There are tremendous advances taking place in medicine today, but in order to benefit from them, the healthcare consumer must take an active role. The best healthcare will not find you — you have to seek it out.

While the United States offers the highest standard of healthcare in the world, there is still huge treatment variation based on the doctor you see. Bottom line — the doctor you choose will determine the quality of care you will receive. Here is an overview of how to navigate through the healthcare system to find the best doctor for you.

“The best healthcare will not find you — you have to seek it out.”

Spine specialists can include neurosurgeons specialized in spine surgery, orthopedic surgeons specialized in spine surgery, physical medicine doctors, anesthesiologists and physical therapists who specialize in the nonsurgical relief of back and neck pain symptoms.

As with anything in life, practice makes perfect. All clinical outcome studies confirm that the more times a surgeon performs a procedure, the better they become at it. Consequently, spine surgeons who perform more than 150 surgeries per year will be more proficient than those who perform 50 each year.

A second indicator of quality is training and experience of the physician. One might believe that a younger physician a few years out of training might be at a disadvantage compared to a surgeon who has practiced for 25 years or more. However, this is not an accurate generalization. In reality, an older physician may be more comfortable using traditional techniques, while a younger, fellowship-trained physician may be trained in the most modern, minimally invasive techniques and instrumentation. Age is not necessarily a good indicator of quality.

Fellowship Training

During their education process, highly trained physicians will have completed four years of college, four years of medical school, and a three to seven year residency in which the physician works under the supervision of a veteran physician to learn a speciality, such as spine surgery.

Fellowship training is an additional year-long study in which the physician works alongside the most highly respected physicians in their particular specialty. Fellowship training is the highest level of training in the United States and can be an indicator that the physician is an expert in their specific area of specialization. Note where the physician has trained. Training at a large or prestigious institution would expose the physician to more complex cases, which in turn makes them more proficient in their chosen specialty.

Board Certification

Board certification indicates a physician has undergone additional training specific to their speciality and met the competency standards within that area of specialization, as judged by the specialty board. Board certification typically requires that a physician has been in practice for several years since graduating from medical school and has passed a rigorous written and oral exam.

Using Your Health Insurance Plan as a Guide

Most people are surprised to learn that their health insurance provides little help in finding the best specialist within a specific niche. Offering a preferred provider directory of specialists gives no real indicator of quality. Inclusion in a PPO directory typically only means that the physician has agreed to accept a discounted rate for payment from the insurance company. In this sense, “preferred provider” simply means that the insurance company would “prefer” you to see doctors who have agreed to accept a discount. These discounts can be steep, depending upon the health insurance plan.

Unlike other industries, in which market demand and the highest quality product commands the highest price, healthcare is an industry that is woefully behind the times. But that is changing.

A growing trend nationwide is that super-specialists, who are in the highest demand by virtue of reputation and outcomes, can be less motivated to accept discounted reimbursement from some health plans. These super-specialists typically have full schedules and don’t need to discount their services to attract patients. Consequently, they are opting not to be included in a PPO panel, while other physicians may have to rely on discounting to attract patients.

Most PPO plans have out-of-network benefits that enable patients to see a physician who is not listed in the PPO directory. Typically, the person may have to pay a larger percent of the bill and a larger deductible. But for complex problems, this still may be the more prudent approach in the long run to access the most current technology and the specialist with the least invasive treatment alternatives.

More and more employers are recognizing that traditional healthcare plans have historically done a poor job of establishing panels of physicians based on quality care. Consequently, several employers are seeking out centers of excellence for the treatment of complex problems like cancer, heart disease, neuroscience, organ transplants, joint implants and spine problems.