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Summary

Your primary care doctor (also known as a "primary care physician" ,"PCP" or "family doct or") is a critical member of your health care team -- no matter how many other doctors you see.

What a Primary Care Physician Does: These days, a primary care doctor has two basic functions:

  • A medical and health repair person who helps to eliminate ailments or manage ailments that cannot be eliminated. 
  • A medical coach to help prevent or head off medical problems before they happen.
  • In taking care of these functions, a PCP:
    • Takes care of the whole you,not just a particular ailment.
    • Gets to know you, your life, your genetic predispositions and your values.
    • Recommends specialists for medical matters beyond his/her expertise.
    • Oversees and coordinates your care.
    • Helps you sort through medical information.
    • Helps you make a decision about treatment if your best course of action isn't clear.
    • Recommends changes in your lifestyle to help prevent future medical problems. He or she also helps motivate you and encourages you.

How To Choose A PCP: A primary care doctor is too important to your health and overall well being to choose one just because a family member or friend likes him or her, or who has an office close to your work, or by looking in the yellow pages. Think about the time you spend picking out a car: the research you do, the people you talk to, and the thought you give it. Isn't your health more important? Your life?

Whoever your doctor is, the more you participate in your health care, the better the outcome is likely to be. Indeed, a partnership with your physician provides the best  long term results.

Consider the following steps, each of which are described in other sections of this article:

Step 1. Decide what kind of doctor you need as your primary doctor. For example, an internist (a doctor who specializes in family medicine) or, if you are a woman, an obgyn.
Step 2. Decide what to look for in a doctor. At the least, you need a doctor who can work with the variety of specialists you are likely to work with over time.
Step 3. Locate a doctor who fits your criteria, including insurance and/or financial criteria.
Step 4. Check the doctor's quality. It's easy to do.
Step 5. Spend a few minutes with the staff.
Step 6. Interview the doctor.
Step 7. Review all you've learned and make a decision.

Don't expect to have a full blown relationship with a doctor after one visit. It will take more than one visit for you and your doctor to really get to know each other and begin to develop a working relationship.

If you have a spouse or significant other, consider both of you seeing the same doctor, or at least doctors in the same group of doctors. It can help the doctor get to know you better.

Learn how to maximize your time with your doctor, when and how to ask for second opinions, how to overcome bumps in the relationship with a doctor, what to do if you are considering switching doctors and how to end the relationship if necessary.

If you cannot locate or afford a primary care doctor, consider using a nurse practitioner, or, if you can find one, the new category of nurses known as "Doctor of Nursing Practice."

  • A Nurse Practitioner genearlly has an MS degree, a Registered Nurse license and a Nurse Practitioner license. He or she has authority to write prescriptions, and to receive Medicare/Medicaid reimbursement.
  • A Doctor of Nursing Practice is a new category of nurses. A DNP has a doctoral degree. DNPs have authority to write prescrptions and to obtain reimbursement from Medicare/Medicaid. There is a growing recognition for payment by commercial health insurers. Hospital medical boards are granting admitting privileges.

Step 1. Decide What Kind of Doctor You Need

The different types of doctor who people use as primary care doctors are:

General Practitioner

The old fashioned doctor, a "jack of all trades."

Family Practitioner

Similar to general practitioners, with extra training to focus on health care for all family members, regardless of age.

Geriatricians

A doctor who specializes in the care of older adults. A geriatrician is trained in family practice or internal medicine, with additional training in caring for older people.

Internist

A doctor who specializes in adults. Some internists take additional training to become specialists. For example, cardiologists are internists who specialize in diseases of the heart.

OB-GYN

A specialist in female problems, or what happens below the waist. Many women believe that they get all the general medical care they need if they see an OB-GYN once a year. Keep in mind that such a specialist doesn't care for the rest of your body. Conventional wisdom is that women should also have another doctor as their primary care doctor.

Oncologist

A specialist in treating cancer. Some oncologists also act as Primary Care doctors. Experts suggest that an oncologist who also acts as a primary care doctor is of great value for a cancer survivor because the doctor can treat your overall health, while looking for any signs of worsening or recurrence of your cancer -- including signs that a doctor who is not a cancer specialist may miss.

HIV Specialist

Many people with HIV use their HIV specialist as a primary physician. HIV has become like a chronic condition. Symptoms run the gamut and many symptoms could appear to be both general population conditions like the flu and HIV complications.

Step 2. Decide What To Look For In A Doctor

Factors to consider when choosing a primary care physician follow. While the factors to consider are, in general, the same with respect to choosing any type of doctor, which factors are important to you may differ depending on the particular doctor's role in your life. At the least, keep in mind that you will likely be working with a variety of specialists over time because of your diagnosis. Your primary care doctor needs to be able to work with those specialists - and possibly coordinate them on your behalf.

  • Board Certification: Certification by the American Board of Medical Specialties is evidence that the doctor has received the proper training, performed the specialized residency, and has passed an extensive examination directly related to a specific condition and/or medical specialty. It does not certify the amount of a doctor's experience with your particular condition. To learn more, see www.abms.org offsite link
  • Hospital Affiliation: Doctors can only admit patients to hospitals if the doctor has an affiliation with that hospital. The better the hospital with which the doctor is affiliated, the better the doctor is likely to be. Hospitals check background and quality on an ongoing basis.
  • Medical School: Do you care in which country the school is located, and about the name of the school?
  • Payment: If you have health insurance, does the doctor accept it? If you don't have health insurance, is the amount of the doctor's charge an issue?
  • Hospital Residency: Some people only want doctors who were a resident at a prestigious hospital.
  • Years in Practice/Age: Does age matter to you? Generally, the age of the doctor does not affect outcome. However, age may relate to your comfort level. The longer a doctor has been in practice, the more experience he or she has. On the other hand, the doctor is also further away from the latest developments being discussed in medical school.
  • Sex: Do you prefer a doctor of the same sex you are?
  • Clinical Trials: Do you care whether the doctor heads or is involved in clinical trials relating to your condition?
  • Solo or Group Practice? Both types of practices have their advantages. A solo practice may provide more continuity of care and allow for the development of a more personal relationship with the doctor. A group practice may be a group of doctors with the same specialty or different specialties. A group practice may provide for additional medical opinions and more extensive services.
  • Location: Is the doctor's location important to you?
  • Parking or Other Transportation: Important to you?
  • Hours: Is it only convenient for you to see the doctor on certain days and/or hours?
  • Language: If English isn't your first language, do you need a doctor who can speak your language -- or at least have translation available?
  • House calls: If you need a doctor who makes house calls, and any doctor you are considering doesn't, see the website of the American Academy of Home Care Physicians (www.aahcp.org offsite link). It lists doctors and other health care providers by state and zip codes for the areas served.

While the following will not be relevant to your initial search for a doctor, start thinking about:

  • Bedside manner: Does the doctor's personality matter to you? You may care more about a personal relationship with a primary care doctor or a specialist you'll see over time than a doctor you see for a particular event, such as a surgeon.
  • How much do you want to participate? Do you want a doctor who tells you want to do? At the other extreme, do you need to make all the decisions? Do you want to think of your doctor as a partner, a member of your team who gives you his or her opinion and expertise, discusses matters, and lets you make the final decision?
  • Overall rapport: It is helpful to have a rapport with a doctor. Studies show that doctors talk more to the patients they identify with and like. Not being liked by doctors and nurses affects your health care.

To Learn More

More Information

Clinical Trials

Step 3. Locate A Doctor Who Fits Your Insurance Or Financial Situation

For many people, the choice of doctor is limited because of the dictates of their insurance plan.  If there is no limitation, there are sources that are helpful for locating a doctor who fits your criteria. The following information helps you locate a doctor depending on the type of health insurance you have, or if you don't have health insurance.

Managed Care Health Insurance Such As An HMO, PPO or POS (where choice of a doctor is limited by your plan)

If you have a managed care health insurance plan, such as an HMO, PPO or POS: the health plan will provide a list of doctors from which to choose.

Save time by only reviewing the most up-to-date list. Generally this list is found on line.

If a doctor you'd like to consider isn't on the list, ask the doctor's office if she or he would be willing to contract with your insurance carrier. If not, it could be helpful to you to learn why not. It may provide information to watch for with respect to the doctors who are on the plan.

If the doctor is willing to be on the list, speak with the insurance company and ask if the doctor could be put on their list. If the company says no, it may also be helpful to know why not.

A Private Fee-For Service Insurance Policy (also known as an Indemnity Policy) and Original Medicare -- where you have the choice of any doctor

Under a Private Fee-For-Service (Indemnity) Insurance Policy you have an unlimited choice of specialists.  See the section below about how to choose a doctor when insurance is not a primary factor in choosing a primary care doctor.

Medicare Advantage or Medicare Plus

If you have a Medicare managed care health insurance plan, such as an HMO, PPO or POS, the health plan will provide you a list of doctors from which to choose.

If a doctor you know you'd like to consider isn't on the list, ask the doctor's office if she or he would be willing to join your insurance carrier. If not, it could be helpful to you to learn why not. It may provide you information to watch for with respect to the doctors who are on the plan.

If the doctor is willing to be on the list, speak with the insurance company and ask if the doctor could be put on their list. If the company says no, it may also be helpful to know why not.

For a list of doctors who accept Medicare, see www.medicare.gov offsite link  (click on "Search Tools" than "Find a Doctor").      

If a doctor you'd like to consider isn't on the list, ask the doctor's office if she or he would be willing to accept Medicare. The odds are the doctor has considered it, and rejected the idea - but it's worth a phone call. If the doctor is willing to be on the list, call Medicare at 800.MEDICARE.

Medicaid

If Medicaid pays for a private managed health care plan: If you have a managed care health insurance plan, such as an HMO, PPO or POS, the health plan will provide you a list of doctors from which to choose.

You may be limited to a choice of designated participating physicians or medical groups. Check your plan to obtain your choice of doctors. If there are no doctors who can provide you with the quality of care that you require, you will likely have to advocate for yourself to see a doctor outside of the network plan.

If a doctor you'd like to consider isn't on the list, ask the doctor's office if she or he would be willing to join your insurance carrier. If not, it could be helpful to you to learn why not. It may provide you information to watch for with respect to the doctors who are on the plan. If the doctor is willing to be on the list, speak with the insurance company and ask if the doctor could be put on their list. If the company says no, it may also be helpful to know why not.

If you do not have a managed health care plan through Medicaid: To locate doctors who accept Medicaid, contact your local Medicaid Office.

If the offices does not have a list, locate doctors who accept Medicaid through:

  • Hospitals: Contact your local hospital, particularly community hospitals. The better the hospital, the better their doctors are likely to be. Ask to speak with one of their social workers.
  • Local disease specific non-profit organizations may know the names of doctors who accept Medicaid.
  • Support Groups: If you are a member of a support group, other members may have suggestions about doctors who accept Medicaid.
  • Clergy: Your local religious organization will likely know the name of doctors who accept Medicaid.
  • Friends and Family: People in a situation similar to yours may have doctors to recommend.

If Health Insurance Is Not A Primary Factor in Choosing A Doctor

The following suggestions should help you locate a doctor who fits your needs in your area, and help you to narrow your choices.

  • Professional Groups If you are looking for a particular type of primary doctor, professional groups provide a helpful place to start:
    • Internists: To locate internists who are board certified, call the American Board of Internal Medicine, tel.: 215-446-3500 1-800-441-2246, www.abim.org offsite link
    • Geriatric doctors: American Geriatrics Society www.americangeriatrics.org offsite link AGS Referral Phone Line:  800.247.4779
    • Family Physicians: American Academy of Family Physicians www.aafp.org offsite link 800.274.2237
  • Healthcare Professionals
    • Ask doctors, nurses or other healthcare professionals for the names of doctors who fit your criteria. Healthcare professionals can often provide valuable "inside" information about the doctors as well. They may also be able to tell you which doctors to avoid.
  • Local Prestigious Hospitals or Large Teaching Hospitals in your Area:
    • If such a hospital is nearby:  Stop by and ask a nurse in the Emergency Room or in the Intensive Care Unit (ICU) or a hospitalist (a doctor who only works in a hospital) who s/he would use, and why. Think about saying something like: "I'm new to town. I have to choose a new doctor who has privileges at this hospital, most ideally one who is particularly good at treating patients with (mention your diagnosis.)  I know all the doctors here are great, but I'd appreciate your telling me which specific doctors you would consider if you were me."
    • If a hospital is not nearby: Call their doctor referral service. You will only receive a list of doctors who are affiliated with their hospital, but these types of facilities tend to attract the "cream of the crop."  
  • Local Medical School
    • Contact the medical school located closest to you.  Explain the type of doctor that you are looking for and ask for recommendations.  Some instructors actually maintain their own medical practices and tend to be informed on the latest recommendations, procedures and treatments.
  • Family and Friends
    • Consider asking family and friends whose opinions you trust for the names of doctors with whom they have had a successful relationship.  
    • Ask members of your support group or self help group.
    • Don't rely solely on their opinion. What works for one person does not necessarily work for another person. We are all individuals.  Further, one person's experience with a particular doctor may be an exception. Do your own research about the doctor.
  • The Internet 
    • There are many easily accessible sites about doctors on the internet.  Unfortunately, there is no one-stop shopping. You can use the sites below to create a list of potential doctors.  These sites can also help you compare the qualifications of doctors whose names you have, or they can help you locate doctors who meet your criteria.
    • For a list of suggested sites, see Leading Sites For Locating a Doctor. All services are free of charge except where noted.

 

 

 

 

Step 4. Check The Doctor's Quality

Even the best schools or residencies have people who are at the bottom of the class who may not be the best doctors.

One way to check quality is to ask the doctor (or his or her office) about the quality data the deoctor collects and how the data collection is performed.  For example, how many patients with high blood bressure or diabetes have their disease controlled? 

In addition, many health plans, state agencies and watchdog groups offer consumer scorecards that rate doctors. The ratings measure such things as whether the doctor follows "best practices," safety, patient satisfaction and cost. Some web sites also include doctors' performance on specific procedures.  (NOTE: Health care does not have standards for reporting doctor performance. The type and accuracy of information varies widely among sites. Consider using these ratings as a guide. If you're interested in the doctor, ask him or her why he or she is rated a certain way.)

  • If you have health insurance, start by checking your health plan's Web site.
  • Check to see if your state health department has a site. For example, New York's www.myhealthfinder.com offsite link and Pennsylvania's www.phc4.org offsite link
  • Web sites ask patients to rate doctors. You can see the results for free. For instance, go to Health Grades, Inc. offsite link (NOTE: It is advisable to take consumer ratnigs with a grain of salt. If you are interested in a doctor, ask him or her why she or he is rated in a certain way.)
  • www.Vitals.com offsite link has patient rating for over 700,000 doctors. You can filter search results based on type of doctor, insurance accepted and illness or condition.

To check a doctor's disciplinary record, see Has A Doctor Been Subjected To Disciplinary Action?

If you learn of additional sites about a doctor's quality, please share the information via Survivorship A to Z.

To Learn More

Step 5. Interview The Staff

Once you've narrowed your choices to a few doctors, call each doctor's office and dig a little deeper to shorten your list. This call could be a good indicator of how you will be treated as a patient by the staff, and possibly even the doctor

Questionnaire For The Doctor's Staff lists the questions to consider asking. Ask the ones that are important to you.

Ask to speak to the office manager if possible. He or she is the most likely to have the answers to your questions.

When calling each office, keep in mind that you are not yet a patient and not every office will be willing to answer all of your questions. Therefore, we recommend that you take a minute to review the list of questions to ask.

  • Cross out the questions that aren't important to you.
  • Prioritize the rest in an order that is most relevant to you. Insert a number from 1 -- 17 (or whatever number remains) in the left margin next to the question in order of importance to you. That way if you only get to ask a few questions, they will be those that are most important to you.
  • Even if you ask all the questions, the office interview should require no more than a few minutes of time. It would be helpful to mention this fact at the beginning of the call.

After you have spoken with the different offices, compare your notes and decide if there is an office that you feel will best meet your needs If you were not satisfied with your office conversations, consider choosing additional doctors and repeat the process. Trust your instincts and do what feels right to you.

To Learn More

More Information

Support Groups

Step 6. Interview the Doctor

Yes, doctors do interview.

During an initial visit, you may choose to simply interview the physician or you may choose to have a physical examination in addition to the interview process -- particularly if the doctor charges for the visit.

While we wish we could say that the doctor will give you an interview session for free, the odds are you will be charged for the interview (or it will be covered under your managed care plan.)

If you will be charged for the interview, you may as well be examined at the same time. This is particularly true if your insurance company won't reimburse for interviews. Insurance will generally pay if there is a diagnosis. (If you decide to have an exam in addition to an interview, read How To Work Most Effectively With Your Doctor, to make the most of your time together.)

When you schedule the appointment, let the person who makes the appointments know the purpose of the visit so the doctor can schedule enough time. Find out if there is a cost difference between and interview and a physical exam before requesting an exam.

For a suggested list of questions to ask the doctor, see Questions To Ask A Primary Care Doctor.

To Learn More

More Information

Maximizing An Office Visit

Step 7. Review All You've Learned And Make A Decision

Once you've completed the investigation process:

  • Review your notes.
  • Ask any additional questions you have.
  • Trust your instincts.