborative opportunities to provide education for providers who are actively working in MS care,” Costello adds.
The final call
Whether you make the decision to stay at a practice, or make the move with your doctor, continuity of high-quality MS care is key. For Dr. Boster, the decision to move across town was an easy one. As the new systems medical chief of neuroimmunology and clinical research at OhioHealth, he has the opportunity to build and develop a comprehensive interdisciplinary practice center—from his standpoint, a dream job.
After some research and careful deliberation, Kolaczkowski decided to make the move with Dr. Boster. She verified that her insurance would cover visits at the new practice, and she realized she really valued the strong relationship she and Dr. Boster shared. “He’s a great resource, partner and co-captain of my team, so the choice was easy,” she says. If your choices aren’t so obvious, make the calls and do the research so you, too, can assemble the best MS care team possible.