A primary care provider is a doctor who handles your routine health care. They are the person to see if you need a vaccination, have an upper respiratory infection or require help to manage a chronic health condition such as diabetes.
Your primary care provider also should monitor your overall physical, mental and emotional health. When your health problem requires additional care, the primary care doctor will refer you to a specialist, such as a cardiologist or an ophthalmologist. Primary care providers also are called primary care doctors and primary care physicians.
Although some people use urgent care or the emergency room for their primary care needs, that doesn’t allow you to build a trusted, long-term relationship with one provider, says Dr. James Wantuck, chief medical officer and cofounder of the telehealth platform PlushCare. Wantuck is an internal medicine physician based in San Francisco.
By building a relationship over time, the provider becomes a detective, like a Sherlock Holmes, to find out what’s wrong when something isn’t right with your health.
Types of Primary Care Physicians
There are several types of doctors who work as primary care physicians:
— A family medicine physician cares for the whole person through all stages of life, from infant to older age. They will focus on seeing you as a whole person rather than just one specific health problem, says Dr. Ada Stewart, president of the American Academy of Family Physicians and a practicing family physician in Columbia, South Carolina.
— An internal medicine physician specializes in care for adults.
— A pediatrician cares for children.
— An OB/GYN can be a primary care provider for some women, particularly young, healthy women. However, OB/GYNs specialize in reproductive health and aren’t equipped to handle problems like strep throat, COVID-19 or other problems beyond women’s health. Also, many family medicine and internal medicine physicians will handle routine gynecological care, such as Pap smears.
A nurse practitioner or a physician assistant also can be a primary care provider. These providers work closely with a medical doctor, so if there’s something they can’t do, they’ll refer to their supervising doctor, says Dr. Susan Besser, a primary care provider specializing in family medicine at Mercy Personal Physicians at Overlea in Baltimore. For instance, some states only allow medical doctors to prescribe certain types of medicines.
You also may wonder about the difference between an MD (medical doctor) and a DO for primary care. Both receive similar training, but DOs (short for doctor of osteopathic medicine) also study 300 to 500 hours of osteopathic manipulation, which is a hands-on approach used to treat the musculoskeletal system. Both MDs and DOs commonly work as primary care doctors.
If you have to choose a new primary care doctor because of a change in health insurance, a move or changing medical needs, for example, consider these following tips.
Choosing a New Primary Care Doctor
1. Ask friends or family.
Many referrals to a primary care provider come from friends or family members. Their recommendation can be helpful because that person knows you well.
However, a stamp of approval from a friend or family member doesn’t always mean the doctor is a good match for you. You’ll have different health issues than your friend or family member. Plus, the personality mix of the doctor and patient together is the real key to a successful relationship, says Dr. Ruth Brocato, a primary care provider specializing in family medicine at Mercy Personal Physicians at Lutherville, Maryland. If a friend or family member likes a doctor, ask what they like about that provider. This will help you determine if there’s a potential match for you.
2. Check online reviews.
Online reviews are popular, but they should be a starting point, not the final say, when choosing a new primary care provider. It’s always helpful if you see mostly positive reviews, as that likely indicates the doctor cares about his or her public image. No doctor wants to be the one on a review site with only one star, Wantuck says. However, negative reviews may not always be accurate, and all reviews are anecdotal.
3. Check the doctor’s background credentials.
This is usually easy to find on the practice website. You can use their online information to check the following:
— Is the doctor licensed in your state? You can find out where a doctor is licensed to practice and their education background at the Federation of State Medical Boards website.
— What is the doctor’s specialty: family medicine or internal medicine?
— Is the doctor board certified? Board certification refers to a special exam that doctors can study for and pass after completing medical school, Wantuck says. Doctors aren’t required to complete board certification, but it adds an extra layer of knowledge. Board certification also requires courses that refresh the doctor’s knowledge every few years.
If it’s important to you, you’ll also want to take into account if the doctor is male or female.
4. Ask about health insurance coverage.
You can whittle down costs when you see a primary care provider who’s covered by your private health insurance plan or Medicare or Medicaid. Many health insurance plans will require you to pay a small fee, or copay, for each appointment, and the plan will cover the remaining cost. Insurance plans have online tools so you can verify which local primary care providers accept your insurance.
You can also call your insurance company to find providers in your area. If you find a primary care provider you like, but their office doesn’t accept your insurance, talk to the provider’s staff. They may be able to arrange an affordable self-pay option. The same is true if you don’t have any health care coverage. If you have health insurance, your plan still may pay for a portion of the appointment as an out-of-network visit, Wantuck says.
5. Consider the office location.
How close is the office to your home? Beyond that, find out if there’s parking or if the office is close to a bus or subway line. If you or a family member has special needs, ask in advance if the office has an elevator and ramps for wheelchairs and walkers, Stewart advises.
6. Ask how long it takes to get an appointment.
You can do this by calling the office and simply asking them how quickly it usually takes to get an appointment. You’ll also want to ask if they have same-day appointments in case you get sick and need to be seen urgently.
It also can be helpful to know how the doctor handles after-hours emergencies and non-emergencies, Stewart says. For example, is there another on-call physician, or does the office use an answering service to field nighttime calls? Another consideration nowadays: Does the office have telehealth appointments?
7. When visiting, consider how long your wait time is.
You usually can expect some waiting at any doctor’s office, but you’ll want to make sure you’re comfortable with the average wait time. That comes with a caveat, Brocato says. “Obviously wait time is important, and I aim to be on time, but realize that I may have been delayed because I was comforting a new widow or talking to a parent whose child is struggling in school or even giving a patient a new cancer diagnosis,” she explains.
8. Evaluate how well the primary care provider listens.
This is a huge factor in finding a new primary care provider, Wantuck says. Does the doctor take the time to listen to your concerns? Do you feel comfortable opening up to him or her?
As part of this, find out about their philosophy of medical care to see if you agree with it, Besser advises.
For instance, do they prefer to prescribe medications, or are they more interested in starting with lifestyle changes? Which do you prefer? The doctor’s focus on prevention of chronic diseases, rather than only treating something once a condition develops, also can be important, Brocato says.
If you have a pre-existing condition such as diabetes or high blood pressure, ask if the doctor regularly treats patients with your condition.
Some patients may wish to ask if the doctor regularly treats LGBTQ patients, Stewart says.
9. Take cues from the office environment.
Staff friendliness and office cleanliness can help indicate the type of care you’ll receive.
When choosing a new primary care physician, you can set up a meet-and-greet visit to get a better feel for that person and the office. You’ll find out more information during that visit to help with your decision, Besser says. You also can ask the doctor’s office if they offer a trial period, so you can see over a few appointments if you feel comfortable going there. Even if they don’t formally offer this, you should still be able to look for a new primary care provider when you want to switch to someone new.
As you try to pinpoint the right primary care provider, keep in mind that it’s a collaborative relationship. You don’t want to contact the provider only when you’re sick. Stay in touch for preventive care appointments, immunizations and when you need emotional or mental health support, Stewart says. By staying in touch, the provider gets to know you better, and that helps to build a stronger relationship.
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