‘‘The Medical Self’’ 61
Doctors Choosing Doctors
The individuals I interviewed had to select physicians to treat them.
Whether they acted fully or only partially as patients, these ill doctors had
to decide the qualities they themselves sought in health care providers. In
so doing, they had to balance a range of personal values and technical,
interpersonal, and emotional factors, engaging in highly subjective pro-
cesses. They made these decisions in the contexts of complicated rela-
tionships with family members and caretakers, physicians-of-record, and
colleagues. Yet their relatively informed decision-making processes offered
many lessons and insights from which lay patients and others might learn.
Therapeutic Tastes and Styles
In selecting their own physicians, most of these interviewees used ‘‘inside
knowledge’’—usually their own, but sometimes that of others. Several of
the doctors made use of the fact that they could find ‘‘the best’’ physician
in a field, and relished their privileged status as cognoscenti. In their
assessments of, and search for, appropriate specialists, some were highly
elitist, wanting only ‘‘the best.’’ Wilma, a physician in her eighties with a
severe GI infection, said:
I discovered there were only four people in this city who could
be considered for doing my surgery. Similarly, I went to a lab—
probably the only one east of the Mississippi that does a proper
job—and got a proper tropical disease examination, and discovered
I had an intestinal parasite.
Wilma, wary of the quality of many physicians, felt her standards were
justified.
These doctors often looked to particular colleagues, specialists, or
friends for information, and cited subjective characteristics—aspects of
styles and tastes. The ability to choose a good doctor may itself vary.
Sally, who brought her laptop to the ICU, described a colleague who
judged such distinctions well.
She’s very fussy about the doctors she picks, and has always been
my main source of information. She has very good taste in doctors:
They have to be competent technically, but also able to listen.