What is a primary care provider, why do I need one, and how the hell do I find one?
Contacting a primary care provider (PCP) or a primary medical doctor (PMD) is a great first move when you need a new health issue addressed or if you want preventative care and guidance. These are the professionals you want to have a great relationship with. You should not settle for seeing an absolute jerk of a doctor, regardless of how great he or she may be. Getting effective medical care from a professional should not be like a fast-food drive thru or vending machine. You cannot hit a button related to your problem and expect a bag of magic pills, at least most of the time. So why should you invest in your relationship with a PCP? The answer would be continuity! Just like how your social media apps get better at reading your mind based on your activity, your medical care tends to improve when a professional follows you for enough time.
So what kinds of primary care providers are out there? Internists usually see patients above 18 y/o and pediatricians below 18 y/o. Family medicine docs see patients of all ages and are the true jack-of-all-trades in the medical field. Ladies can designate a gynecologist as a PCP, but in some cases insurance plans may place restrictions on doing that. Check if your health plan makes you pick an internist or other traditional PCP instead. Older patients with chronic and/or several complex issues may also consider a geriatrician as a PMD.
Even though you will hear me say that you need a doc for this and a doc for that, the patients considering themselves to be perfectly healthy may find a better match with a different healthcare professional like an FNP instead where the patient can have various primary needs addressed but can still get referred to a specialist when needed. It is more important to strike a balance: make sure to have a medical provider who has both expertise and professional courtesy.
According the Kaiser Family Foundation, there are around 495k active PMDs in the US as of September 2021. In our country of over 330 million people, it should be no surprise that low supply makes it hard to get scheduled with any doctor, let alone a good one. About 25% of those PMDs are in CA, NY, and TX alone.
So how can you find a reasonable PMD? Most websites and forums will tell you to seek out friends/family or use your insurance plan’s directory. While these sources are nice, not everyone is fortunate to have family in good medical hands already and health plan directories themselves may not be up to date (plug BCBS, UHC, Healthline source here).
Let me make this easy: crack open google maps and type ‘internist/pediatrician near me’ or write ‘internist/pediatrician in [insert your town here].’ Convenience to medical care should matter just as much as how solid a professional’s advice may be. Even when your insurance company requires you to designate a PCP, you can seek out whatever prospects are reachable. Go check out the map listings, scroll past the ads, and certainly read some reviews. But don’t stop there! If you want another sophisticated tool to complement your impeccable google search, see Medicare’s physician comparison site, which is also linked on my Substack’s resource page (at rushinagalla.substack.com).
Now for the good part: it is better to hear things from the horse’s mouth and actually contact the prospective medical offices you see on your computer screen. Good offices want to have nice conversations with new patients and are usually willing to go over all the nuances with you. There is no reason to be shy. Let me give you a few basic questions to ask for improving your screening process.
Here’s the first thing to open up with: do you take new patients? If you get a ‘yes’ then you should follow up with asking what to expect with the first consultation. Given that you are new, there is more history for the PCP to collect. Some physicians give new patients more time for the opening visit or change the overall structure of the appointment. The office’s response to describing how new patients are treated should matter in your screening process.
The next thing to cover is this: does your physician have experience treating the condition I have? Your expectations here would vary based on your social, personal, and family history, but understanding if a prospective doc has been treating patients with certain conditions for X number of years is a great thing to know regardless. We know already that PCPs treat you for a wide variety of conditions—that being said, we all know what an iPhone does but we still check what the features and specialties are for each new generation. This is why it is helpful to know what kind of tilt a prospective doctor has.
Now it would be reasonable to ask another necessary question now rather than later: does your doctor and facility take my insurance? Although you should expect a yes or no answer to this, you should remember that there are a gazillion variations of plans under each insurance network. This is why it is best to have your insurance card handy when you ask that question to clarify what specific health plan you have. You are now making the office staff’s job and your screening process easier.
The last effective question to ask, which tends to be overlooked, is: Can I get labs and tests performed at the clinic itself? When your new PCP gives you some orders to fill you do not want to realize right then that you need to go to another facility to get additional medical care taken care of. Some primary care facilities are fully equipped to have a test drawn on site but it is easy to know for sure when you ask about their setup over the phone. If all of the aforementioned questions are answered to your satisfaction, it is worth scheduling a visit. Now you have made it through the first major hoop in screening your PMD prospects. It is important to do your research here because you are, ideally, going to see your PCP once a year to stay on top of things. If you wait until a busy season like the end of the year to squeeze in a physical, you will not get to the clinic in a timely manner. Leaving a 6-month calendar reminder on your phone to schedule a visit later makes this part easier.
Let’s say you make it to the clinic in a reasonable time frame, like within a month or two of your initial phone call, for a regular physical and you are chilling in the waiting room. At this moment you are more likely to check your crypto wallet or social media newsfeed than to think up some questions for your doc. In the next episode, I’ll fill you in on simple tips and tricks to get the most of your routine visit even if you’re fit as a fiddle.
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