This page may have documents that can’t be read by screen reader software. For help with these documents, please call 1-800-311-0419.

How to Choose a Doctor

PPO Plan members do not need to choose a primary care practitioner (PCP) to receive medical services. You can get services from any participating doctor any time you need care.

If you already have a primary care doctor and simply wish to confirm that your doctor is in the network plan, search our list of Doctors and Hospitals.
If you don't have a regular doctor and want to find one or wish to select a specialist, there are a few considerations to bear in mind as you make your choice

Finding a doctor you like and trust and who respects you and answers your questions is worth the time and effort. There's more to finding such a doctor, however, than simply getting a reference from family or friends.

Questions to Ask

Start by asking yourself whether you prefer a male or a female doctor, then begin making inquiries by asking some of the following questions:

  • Education and Background
    • Is the doctor board certified in his or her specialty area? (Note: Both family practitioners and specialists can be board-certified.)
    • Is the doctor a specialist in any other area of medicine?
    • What is the doctor's background, credentials and schooling? Where was his or her internship and residency? How long has this doctor been practicing medicine? How long in your state?
    • Has the doctor had his or her medical license withdrawn in another state or been convicted of a felony in this or any other state? Can you get the doctor's malpractice history?
  • Access and Availability
    • Is the doctor taking new patients? This is important, because a "no" here will eliminate this doctor from consideration.
    • In which hospital(s) is this doctor on staff? You may prefer some hospitals over others because of location, medical school affiliation, or other factors.
    • How does the doctor compare with other doctors in the network regarding patient satisfaction ratings? How does he or she compare regarding the annual percentage of patients who switch from this doctor to another doctor in the network?
    • Is the doctor able to handle any special medical needs that you may have?
    • Does the doctor practice with other doctors with whom you are comfortable? (This is important if the doctor is part of a group practice or has a partner who is regularly on call for his or her patients.)
    • If English is not your native language, is the doctor, nurse, or any other doctor in the practice, able to speak to you in your native language?
    • How long does it take to get an appointment when you are sick?
    • How does this doctor handle medical emergency calls from patients?
    • Will the doctor or his or her nurse take your call during office hours? If the office takes a message, how promptly does the doctor or nurse return the call?
    • How does the doctor's office handle calls made after office hours? If the call is urgent, will someone return the call promptly or will you have to wait until the next day for a reply? Will you have to seek urgent care on your own?
  • Compatibility
    • Do you and the doctor share similar philosophies and expectations regarding your care or your family's care?
    • Does the doctor consider the whole person—the physical, mental, emotional and social aspects of the person—in conducting an exam and prescribing treatment? Does the way the doctor or nurse discuss the reason for a visit or the way in which the medical history is taken support this?
    • Does the doctor want to know what your life is like? For example: Does he or she ask what stresses you are under or what problems you face at home, at work, with family or friends, or in your love life? Does he or she ask about what you do for a living or your daily routine? Does the doctor ask how much you smoke, drink, or exercise, whether you use seatbelts and helmets, or if you practice safe sex? Does the doctor ask whether you live alone, and if so, what kind of a support network you have?
    • Do you respect this doctor enough to follow his or her advice?
    • How does the doctor feel about your obtaining a second opinion regarding his or her diagnosis or suggested treatment? Does the doctor prefer that you get the second opinion from a doctor he or she suggests, or are you free to choose your own source for the second opinion without this doctor objecting?
    • Does this doctor respect you, treat you in a professional manner, listen to all your questions seriously, give you full and detailed answers, and truly encourage you to discuss your care and your questions? Do you find him or her easy to talk to, or are you discouraged from asking detailed questions? Would you feel comfortable asking this doctor a "silly" question? What about a more sensitive question, such as about sexually transmitted diseases or sexual performance?
    • Does the doctor take time to sit down with you, either before or after you change for the visit, to discuss your reasons for coming in and your progress in treatment? Do you feel that the doctor takes all the time necessary for discussing your care, or do you feel rushed about having any conversation with the doctor?
  • Treatment and Prevention
    • Does the doctor fully explore your complaints before deciding what to do about a specific problem or condition?
    • Does the doctor discuss treatment options with you and fully explain all prescribed treatments and medications, along with their possible side effects? Are you cautioned about possible drug or food-drug interactions?
    • Is everything explained to you in a manner you understand?
    • Does the doctor check before the visit ends that you fully understand his or her instructions and tell you what to do if you don't feel better or have a bad reaction? Does the doctor tell you what to do or how to reach him or her in case of an emergency?
    • Is a follow-up visit or telephone call made to make sure the treatment is working properly, without adverse effects?
    • How long is the typical wait for a scheduled wellness visit?
    • What does the doctor do to keep you healthy? Are you asked to keep an exercise or diet log, attend wellness classes, or participate in any kind of activity to promote better health? Does the doctor even ask whether you diet, take vitamins, exercise, etc.?
    • What kind of educational materials are available through this doctor's office so that patients and family members can learn more about specific medical conditions, their treatment and prevention, or suggested surgery?
    • How does this doctor handle "living wills" and DNRs ("do not resuscitate" orders)? Do the doctor's personal moral or ethical beliefs preclude your receiving certain types of medical services from this doctor? If so, what kind of services, specifically? Is the doctor willing to refer you to another doctor who will provide these services, or are you on your own to find such a referral?
  • Office Hours and Staff
    • Are the doctor's hours and office location convenient for you? If not, does the doctor practice at another office or clinic that might be more convenient?
    • Is the doctor's office staff helpful, pleasant, courteous, and professional? Does the staff generally understand and respond efficiently and correctly to your questions, especially those regarding tests or test results, messages to or from the doctor, referrals, or billing? Can you rely on the staff for answers, or do you find yourself wanting to hear from the doctor or nurse instead?
    • If you have a problem with the office staff, is the doctor or the office nurse responsive in solving the problem promptly?
    • If you have a problem with the doctor, is your complaint handled promptly, courteously, and professionally? Are you satisfied with the result?

    Answering all these questions won't completely guarantee that you and the doctor of your choice will be a "good fit" as doctor and patient, but it will help put your mind at ease about making a good, informed choice and will pave the way for starting a good relationship. Remember, you and your doctor should be partners in the conduct of your care.

    Please note: Doctors participating in the Blue Cross and Blue Shield Network PPO Plan are independent contractors of Blue Cross and Blue Shield and are not employees or agents.