Finding the Right Doctor for You and Your A-Fib
By Steve S. Ryan, PhD, Updated December 6, 2016
The cardiologist will want to put you on different medications (called Drug Therapy) over the next six months to a year or more to see if any of these medications will stop or control your A-Fib. But current A-Fib medications are not very effective. They work for only about 40% of patients and frequently stop working over time. Many can’t tolerate the bad side effects.
Know that time is of the essence in treating A-Fib. The longer you have A-Fib, the more your A-Fib may “remodel” your heart (i.e., change it physically and electrically). “…once the diagnosis of atrial fibrillation is made, it’s important not to spend too much time trying to keep a patient in normal rhythm with medical (drug) therapy” before referring them to catheter ablation, according to Dr. Oussama Wazni, Co-Director of the Center for Atrial Fibrillation at the Cleveland Clinic.
With this information in mind, drug therapy may not be the best option for you.
To seek treatments beyond medications, you may need to change doctors.
Since Atrial Fibrillation is an electrical problem, you should see a Cardiac Electrophysiologist (EP)—a cardiologist who specializes in the electrical activity of the heart and in the diagnosis and treatment of heart rhythm disorders.
The EP’s primary concern is creating a ‘treatment plan’—an organized path to finding your A-Fib cure or best outcome.
If you know nurses or support staff who work in the cardiology field or in Electrophysiology (EP) labs, they can be great resources.
To find a local Electrophysiologist yourself, we recommend the Heart Rhythm Society website and their feature called ‘Finding a Heart Rhythm Specialist’. ‘Check’ the box “to limit the results to Fellows of the Heart Rhythm Society (FHRS)”. (EPs with the FHRS designation have been recognized by their peers and are experienced heart rhythm professionals working in the field of electrophysiology and/or pacing).
When you type in a U.S. city and state (or country), the site gives you a list of Electrophysiologists in your area. Check for their list of specialties (not all EPs perform catheter ablations, for example; some focus on pacing/pacemakers, or clinical research, etc.). Look for additional information such as which medical insurance they accept.
Our A-Fib.com Directory
This A-Fib.com Directory of Doctors and Facilities is an evolving list of the physicians and medical centers who treat patients with atrial fibrillation. Our directory is offered as a service and convenience to A-Fib patients.
It’s divided into sections: U.S. Doctors and Centers by state/city and International listings by country or geographic region. In addition, I’ve compiled several rosters, called ‘Steve’s Lists’ of doctors by specialty.
Organize Your Research
To find the right doctor to cure your A-Fib, start your research with a notebook and a three-ring binder or a file folder. Learn Why You Need an A-Fib Notebook and 3-Ring Binder.
You need to organize the information you will be collecting: printouts of information from the internet, copies of documents from your local public library or medical center library, notes from phone calls, and answers to “interview” questions during doctor consultations.
Your 3-ring binder, or file folder is also where to collect copies of all your lab tests, notes from doctor visits, doctor correspondence, etc.
Obtain Copies of Your Medical Records, Tests, and Images
If you need to request copies of some medical records, read our article, How to Request Copies of your Medical Records. We give you three ways to request your medical records from your doctors and healthcare providers.
Later, when you are ready to interview new doctors, you will want to send each office a packet with your medical records, test results, and images or X-rays. (As a back-up, bring your three-ring binder with the originals.)
We strongly encourage you to get in the habit of keeping a copy of every test result you get in a designated three-ring binder. Don’t leave your doctor’s office or hospital without a copy of every test they perform. Or if the test result isn’t immediately available, have them mail it to you.
Don’t rely on a single online source when researching and selecting doctors. Be cautious of all doctor informational listings you find on web sites (yes, including this one).
Doctors may be listed or appear most prominently because they pay for that privilege (but not so at A-Fib.com). Read my article, Don’t be Fooled by Pay-to-Play Online Doctor Referral Sites.
Don’t depend on websites of patient’ ratings of doctors or with patient surveys. They lend themselves to manipulation. Ratings often reflect how well-liked a doctor is, not competency. Consult several sites.
You must do your own homework. To narrow down your list of prospective doctors you will want to scrutinize their credentials. To research each doctor, consult the internet or your local library. One or more of the following online resources may be helpful.
• The Heart Rhythm Society ‘Find a Specialist’ searchable directory for a doctor’s specialties, insurance accepted, etc.;
• The American Board of Medical Specialists (ABMS) Directory of Board Certified Medical Specialists;
• The American Board of Internal Medicine; Check a doctor’s certification;
• The Cardiothoracic Surgeon’s Network Directory of Surgeons;
• Vitals, an independent healthcare ratings organization; provides physician’s profile, education, awards & recognition, insurance accepted, hospital affiliations, and info on malpractice and sanctions.
Narrow down your list to the top three doctors. Now you are ready to set up a consultation appointment with each doctor. Think of this as an interview. Don’t worry, doctors are also ‘interviewing’ you to determine if they can help you.
What to say:
1. You have Atrial Fibrillation, and what kind (paroxysmal, persistent or long-standing persistent);
2. You want to consult with the doctor about your treatment goals, for example, you are seeking to cure your A-Fib, not just manage it with drugs.
Note: some EPs have a “referrals only” policy, which means they won’t talk to you directly. You have to be referred by a cardiologist or a family doctor.
Send Your Medical Records Beforehand
Before your appointment, send each doctor a packet with your A-Fib-related medical records. To learn what to include in your packet of medical records, read Why You Need an A-Fib Notebook and 3-Ring Binder and Your Personal A-Fib Medical Summary.
To help you scrutinize prospective doctors, we’ve written a set of 10 interview questions to help get you started. Download the FREE PDF and save to your hard drive. Then, print a worksheet for each doctor you interview.
Prepare and add your own list of questions for each prospective doctor.
During Your “Interview”
When you arrive at the doctors offices’, make sure they have indeed received your medical records. (As a back-up, bring your own originals from your three-ring A-Fib binder.)
Be sure you have your worksheets and list of other questions, a notepad and pen to take lots of notes.
Audio Recording: In addition, consider using an audio recorder to help you remember things. (Most doctors don’t mind, but always ask permission beforehand.) Many cell phones can be used to make a recording.
Take Along a Trusted Friend: You may want to take along a trusted friend or family member. As needed, your ‘personal advocate’ can question the doctor for you and verify your list of questions have been answered. It’s hard to be on top of your game when you feel ill and anxious. Studies show that patients immediately forget up to 80% of what’s discussed during a doctor visit, and get about half of the remainder wrong.
Afterwards, your patient advocate friend can help you evaluate the doctor’s answers, discuss anything that’s unclear and comment on the doctor’s demeanor.
Afterwards: How to Interpret the Answers You Received
Back home, study your notes about each doctor. To ‘interpret’ the doctors’ answers, see our article, “Choosing the Right Doctor: 10 Questions You’ve Got to Ask (And What Their Answers Mean)“. We’ve included the various responses you might receive, and what each response means to you when searching for the right doctor for you and your treatment goals.
Also Assess the Doctor’s Manner and Personality
You’ll also want to assess the doctor’s manner and personality. Is this someone who will work with you? Someone who listens to how A-Fib makes you feel? Does this doctor inspire confidence? Is this someone you feel comfortable with and trust with your health care?
Your relationship with your doctor is important. See our post: ‘Do you Like’ Your Doctor, Do You ‘Connect’?…How it Affects Your Health
Rudeness, bad temper, boorish behavior, etc. from a doctor, no matter how highly recommended, should be a red flag for you. That kind of behavior is not just personally offensive but can be dangerous for your health.
Gender bias: Does he/she respect you? Women in particular should be wary of condescending behavior. Read “It’s All In Your Mind” Her MD Said. Women in the US often don’t receive the proper diagnosis and treatment of their A-Fib.
Does the poor behavior also extend to how the doctor treats his staff? Patients of doctors “who don’t show respect for their medical staff have much higher rates of adverse effects, than patients of their more congenial colleagues,” according to Gerald B. Hickson, MD of Vanderbilt University Medical Center.
If your doctor is condescending or dismisses your concerns, you’re getting poor care. If a doctor is too busy to talk with you and answer your concerns, he’s probably too busy to take care of you properly.
But do give the doctor a break. They may be having a bad day or may have heard your questions too many times before. So say something, speak up! Or contact the patient-relations representative at the medical center. They want to know if a doctor is rude (those patients are more likely to sue!). Once a doctor’s bad behavior is called to his attention, they are likely to do better. And you’ll feel better, too.
Evaluate the Consultations
After seeing your top three doctors, compare their answers. Did one doctor stand out? If not, you may want to go back to your research list for number four and five on your list and set up appointments with them too.)
The A-Fib.com Directory of Doctors lists US & international physicians and medical centers treating Atrial Fibrillation patients. This evolving list is offered as a service and convenience to A-Fib patients. (Unlike other directories, we accept no fee to be included.) The directory is divided into three categories.
For a list of EPs doing Catheter Ablation procedures, see Steve’s Lists/US EPs with FHRS-designation performing A-Fib ablations by US State/City.
For surgeons performing Maze/Mini-Maze operations, see Doctors & Facilities/Steve’s Lists Doctors by Specialties and more specifically, US Surgeons performing Maze and Mini-Maze operations.
Last updated: Monday, March 20, 2017
Hussein, AA, et al. Radiofrequency Ablation of Persistent Atrial Fibrillation: Diagnosis-to-Ablation Time, Markers of Pathways of Atrial Remodeling, and Outcomes. Circulation: Arrhythmia and Electrophysiology. 2016;9:e003669. https://doi.org/10.1161/CIRCEP.115.003669.
McDaniel, Susan H. The Right Way to Ask Your Doctor Questions. Bottom Line Health. Volume 31, Number 4, April 2017, p. 14.