An important first step after securing the health insurance plan that works best for you is to plan for your well-being with regular checkups. But sometimes jumping from one plan to another means that your former doctor may no longer accept your health insurance...meaning you're suddenly shopping around for a new doctor. How do you go about choosing one? Let's break it down.
TYPES OF DOCTORS
The two main types of doctors are primary care physicians (PCPs) and specialists.
A primary care doctor, also known as a general practitioner, is who you would visit for routine checkups and non-emergency care, especially when symptoms first appear.
Specialists, on the other hand, have a more narrow scope depending on a particular area of expertise; these would include allergists, anesthesiologists, neurologists, psychiatrists, surgeons, cardiologists, etc.
Many health insurance plans require patients to first visit a primary care physician before covering specialist costs. Consequently, the primary care physician serves an important role in the maintenance of a patient’s health and long-term welfare.
THE ROLE OF THE PRIMARY CARE PHYSICIAN
Primary care physicians provide general medical services to specific patient populations and specialize in one of the following areas:
• Pediatric medicine: Pediatricians manage the physical, mental, and behavioral health of infants and children.
• Adolescent medicine: Adolescent specialists meet the health needs of young people roughly between the ages of 11 to 19.
• Internal medicine: Internists provide care to adults, specifically the diagnosis and nonsurgical treatment of diseases.
• Geriatric medicine: Geriatricians are specifically trained to evaluate and manage the unique health needs of elderly adults.
• Family medicine: These physicians provide versatile care for patients of all ages and gender.
• Gynecologists/Obstetricians: Gynecologists focus on women’s sexual health issues, while obstetricians deal specifically with pregnancy, childbirth, and the postpartum period.
PCPs, unlike many other health specialists, get to know their patients intimately over a continuous period of time and are better able to assess what constitutes an aberration from that patient’s norm. Instead of focusing solely on the treatment of a specific organ such as the brain or eye, primary care physicians consider the patient as a whole. Treatment plans are then tailored to meet the individual’s needs based on personal history and mutual understanding.
BENEFITS OF HAVING A PRIMARY CARE PHYSICIAN
The primary care physician often serves as a patient’s go-to medical resource. They seek to understand and evaluate any medical concerns the patient might have in order to provide the best mode of care, whether in-house or through referral to an outside specialist.
Over the course of time, primary care physicians and patients engage in what is called “continuity of care,” which means establishing a personal relationship that develops year after year. Tracking a patient’s health over time allows PCPs to make more informed treatment decisions and manage overall progress and goals.
Keeping a close watch over a patient’s health allows PCPs to better intervene with disease prevention, patient education, health maintenance, and the diagnosis and treatment of both acute and chronic illnesses.
Lastly, the ease of access and communication involved in visiting a primary care physician is unparalleled; the intimacy fostered in such a relationship gives patients the opportunity to better understand and participate in health decisions.
CHOOSING A PRIMARY CARE PHYSICIAN
You will likely discover that the sheer number of PCPs makes the decision process difficult if not overwhelming. Luckily, there are several tips to keep in mind that will help you choose a doctor who best fits your personal needs.
• Ask around: Consider asking for referrals from friends, family, and coworkers. Many patients feel more comfortable visiting doctors that are recommended by trusted sources. Additionally, other people (or websites) can help you pinpoint what you are looking for in a provider. The more you know about a doctor increases the likelihood that you will find the one that is right for you.
• Know your insurance: Consult your health insurance benefits to determine which doctors are “in-network.” It is common for insurance plans to provide a directory of in-network providers whose discounted rates have been negotiated beforehand by your health plan. Often, out-of-network doctors require patients to pay for services in full, so do yourself a favor and make sure your PCP is willing to work with your health insurance.
• Understand availability: Not all primary care physicians accept new patients, and even doctors with availability may have hours that conflict with your schedule. Additionally, some doctors are responsible for more patients and require longer wait times to schedule an appointment. Reach out to a doctor beforehand just in case.
• Evaluate qualifications: Like all professionals, you want your doctor to be an authority in their field with an education and background that reflects competency. Check online or through the doctor’s office to see if the doctor is board-certified in the field(s) that you are visiting them for. You may also want to consider hospital affiliation if you already have a trusted provider.
• Plan logistically: If you have a specific condition like diabetes, you may want to choose a PCP who has specialized training or experience in endocrinology. Spend some time contemplating the distance required to travel to the doctor’s office, if the office hours are convenient for you, whether or not the doctor can understand you preferred language, if gender and age matter to you, etc.
• Look for compatibility: Many patients schedule preliminary interviews with potential doctors to determine compatibility. Try to see the first visit as a trial run, and do not underestimate the power of gut-feeling. Does the doctor explain things clearly and listen without interrupting? Is the doctor relatable or more formal than your liking? Can you tell if the doctor prefers aggressive treatment or a more prolonged wait-and-see approach? Is the doctor quick to refer patients to outside specialists, or do they prefer to handle care in-office?
All of these questions and more will help prepare you to best weigh your options when choosing a primary care physician.