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Choosing a Primary Care Provider

What is a primary care provider?

A primary care provider (PCP) is your main source for general medical care. When you need a specialist, such as a surgeon, urologist, or psychiatrist, your PCP may refer you to one. Many specialists will not accept patients unless they are referred by a PCP. Insurance companies may not pay for a specialist's care without a referral from a PCP.

Choosing the right PCP for you is an important decision for you and your family. This person will:

  • Provide preventive care such as physical exams, blood tests, and vaccinations
  • Teach healthy lifestyle choices
  • Diagnose and treat common medical problems
  • Provide support and counseling during times of stress or grief
  • Refer you to medical specialists when necessary

After medical school many healthcare providers do a residency in a specialty, such as family practice or internal medicine. This typically involves 3 or more years of training in the specialty.

The main types of primary care providers are:

  • General practitioners have completed an internship but not a residency. An internship is the first year of training after medical school. They see patients of all ages.
  • Family practice physicians have done a residency in family practice and most care for patients of all ages.
  • Internists specialize in diseases of adults.
  • Pediatricians have special training in the medical care of children and teens.
  • Obstetrician/gynecologists have done a residency in pregnancy and female medical problems and see women only.
  • Geriatricians specialize in the care of older adults.
  • Nurse practitioners and physician assistants have different preparation and licensing than doctors and may specialize in children, adults, older adults, or women.

Physicians may have either an MD or a DO degree. The main difference is that doctors of osteopathy (DO) are trained in hands-on manipulation to treat joints, muscles, and bones. Both DOs and MDs take the same licensing exams to become licensed to practice medicine.

How do I start my search?

If you belong to a health plan, your choice of healthcare providers may be limited to providers that are included in the plan. Check the plan's list of primary care providers.

Ask for referrals from friends, coworkers, or pharmacists. If you are moving, ask your current provider to recommend someone in your new location. Local medical societies usually have a referral service and will give you names based on your location or the type of provider you need. Some hospitals may give you names of providers to consider.

What should I check?

Check on the provider's credentials. Board-certified primary care physicians have received at least 2 additional years of residency training beyond an internship in a medical specialty. They have also passed a national board exam. Physician assistants and nurse practitioners may also be certified by passing a national exam and completing certain education requirements. Check on certification by calling the local medical society or state board of nursing. The state's medical licensing board can tell you if a provider's license is current or if it has expired.

Look for a provider in a convenient location. Your PCP should be fairly close to home or work. Contact the provider's office and ask if they are accepting new patients. Ask about office hours and appointments, payment policy, and insurance coverage. Schedule an interview to meet and get to know the provider. This will give a clear idea of the provider's approach. While at the office, notice how the office looks and how patients are greeted. Expect courtesy, respect, dignity, and responsiveness. Be prepared to discuss your special needs and to pay for this office visit.

What questions should I ask?

Ask questions such as:

  • Which insurance plans do you accept?
  • At which hospitals do you have staff privileges and admit patients?
  • Do you practice alone, or are you part of a group?
  • Who provides care for your patients after hours or when you are out of the office?

After your visit, ask yourself:

  • Was I treated courteously?
  • Were all of my questions answered?
  • Did I feel rushed or dismissed?

Don’t be tempted to make a quick decision. Make the choice when you are healthy, not sick.

Developed by RelayHealth.
Published by RelayHealth.
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