The moving boxes are unpacked, the children enrolled in school and the family photos neatly arranged. Everything is in its place. But what about your family's medical records?

Local experts agree that establishing oneself with a physician before getting sick is one of the most important decisions a person can make.

Upon entering a new community, those with a chronic illness should connect with a doctor right away, said Dr. Michael Zia, vice president of medical affairs and quality for Decatur Memorial Hospital. Those who have been otherwise healthy can wait up to six months to see a physician.

"More and more and more emphasis in our health care system is really on prevention," Zia said.

One of the first issues those looking for a physician should consider is whether local doctors are accepting new patients. Contact either hospital in town, Zia said. Each has a directory and will work to help patients find the right doctor. The Macon County Medical Society also can help patients find out which providers are available, he said.

After determining who is a potential provider, identify individual or family needs, Zia advised. Pick a pediatrician for the children and choose an internist for the adults, or select a family practitioner for everyone.

"To a large extent, that's primarily a personal preference," he said.

Family practitioners treat the family as a unit, he said. Internists are usually focused on adult medicine and frequently have older practices. Some may have extra training or expertise in taking care of aging adults.

It is important to at least determine if the practitioner is a member of the medical staff of one of the hospitals in your community, Zia said.

"If not, ask why not."

The Illinois Department of Professional Regulation can provide some information about any disciplinary action taken against physicians.

"Beyond that, there are an increasing number of Web sites that attempt to create what we would commonly call report cards or scorecards of physicians," Zia said.

Web sites such as Angie's List, at www.angieslist.com, contain patient reviews of doctors. Depending on the insurance carrier or managed care plan, some also have specific information on providers, Zia said.

In making a decision, a person also might want to talk to the doctor's current patients about wait time, bedside manner and other issues of importance.

A final step that very few people actually take is to set up an interview or an appointment to see the doctor face-to-face and ask about the practice, he said.

"I think that is critical," Zia said. "Because ultimately it is an issue of trust in your provider, your doctor and the feeling that your physician is accessible or available and you can communicate with the person."

Fewer people are establishing a relationship with a primary provider, Zia said. Instead, they are using episodic care providers such as hospital emergency rooms or emergency care centers.

Zia and St. Mary's Hospital Chief Operating Officer Theresa Rutherford said there is an advantage in establishing an ongoing relationship with a primary care provider.

"A physician and patient relationship is one of the most important relationships that you will have in your life," Rutherford said. "It can actually be lifesaving, and you need to realize that you and your physician are a team."

The relationship needs to work for the patient, she said. Each person should think about what communication style he or she prefers in a doctor and ask lots of questions when deciding on a physician and at all appointments.

"Don't hold back when it comes to your doctor," she said. "Things that you think may not be any big deal, when you put them together as a larger picture, they're important when a physician is trying to make a diagnosis or determine what type of treatment plan you need to be on."

Don't minimize herbal medications or self-treatments, she said. Be as honest as possible, and share all information up-front and early in a diagnosis.

Ineffective communication can cause a breakdown in medical care because important data can be left out of the diagnosis, Rutherford said. This can prolong illness or delay correct treatments.

St. Mary's uses a system that provides patients searching for doctors with a list of potential providers. A doctor's office will want to know as much about a patient's health insurance as possible. More and more patients also come to appointments having researched symptoms, conditions and treatments, Rutherford said.

"When I first went into nursing or an administrative task, many of our patients let medicine happen to them," she said. "They expected us to do that for them, and now our patients are so much more informed. They bring so much more to the table."

Sometimes an illness will necessitate a trip to a specialist, or a person's needs will change. Patients and doctors should be receptive to those changes, Rutherford said. Your primary care physician can be an excellent starting point if you are seeking to make a change.

"A lot of people are under the impression that once you choose a doctor that that's forever the doctor that you need to keep," Rutherford said.

Time, attention to detail and effort in fostering a positive and meaningful doctor-patient relationship will lead to better health outcomes in the future, she said.

"We sometimes spend more time buying a car than we do deciding on what physician should work for us," Rutherford said. "We need to take it a little more seriously, and don't be afraid to do that interview and ask questions. If it works well for you, it will work well for the doctor."

agetsinger@herald-review.com|421-6968