“Your health is your wealth.” Anyone who’s ever been sick or injured knows how true this is. No matter how positive your life circumstances are, it’s hard to be happy when you’re burdened with the discomfort and worry of being unwell.
If your health is as important as wealth, you’ll want to spend at least as much time selecting your doctor as you would spend selecting your accountant. Yet many people choose their primary care doctor at random from their insurance company’s provider list. Worse yet, many people don’t have a primary care physician at all! There are plenty of reasons to sign on with a primary care doctor, and a few simple ways to find the best one you can.
Not so long ago, your doctor would come to your house when you got sick. Just a few decades later, the world of healthcare, and of doctor-patient relationships, is vastly different. Today, you may pop into an urgent care clinic or even just teleconference with a nurse practitioner when you get sick. We live in a time when the relationship between patients and primary care physicians seems to be declining. In fact, over 22% of percent of Americans at any time don’t have a designated primary care physician, according to the National Academies of Sciences, Engineering, and Medicine..
But if this has come to seem like the normal state of affairs, it’s not a healthy one. People without a primary care physician are less likely to get annual physical exams, less likely to get prescriptions filled, and less likely to get important screenings like mammograms, colonoscopies and necessary high-value tests like MRIs, according to research published in The American Journal of Medicine. And making more primary care physician visits is correlated with fewer costly and time-consuming visits to specialists, hospital stays, and fewer unnecessary tests, according to a survey of over 500 patients. But the benefits of having a primary care physician go beyond better health, and some of them may surprise you.
But before you can start reaping the rewards of a relationship with a primary care doctor, you’ll have to understand what one is and where to find one. Our guide to choosing a primary care physician can help you get started on your path to better health.
What is a primary care physician?
Your primary care physician is the hub of your medical care team. They provide general care and make referrals to specialists to address specific conditions, injuries, etc. So many people are surprised that there are several kinds of primary care physicians. In fact, there are three types of doctors that qualify as primary care physicians. Which you choose will depend on your family and healthcare needs.
Family Practice: Family practitioners are qualified to treat patients of all different ages, from infants to the elderly. As generalists, they can handle pediatric, adult, and geriatric issues. They can also treat conditions that you might otherwise have to see a specialist for, such as some women’s health issues, sports injuries, or skin problems.
Internal Medicine: Doctors of internal medicine, AKA internists, are physicians who provide care for adults. Doctors of internal medicine can diagnose, manage, and help prevent chronic illness, conditions, and diseases.
General Practice: General Practice physicians, AKA general practitioners (GPs), treat people of all ages and genders, just as family physicians do. This category also includes osteopaths, doctors who practice alternative medicine focused on the skeletal and muscular systems.
What does a primary care physician do?
Every team needs a manager. You can think of your primary care physician as the leader of your medical care team. Another way to think of the role of your primary care physician is as the homeroom teacher, who serves as the hub of a student’s academic experience. Your primary care physician maintains a relationship with you over time, and oversees your medical care through the following functions:
- They perform your routine annual physical exams, recording your health stats and changes over time, and performing routine screenings.
- They treat your illnesses and injuries, assess symptoms, run tests and diagnose new conditions.
- They make referrals to specialists as needed to diagnose and treat specific medical needs and conditions outside the scope of normal practice. A primary care physician may refer you to an allergist to address your persistent hay fever, or to a physical therapist to help with your lower back pain.
Benefits of having a primary care physician
In this era, most of us opt for the convenience of an urgent care or walk-in private clinic when health concerns pop up. Certainly, no one wants to wait days (or weeks!) for an appointment to treat a UTI, flu, or sinus infection. But there are some real- and surprising- benefits to finding a primary care physician. Having a primary care physician can save you time, save you money, and even save your life.
A primary care physician will get to know you and your health in-depth. They’ll ask you detailed questions about your medical history and that of your family. They’ll learn about procedures and health problems you’ve had in the past. They will ask about your current health, symptoms, and goals. Your primary care physician will even screen you for behavioral health concerns, including anxiety and depression. In short, they will look out for your long-term physical and emotional health.
You can’t talk to a stranger as easily as an old friend, can you? Your primary care physician should be someone you see month after month and year after year, who knows your family and personal medical history, and who understands your health goals and concerns. You’ll also be able to develop a rapport in this long-term medical relationship; a good physician should have a bedside manner that allows you to feel heard and inspires trust. Open communication does more than make you feel good. You and your primary care doctor’s questions and responses can uncover health issues that might go overlooked in a more cursory acute-care setting like a walk-in clinic. You’ll also be able to bring up important but sensitive medical topics with a trusted primary care physician, such as sexual wellness and substance use.
Compared to the convenience of a walk-in clinic at a major pharmacy chain or a Skype session with a nurse practitioner, seeing your primary care physician in their office may not seem like a timesaver. But your primary care doctor’s knowledge of your health can actually save you time in the right situation. For instance, they may be able to authorize a prescription for you after speaking with you on the phone about your symptoms, based on their knowledge of your medical history. They may also be able to treat multiple routine health concerns in the same visit, such as diagnosing a rash, delivering a flu shot, and writing a prescription for migraine medication.
A primary care physician can save you money in more ways than one. As noted above, a primary care physician can take care of multiple health concerns in a single visit, since they specialize in general care, and since appointments with them are typically longer than appointments at a walk-in clinic. That can mean fewer office visits, and therefore fewer copays. And your annual physical exam, including preventative care like vaccines, at the office of a primary care doctor is completely free under most health insurance plans.
If you’re relying only on an urgent-care doctor to treat your acute illnesses as they pop up, you’re not addressing the bigger picture. A car needs the occasional tune-up to uncover and correct issues before they lead to a roadside breakdown, and your body needs the same preventative care. Your annual physical exam is your primary care doctor’s chance to assess the state of your health and head off health problems. Because you and your primary care doctor will have a long-term relationship, they will know you well enough to note changes in your health over time that could be cause for concern or investigation. That’s probably why, as research shows, people who live in areas with greater access to primary care doctors are less likely to die early from conditions like heart disease, diabetes, and cancer.
Steps to choosing a primary care physician
You probably wouldn’t choose your next restaurant or shoe store at random from a list. So why would you visit the first primary care doctor whose name jumps out at you on your insurance company’s provider directory?
For a decision this important, you’ll need to be strategic and put in a little footwork. In looking for a primary care physician, you’ll want to find someone you can see yourself sticking with for years to come, someone who is convenient, easy to work with, and who provides excellent comprehensive care.
Finding that person, though, can feel overwhelming, especially when most provider directories give you little information to go on. The following seven systematic steps can make researching and choosing a primary care physician easier.
1. Start with your insurance company website
Insurance companies love preventative care. Your insurance company makes a higher profit when you stay healthy, and so they actively encourage subscribers to see a primary care doctor, even making annual physicals, flu shots, and other vaccines free. Your insurance company should have a list of in-network primary care physicians on their website that’s easy to find, sort, and search. This will be your jumping-off point. Some plans, especially basic ones, offer a small network, while higher-coverage p[lans tend to give you a bigger range of choices.
Be absolutely certain that a primary care provider you’re considering is not only in-network for your insurance company but also in-network for your plan. Some health insurance plans only cover select providers within the larger network- check their page for this designation and also confirm with the provider’s office before booking- accidentally seeing an out-of-network doctor can be very expensive! The same goes if you’re a Medicare or Medicaid subscriber- be sure your prospective primary care physician will accept your plan before making an appointment.
2. Narrow by neighborhood
Convenience is king. If you want to build a long-term relationship with a primary care doctor, and continue seeing the same person for years, you really won’t want to continually drive an hour each way to appointments. This is doubly true if you’re not feeling well. Look for a doctor with an office located near your home, office, your child’s school, or some other place that’s convenient for you. Think about distance, traffic, and parking.
Many health insurance companies allow you to see your in-network primary care provider results laid out on a map, so you can select one that will be easy to get to. When you call to make an appointment, be sure to ask which days your prospective primary care physician is in the office. Some primary care doctors work from different locations of different days of the week, and this is often not reflected in the address that’s listed on an insurance company’s website.
3. Choose area of specialty
As we’ve noted above, there are different kinds of doctors who can serve as your primary care physician. Consider which of these types of primary care doctor makes the most sense for you. Perhaps you’d like for you, your partner, and your kids to all see the same doctor; you’d want to make an appointment with a family physician. If you have a chronic condition like diabetes or asthma, on the other hand, you may want to look for a doctor of internal medicine.
Your insurance company will list a provider’s type on their profile page, and may include information on other areas of specialty they may have, such as women’s health. You may also want to look for a doctor who’s affiliated with a large medical center, since primary care physicians in a hospital-based practice can easily make referrals to providers in the same medical center and can easily share records and communicate with the rest of a hospital-based team.
4. Look for referrals, reviews, and recommendations
This is the toughest step in finding a primary care physician. Once you’ve narrowed down your potential primary care providers by neighborhood and specialty, you’ll want to figure out which of them might be a good fit for you. If you have family and friends in town, you can ask if they know any of the doctors on your list. If you already have a doctor you see for specialist treatments, such as a chiropractor or cardiologist, try asking them for a referral. A recommendation from someone you know personally is ideal, since you can trust the referral source.
Another option is to turn to the internet for reviews and ratings. Doctor’s offices are businesses, and that means Yelp has no shortage of reviews of primary care physicians. Healthgrades operates like Yelp, awarding stars based on service quality alongside user reviews, but specifically covers healthcare providers. On this website, you’ll find listings for each doctor that include their school and residency site and dates, board certifications, specialties, as well as a statement from the provider themselves about their treatment philosophy. User reviews can give you useful insights into the quality of care they provide, as well as how their office and billing departments operate. Vitals is another large and popular reference website for physicians, which also posts user reviews and background information on doctors and their practices. Be a savvy researcher and read review carefully- look out for those that sound too effusive or too disgruntled, and be skeptical of any that don’t sound credible.
5. Evaluate the ease of office communication and scheduling
A great doctor that’s impossible to get hold of is… not great. You’ll want a primary care doctor whose staff is as good as they are, and who’s easy to interface with. When you search listings and start reaching out to offices, look at your prospective doctor’s office hours. Ask if there’s a nurse or nurse practitioner on staff who can answer routine medical questions. Ask if someone will be on call after hours (heads up- there’s usually an extra charge for calls outside of office hours).
Many doctors, especially those affiliated with hospitals, have an online portal where you can send online messages to request prescription refills and ask non-urgent medical questions. Most allow you to fill out paperwork ahead of time online, saving time at the office. Take note of how quickly your call is returned, how soon your appointment is scheduled, and how courteous the office staff is. You can’t judge a book by its cover, of course, and a great primary care physician may have a brusque or crabby office staff member. But a doctor’s office does reflect on their practice, and the way the people working the phones and booking the appointments treat you can tell you a lot about the doctor’s concern for their patients.
6. Judge their thoroughness and knowledge firsthand
On your first visit, you may be getting a physical exam, but you’ll also be examining your doctor. Do they seem to have read through your paperwork ahead of your meeting, and come in knowing your name and basic health stats? Do they ask meaningful medical questions and take down a thorough medical history? Do they suggest appropriate lab work, vaccines, and follow-up care? Do they rush through your exam? Do they give you a chance to ask questions?
Try to subjectively assess the quantity and quality of attention your prospective primary care physician seems to be paying to you. Notice whether they seem knowledgeable about medical issues that are of social concern to you, whether that means cancer prevention or sleep issues. If they can’t answer a question you have, do they seem dismissive or commit to looking into it and getting back to you to address your concern? Do they bring up current research to support their medical advice? With their training and status, it can be easy to defer to doctors as the experts in charge of your medical care, rather than evaluating them as you would any other service provider, like a mechanic or contractor. Keep in mind that you get to make the final judgment call about whether to trust this professional with your health, and look for indicators of their competence and quality.
7. Decide if you have a rapport
Bedside manner matters. According to an article in the American Journal of Medicine, doctors who understand the personal narrative of their patients are able to provide medical care. A doctor-patient relationship that is strong and open will result in better communication on both sides, which has an obvious and positive health impact. You’ll also want to feel that you can trust your primary care doctor, and to be comfortable enough to ask medical questions that may be sensitive, from sexual health to gastrointestinal concerns.
You may have an immediate sense of rapport with your prospective primary care physician, or you may need some time to get to know them better before deciding if this is someone you’d like to work with. There are a few basic interpersonal qualities to look for in a prospective primary care doctor. Do they reassure you and put you at ease, while still delivering information honestly and directly? Do they encourage you to ask questions about your health care or their own practices? Do they explain technical things like lab results and vital stats in plain English, and tell you what they mean in terms of your health? Do they project a non-judgmental attitude? Do they involve you in decisions related to your medical care, instead of giving you directions from a poison of authority? Decide if this is a doctor-patient relationship with long-term potential, and trust your gut.