Choosing a primary care provider may be one of the most important health decisions you’ll make. Think of your doctor as your partner in health, someone who can help you stay healthy and be there for you in case you need treatment. It’s a relationship that’s likely to last for many years and may even extend to other family members.
Do you need a primary care physician?
Almost certainly. Some plans may require you to choose a primary care doctor to get referrals to specialists. Even if your plan doesn’t, it’s a really good idea.
Patients with a usual source of care are more likely to receive recommended preventive services such as flu shots, blood pressure screenings, and cancer screenings. Research suggests that this relationship translates into better care. A January 2019 analysis of survey results from more than 70,000 adults in the US found that those with primary care received more high-value care than those without, and were more likely to get important preventive care and diagnostic tests, like flu shots and cancer screenings.
Participants with primary care reported significantly better health care access and patient experience; 64% of those with primary care highly rated their doctor’s communication, compared with 54% of those without a primary care provider. Earlier research also showed that regions in the US with a high density of primary doctors also have better health outcomes, lower rates of ER visits and hospitalizations, and reduced costs.
What does a primary care physician do?
How, exactly, does a primary care doctor improve care? Sterling Ransone Jr., MD, a practicing family physician in Virginia, credits the continuous relationship primary care doctors have with their patients, which allows them to quickly notice any unusual changes that may indicate a health problem and treat it early.
“I’ve had a good majority of my patients for over a decade,” he says. “I know them. I know what medicines they take. I know how they normally act. When we see something that’s off, we can pick it up a lot sooner.” He often sees their family members, too, which gives him an even more complete picture of their health. The longstanding relationship he has with his patients also makes them more comfortable sharing sensitive information with him — about substance use or sexual health, for instance — which can also help with detecting and treating problems early.
What’s more, a primary care doctor can help streamline care, which may be especially important if you have a complicated medical issue that requires several different specialists, says Teresa Everson, MD, MPH, a family medicine doctor and assistant professor at Oregon Health and Science University. Besides referring you to those specialists, a primary care doctor “can make sure everyone talks to each other, and that everyone knows what everyone else is doing.” For instance, they can tell the other providers involved in your care what medicines you’re currently taking, so they don’t prescribe you something that could interact badly with any of them, Ransone says.
Finding the right person to fill this role can be a challenge. Where do you start? How do you pick the right one? Here are a few tips for making the decision process a little easier.
How to Choose a Doctor
Try to find someone in your insurance plan’s network. Since most of us want to avoid paying doctors from our own pockets, you can start by calling your health insurance plan or checking their website and searching the list of primary care physicians in your area. Some plans will let you go out-of-network for a higher copay and/or coinsurance.
What to look for in a primary care physician. Everyone else’s favorite doctor may not work for you. Sure, she’s popular and highly skilled, but it might take weeks to get an appointment. Take a moment to list the qualities you value most in a physician.
Provider type. Primary care is a specialty, too. Several actually. Choose a primary care doctor with a background that fits your needs.
- Family medicine. Family practitioners are trained to treat you and your family your whole life, from infancy to old age.
- Pediatrics. A pediatrician is a doctor for kids, from newborns to new adults. They are trained to treat and track physical health, development, and mental health as kids grow.
- Geriatrics. A geriatrician is trained to treat the complex needs of older patients, who may have complicated health issues.
- Internal medicine. Internists focus on the medical needs of adults of all ages. If you are managing a medical condition you might look for an internist with a subspecialty in that field.
- OB/GYN. Obstetricians and gynecologists focus on women’s health, particularly during their reproductive years. But these practices may also offer well-woman visits focusing on preventive care, screening, evaluation, and health counseling.
- Nurse practitioners. These primary care providers are trained to diagnose and treat diseases, and can prescribe medicine, just like doctors. They often focus on prevention and health management.
- Physician assistants. More and more patients are seeing physician assistants who are licensed to practice medicine and deliver primary care under a doctor’s supervision.
Gender and language. You may feel more comfortable seeing a doctor of the same gender. If you or someone in your family speaks limited English, it can also help to have a doctor or nurse who speaks your language.
Convenience. How easy is it to reach the office? How long does it take to book an appointment? Do the hours fit with your schedule? Is the office open on evenings and weekends? Who covers for the doctor when they’re not available? Can you email the doctor?
Affiliations. Which hospital is the doctor affiliated with? Do they belong to a group practice, and if so, who are the other doctors you might end up seeing?
Other services. Can the doctor provide in-office procedures and screenings, like X-rays and lab work?
Do Your Homework
Ask your social circle. If people you know and trust love their doctors, chances are you will, too. Ask friends, relatives, co-workers, and others in your social circle about their primary care doctors, and whether they would recommend them.
Read reviews — with a grain of salt. Doctor ratings, like Healthgrades’ star ratings of providers, are based on data from patients, claims data from government and third party sources, and information from the providers themselves. They collect survey information to help patients understand topics like:
- How likely patients are to recommend the doctor
- How well doctors explain medical conditions
- How well doctors listen to and answer questions
- The level of trust in the doctor’s decisions
- Whether doctors spent an appropriate amount of time with patients
- Staff friendliness
- The ability to schedule appointments
- Wait times
- Office cleanliness and comfort
These ratings may provide valuable insight into respondents’ experience with a provider, but they may tell only part of the story. You might also look at preferred providers from your insurer. United Health has a premium rating that rates providers for quality and cost-efficient care.
“A doctor is such a personal thing,” says Matthew Thompson, MD, MPH, PhD, a professor of family medicine at the University of Washington School of Medicine and a family practitioner at UW Northgate Neighborhood Clinic. “There’s not going to be a perfect way of ranking them. Ranking a doctor is a little different from ranking a restaurant or coffee place. It may be more nuanced than ranking a barista.” That’s especially true for primary care doctors, whose quality of care isn’t based on specific metrics, such as numbers of surgical site infections, he adds. Their patient demographics also vary widely, which also makes drawing comparisons difficult.
Do a background check. Visit your state medical board’s website to make sure the doctor you’re considering is board certified.
Pick up the phone. Once you’ve narrowed your options down to a few doctors, call their offices to confirm they’re accepting new patients and take your insurance plan.
Schedule an interview. In a way, you’re the “hiring manager” — so why not do an in-person interview? Ask the office staff about costs; some providers don’t charge for this type of appointment, while others require a small fee. Some group practices even host open houses that allow you to meet the providers that belong to it.
Scope out the staff. Are they helpful and friendly? Do they make you feel comfortable? Do they explain things clearly and listen carefully to you? Do they treat you with respect?
At Your First Visit — and Beyond
Look for a good listener
Did you feel as if the doctor was truly listening to you? Did they let you ask questions, too? If you had trouble understanding what they were saying, did you feel comfortable asking them to repeat themselves? “You should be able to talk with them and feel like they’re not being judgmental,” Ransone adds. Look for red flags. For instance, “were they distracted, running super late or typing into the computer all the time?” Thompson says.
That said, doctors have bad days, too. While it’s important to take note when a doctor doesn’t feel like a good fit during your first visit, remember that “you’re getting a 20- or 30-minute snapshot of what your doctor’s day is like,” says Isabel Valdez, MPA, a physician assistant and instructor of general medicine at Baylor College of Medicine. Look beyond first impressions. Maybe they’re in a rush because they were working in the hospital all night, and they’re still trying to catch up. Maybe they had to give a patient bad news right before meeting with you, and they’re not their usual cheerful selves. Trust your gut — but consider giving them a second chance if it doesn’t work out the first time. “I think we forget that doctors are humans, too,” Valdez says.
Be willing to compromise. Insurance plans sometimes offer limited choices for primary care doctors, and you might find that many within your network are no longer accepting patients. When faced with limited options, remember, “you’re not looking for a best friend,” but someone who has your best interest in mind as they make recommendations, Valdez says. A warm communication style isn’t everything. Even if your doctor comes across as aloof, they might have excellent clinical judgment. Ransone says he often thinks about this tradeoff when he refers his patients for surgery. “Sometimes I don’t have an option. Maybe there’s just one guy in the state,” he says. “He may not have a good bedside manner, but he’s great technically.”
If you do find someone great, having a relationship with your primary care doctor can pay off in many ways — timely preventive care, better management of your conditions, if any, and possibly even lower medical bills. It’s worth the effort.
MELISSA PANDIKA
Rally Health
