What is Primary Care?

A primary care provider (PCP) is your main provider for general medical care. When you need a specialist (such as a cardiologist, dermatologist, or psychiatrist), your PCP will refer you to one. Many specialists will not accept patients unless referred by a PCP. Also, many insurance companies will not pay for specialist’s care without a referral from a PCP.

The main types of primary care providers are:

• Family practitioners (have completed a family practice residency and are board-certified, or board-eligible, for this specialty. Family practice physicians see all ages.)

• General practitioners (have completed an internship but not a residency, and see all ages)

• Geriatricians (specialize in older adults)

• Internists (specialize in adults)

• Nurse practitioners and physician’s assistants (have different preparation and licensing than doctors and may specialize in children, adults, older adults, or women.)

• Obstetrician/gynecologists (see women only).

How do I start my research?

If you belong to a health plan, your choice of health care providers may be limited to providers that are part of the plan. Check the plan’s list of primary care providers.

Ask for referrals from friends, colleagues, pharmacists, or the county or state medical society. If you are moving, ask your current doctor to recommend someone in your new location. Local medical societies usually have a referral service and will give you names based on your geographical area or the type of doctor you need. Some hospitals may give you names of providers to consider.

What should I check?

Check on the provider’s credentials. Board-certified physicians have received additional training (up to 7 years) in a medical specialty and have passed a national board exam. Some providers use the term "board eligible" for the first year or two after training before taking the exam. Beware of providers who use it continually, because they have never passed the exam. Check on certification by calling the local, county, or state medical society. The state’s medical licensing board can verify whether the provider’s license is current or expired.

Contact the provider’s office and ask if they are accepting new patients. Ask about office hours and appointments, location, payment policy, and insurance coverage. Schedule an interview to meet and get to know the provider. This will give a clear idea of the provider’s approach. Is the office in a convenient location? Your PCP should be fairly close to home or work. While at the office, notice how the office looks and how patients are greeted. Expect courtesy, respect, dignity, and responsiveness. Be prepared to discuss your special needs, to pay for this office visit, and to ask questions such as:

• Which insurance plans do you accept?

• At which hospitals do you have staff privileges and admit patients?

• Do you practice alone, or are you part of a group?

• Who provides care for your patients after hours or when you are gone?

After following these steps, ask yourself:

• Was I treated courteously?

• Were all of my questions answered?

• Did I feel rushed or dismissed?

Choosing the right PCP is a decision that will affect you and your family for quite a while. This person will:

• Provide preventive care such as physical exams, blood tests, and vaccinations.

• Teach healthy lifestyle choices.

• Diagnose and treat common medical problems.

• Refer you to medical specialists when necessary.

Do not be tempted to make a quick decision. Make the choice when you are healthy, not sick.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Copyright © 2004 McKesson Health Solutions LLC. All rights reserved.