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" In today&amp;#039;s medical marketplace, you&amp;#039;re not a patient -- you&amp;#039;re a &amp;quot;health-care consumer.&amp;quot; That&amp;#039;s good news and bad. It means you have more autonomy and choice than ever -- but it also means the ball is in your court when it comes to figuring out whom to trust with your health. Should you see an optometrist or an ophthalmologist for your eyestrain? Do you need a chiropractor or orthopedist for your back pain? And how can you be sure the health professional you choose has the training to treat you safely and effectively?   To help make &amp;quot;doc shopping&amp;quot; easier, here&amp;#039;s our guide to finding the best treatment for your symptoms so you can feel better fast.  Your health complaint: Back painYour options: Chiropractor, orthopedist, physical therapist, or neurosurgeonYour best bet: Chiropractor  Though long dismissed as bogus by many medical doctors, chiropractic care is lately gaining legitimacy, thanks to recent studies showing it may be more effective at treating lower back pain than conventional remedies, such as physical therapy and drugs. Even health insurers are convinced, with most now covering at least some chiropractic care.  Chiropractors perform spinal manipulations -- manually applying gentle force to rigid vertebral joints to restore mobility -- often in combination with massage, ultrasound (for deep-heat tissue stimulation), and acupuncture.  Although chiropractors don&amp;#039;t attend medical school (and so can&amp;#039;t prescribe meds or perform surgery), they do complete four years of education and training and a one-year internship, and they must pass national boards. Typically, patients see a benefit after one or two treatments, and a half-dozen visits are usually enough to resolve acute back pain.  If your back pain is accompanied by limb pain, weakness or tingling, loss of bladder or bowel control, or is so sharp it disrupts sleep, it may signal nerve or spinal cord damage that requires an M.D. Ask your doctor for a referral to a good orthopedist or neurosurgeon who specializes in the spine.  An orthopedic surgeon (or orthopedist) treats injured bones, muscles, joints, cartilage, tendons, and ligaments. Despite the title, orthopedic surgeons typically begin with nonoperative treatments, such as physical therapy, massage, and exercise. &amp;quot;Most back-pain patients will get better without surgery,&amp;quot; says Rey Bosita, M.D., an orthopedic spine surgeon at the Texas Back Institute in Plano. If surgery is required, either an orthopedic surgeon or a neurosurgeon can operate.  Your ideal chiropractor is: Board certified and state licensed (check with your Chiropractic State Licensing Board). To find one near you, click on &amp;quot;Find a Doc&amp;quot; at amerchiro.org. Your health complaint: Blue moodYour options:  Psychiatrist or psychologistYour best bet:  Psychologist  Psychologists are Ph.D.&amp;#039;s who practice psychotherapy, or talk therapy, which is proved to be highly effective in treating mild to moderate depression, says John Bachman, Ph.D., interim mental health director for California&amp;#039;s El Dorado County. When symptoms are more severe or recurring, your psychologist may refer you to a psychiatrist, an M.D. who can prescribe antidepressants. But taking a pill doesn&amp;#039;t mean you should take a pass on psychotherapy. &amp;quot;Research has shown that a combo of the two is best for severe or recurrent depression,&amp;quot; says Bachman. Although there are still psychiatrists who perform psychotherapy, the number is dwindling. That means if you want to get at the underlying cause of your depression, you&amp;#039;ll need to stick with your psychologist.   Another option: a licensed clinical social worker (LCSW) or master&amp;#039;s-level counselor or therapist (M.S., M.A.). These mental health providers don&amp;#039;t have the same level of education or training as Ph.D. psychologists, but they typically charge less and many are excellent therapists, says Bachman. &amp;quot;The latest research suggests that the effectiveness of therapy may hinge more on the quality of the therapeutic relationship than on the type of therapy,&amp;quot; says Bachman.   Your ideal psychologist is: State certified (call your State Board of Psychological Examiners to find out), has a Ph.D. in clinical or counseling psychology, and has treated depression in women.  Your health complaint:  Fuzzy visionYour options: Ophthalmologist or optometristYour best bet:  Optometrist  These eye professionals attend four years of postcollege optometry school that&amp;#039;s specifically geared toward learning how to measure vision and prescribe glasses or contacts. But if it&amp;#039;s permanent vision correction by laser surgery you want, ask your optometrist to refer you to an ophthalmologist, and request one who specializes in corneal and refractive surgery. These medical doctors are the only &amp;quot;eye doctors&amp;quot; who can perform surgery on the eyes, including LASIK.   Your ideal optometrist is:  A graduate of an accredited optometry school (look for the initials &amp;quot;O.D.,&amp;quot; which stand for Doctor of Optometry, after his name), and state certified and licensed, credentials you can confirm with your state optometric association by logging on to healthguideusa.org/state_optometry_boards.htm. Your health complaint:  An itchy rashYour options:  General practitioner or dermatologistYour best bet:  Start with your primary care physician  He should be able to diagnose and treat most common rashes. But if your rash persists or recurs, or if there is any blistering or sign of infection (yellow crusting or fever), see a dermatologist, advises dermatologist Bruce P. Robinson, M.D., an assistant clinical instructor at Mount Sinai Medical Center in New York City. These medical doctors diagnose and treat rashes and other skin conditions, including psoriasis, eczema, and skin cancer. If you or your dermatologist suspect your rash is triggered by something you&amp;#039;re eating, it may be wise to consult an allergist. Although both dermatologists and allergists can perform patch tests to identify the source of a contact skin allergy (top culprits are jewelry metals and fragrances), an allergist will run blood and skin tests to determine if your itch is diet-related.   Your ideal dermatologist is:  Board certified and has experience treating your condition (some skin docs are extremely specialized). To find one by location and expertise, try the American Academy of Dermatology&amp;#039;s &amp;quot;Find a Dermatologist&amp;quot; tool at aad.org.   Your health complaint: High cholesterol, diabetes, weight loss...anything diet-relatedYour options:  Nutritionist or dietitianYour best bet:  Dietitian  &amp;quot;Anyone can call themselves a nutritionist -- the title is completely unregulated,&amp;quot; warns Ruth Frechman, R.D., a registered dietitian in Burbank, CA, and a spokesperson for the American Dietetic Association. That means the &amp;quot;nutritionist&amp;quot; working at your gym may be anyone from a highly qualified expert to an amateur with no formal training or education whatsoever. The title &amp;quot;registered dietitian&amp;quot; (R.D.), on the other hand, is reserved for people who have completed a four-year degree in nutrition, plus 900 supervised clinical hours, and have passed a national exam, qualifying them to help manage medical conditions through diet. Some states require that R.D.&amp;#039;s also be licensed.  In general, be wary of anyone who sells dietary products, insists high-dose vitamins or minerals are necessary, or pushes a particular brand. That&amp;#039;s not to say that an omega-3 fatty acid or another supplement is never helpful, says Frechman. But the only thing your dietitian should be trying to sell you on is the benefits of healthier eating.  Your ideal dietitian is:  Registered, state licensed where required, and specializes in your particular dietary issue, whether it&amp;#039;s high cholesterol, diabetes, or weight control. Log on to the American Dietetic Association website (eatright.org) to search for one by location and area of expertise. Your health complaint:  Joint painYour options:  Orthopedist or rheumatologistYour best bet:  Depends on the source of the pain  If your pain is due to exercise, overuse, or injury, see an orthopedist. He or she will perform a physical exam, order any necessary diagnostic tests, and may prescribe pain meds, physical therapy, or surgery. However, if you&amp;#039;re experiencing unexplained pain in multiple joints, visible joint swelling, or morning stiffness, you could have an inflammatory disorder and should see a rheumatologist. They&amp;#039;re trained to recognize and treat tough-to-identify joint conditions, such as rheumatoid arthritis and fibromyalgia. &amp;quot;Rheumatologists have to be medical detectives, because so many of the diseases that we treat are obscure,&amp;quot; says Neil Birnbaum, M.D., president of the American College of Rheumatology.   Your ideal orthopedist is:  Certified by the American Board of Orthopaedic Surgery (see abos.org/directory.aspx) and specializes in the joint causing you pain.Your ideal rheumatologist is:  Certified in rheumatology by the American Board of Internal Medicine (check out &amp;quot;Who is Certified&amp;quot; at abim.org).   How to Manage Your PCP Every doctor is busy, but it&amp;#039;s crucial for your health that your primary care physician (PCP) be someone you can rely on. If yours perpetually runs late, or demonstrates any of the following behaviors, it&amp;#039;s time to switch docs, says Kevin Soden, M.D., author of Special Treatment: Ten Ways to Get the Same Special Health Care Your Doctor Gets.   Red flag:  The doctor has limited office hours and/or tells you to go to the ER if anything comes up while he&amp;#039;s off-duty.Red flag:  The wait for a checkup (a well visit) is several months.Red flag:  He won&amp;#039;t even discuss a new treatment you&amp;#039;ve read about.Red flag:  He refuses to provide patient references.Red flag:  His support staff treats you rudely more than once.   Strange Specialties Think your symptoms are too weird for the average doc to diagnose? Odds are there&amp;#039;s a health pro out there who specializes in treating exactly what you&amp;#039;re going through. To name a few:   Andrologist:  Specializes in male reproductive health and male infertility.Angiologist:  Treats lymph and blood vessel diseases.Hospitalist:  Specializes in caring for hospitalized patients.Psychosomatic specialist:  Consults in cases where a patient&amp;#039;s mental health may be interfering with a medical treatment. Vulvar dermatologist:  Treats skin diseases affecting the vulva, including HPV (genital warts) and vulvar dermatitis. "^^<http://www.w3.org/2001/XMLSchema#string>
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