Choosing a primary care provider

Definition

A primary care provider (PCP) is a health care practitioner who sees people that have common medical problems. This person is usually a doctor, but may be a physician assistant or a nurse practitioner. Your PCP is often involved in your care for a long time, so it is important to select someone with whom you will work well.

Alternative Names

Family doctor - how to choose one; Primary care provider - how to choose one; Doctor - how to choose a family doctor

Information

A PCP is your main health care provider in non-emergency situations. Your PCP's role is to:

• Provide preventive care and teach healthy lifestyle choices
• Identify and treat common medical conditions
• Assess the urgency of your medical problems and direct you to the best place for that care
• Make referrals to medical specialists when necessary

Primary care is usually provided in an outpatient setting. However, if you are admitted to the hospital, your PCP may assist in or direct your care, depending on the circumstances.

Having a primary care provider can give you a trusting, ongoing relationship with one medical professional over time. You can choose from several different types of PCPs:

• Family practitioners -- doctors who have completed a family practice residency and are board certified, or board eligible, for this specialty. The scope of their practice includes children and adults of all ages and may include obstetrics and minor surgery.
• Pediatricians -- doctors who have completed a pediatric residency and are board certified, or board eligible, in this specialty. The scope of their practice includes the care of newborns, infants, children, and adolescents.
• Internists -- doctors who have completed a residency in internal medicine and are board certified, or board eligible, in this specialty. The scope of their practice includes the care of adults of all ages for many different medical problems.
• Obstetricians/gynecologists -- doctors who have completed a residency and are board certified, or board eligible, in this specialty. They often serve as a PCP for women, particularly those of childbearing age.
• Nurse practitioners (NP) and physician assistants (PA) -- practitioners who go through a different training and certification process than doctors. They are often referred to as "physician extenders." They may be your key contact in some practices. All PAs or NPs consult with physicians.

Many insurance plans limit the providers you can choose from, or provide financial incentives for you to select from a specific list of providers. Make sure you know what your insurance covers before starting to narrow down your options.

When choosing a PCP, also consider the following:

• Is the office staff friendly and helpful? Is the office good about returning calls?
• Are the office hours convenient to your schedule?
• How easy is it to reach the provider? Does the provider use email?
• Do you prefer a provider whose communication style is friendly and warm, or more formal?
• Do you prefer a provider focused on disease treatment, or wellness and prevention?
• Does the provider have a conservative or aggressive approach to treatment?
• Does the provider order a lot of tests?
• Does the provider refer to other specialists frequently or infrequently?
• What do colleagues and patients say about the provider?
• Does the provider invite you to be involved in your care? Does the provider view your patient-doctor relationship as a true partnership?

You can get referrals from:

• Friends, neighbors, or relatives
• State-level medical associations, nursing associations, and associations for physician assistants
• Your dentist, pharmacist, optometrist, previous provider, or other health professional
• Advocacy groups -- especially to help you find the best provider for a specific chronic condition or disability
• Many health plans, such as HMOs or PPOs, have websites, directories, or customer service staff who can help you select a PCP who is right for you

Another option is to request an appointment to "interview" a potential provider. There may be no cost to do this, or you may be charged a co-payment or other small fee. Some practices, particularly pediatric practice groups, may have an open house where you have an opportunity to meet several of the providers in that particular group.

If you do not currently have a primary health care provider, and a health care problem arises, it is usually best to seek non-emergency care from an urgent care center rather than a hospital emergency room. This will often save you time and money. In recent years, many emergency rooms have expanded their services to include reasonably priced urgent care within the emergency room itself or an adjoining area. To find out, call the hospital first.

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References

Martin JC. The Future of Family Medicine: a collaborative project of the family medicine community. Ann Fam Med. 2004;2(1):S3-S32.

Carryer J, Gardner G, Dunn S, Gardner A. The core role of the nurse practitioner: practice, professionalism and clinical leadership. J Clin Nurs. 2007;16:1818-1825.

Staton FS, Bhosle MJ, Camacho FT, Feldman SR, Balkrishnan R. How PAs improve access to care for the underserved. JAAPA. 2007;20:32, 34, 36 passim.

Gourevitch CE. Medical homes: challenges in translating theory into practice. Med Care. 2009 Jul;47(7):714-22.