If we live in a smallish town, we somehow usually know who the best doctors are. In a big city like New York City where there are many excellent doctors, people can find the selection process daunting.

We usually get referrals from our own doctors; we also ask friends who may connect us with other friends who’ve successfully dealt with the same health issue. In cases where our problem is not “garden variety,” we may think it important to select the doctor who has had the most successful results, done the most procedures, and/or cared successfully for the most patients with whatever our problem is.

The large medical centers (often university-affiliated) have specialists within the specialty. The specialty, Urology, for example, can have specialists for kidney stones, male infertility and erectile disfunction, cancer of prostate or bladder, incontinence–you get the idea.

But we may not need a top specialist for everyday problems. And top doctors can be prima donnas with no bedside manner. We must prioritize our needs—personality or skill.

There’s a practical element that also comes into play. Not all doctors accept Medicare, making it more difficult for some senior citizens to even find a doctor who will accept them as a patient. But the latter need not be a deterrent if you decide to go to a doctor who has opted out of Medicare participation. You will pay more but you will receive some reimbursement. Specifically–

If you’re on Medicare and have Medicare part B coverage (covers doctors’ bills) you are covered by Medicare. You’ve paid for that health insurance. Even if your doctor has opted out of Medicare and your doctor’s office won’t and can’t process your bill to send to Medicare, you will be reimbursed if you apply to Medicare directly. (Click this link for 2015 post with complete details.).

Related: For those who have no encumbrances besides a health issue, check out these links: http://www.castleconnolly.com/about/nomprocess.cfm   and   http://www.castleconnolly.com/doctors/index.cfm
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