A primary care provider (PCP) is a doctor or nurse who provides patients with routine medical care and coordinates more defined care with specialists. Choosing the right PCP is an important decision that requires some time and research. With that said, the following article will provide some guidance on how to choose a primary care provider that meets your needs.
Key Factors to Consider When Looking for a New PCP
When you're considering how to choose a primary care provider, some key factors to keep in mind include the following:
Confirming they are in your insurance network
Finding out if they are accepting new patients
Reading online reviews (if available) about their communication style, wait times, and personality
Considering their office’s location and whether it is convenient for you
Determining whether their fields and services fit your needs (such as internal medicine, family medicine, geriatrics, or pediatrics)
Some common PCPs include family medicine doctors, nurse practitioners, internists, and physician assistants. Each of these medical professionals can provide general care, immunizations, and annual check-ups, and they can help set up specialty care if needed.
Questions to Ask When Choosing a PCP
Below is a (non-exhaustive) list of questions you may want to think about when choosing a new PCP:
Do they seem warm and friendly?
Are they a good listener?
Do they make you feel comfortable?
Do they clearly explain conditions and treatment options in a way you understand?
How far in advance do you need to schedule a routine checkup or physical?
What are the typical wait times for appointments?
Are their patients generally seen in a timely manner?
Are evening or weekend office hours available for appointments?
Is their office conveniently located near either your home or place of work?
Is the office accessible for those with disabilities?
Do they offer telemedicine?
Which local hospitals and health systems are they affiliated with for admissions or specialist referrals?
If hospitalized, will they help coordinate care with hospital doctors?
Billing & Insurance
Is the provider in-network, and do they accept your specific insurance coverage?
Is their billing department responsive if you have issues with claims?
Asking questions about these key areas — personality, communication style, office operations, location and hours, hospital affiliations, and billing and insurance details — will help you ensure the PCP you select is the right fit.
Narrowing Down Your PCP Choice
Once you’ve researched some potential PCPs, you should narrow down your options by determining your top priorities:
If continuity of care is most important, choose an individual provider rather than a clinic with rotating doctors.
If you want a PCP who is focused on wellness and preventive care, select one who is trained in those areas or who offers nutrition coaching.
If you’re managing a chronic condition (like diabetes or a heart condition), select a PCP with proven expertise in your disease.
If you prefer alternative medicinal methods, consider a PCP who is open to integrating complementary treatments into your healthcare plan.
If you’re looking for a PCP who shares your cultural background or language, look for one with relevant ties to your community.
If you have preferences, you may also want to consider the PCP’s gender and age.
Ultimately, you should prioritize the factors which are most important to you. You can call their offices and ask if they’re willing to do meet-and-greet appointments so you can meet with the provider before making a final decision. In any case, don’t be afraid to ask questions about these sorts of things, as having a PCP who fits your needs and preferences is vital for your long-term health.
Understanding Costs of PCP Services
If you have health insurance, the costs for the services you receive will be determined by your specific plan benefits. Note the copay or coinsurance rate for PCP office visits and what services are covered under your plan.
If you’re uninsured, call the PCP’s office to inquire about costs for standard services or a first appointment. The office will have this information, or at least an estimate, and they have an ethical — and now legal — requirement to provide you with it. When talking to the office staff, ask whether they have sliding scale fees or an affordable fee structure based on your income.
Preparing for Your First PCP Appointment
To get the most out of your first visit, come prepared with the following:
Your full medical history, including allergies, medications, surgeries, past conditions, and family history
A list of current concerns and health goals you want to discuss
Your insurance card ready and any forms you need to complete (some offices allow for early check-in)
Arrive 15 minutes early to complete the intake process, and be ready to describe your symptoms and health concerns so that the PCP can fully assess your needs. Having these items and materials at the ready will help you feel more confident and prepared for your first appointment.
Questions to Ask at Your First New PCP Appointment
Once you’ve narrowed down your options, it’s time for your first appointment, which is an excellent opportunity to establish rapport and determine whether the PCP you’ve chosen is truly the right fit.
You should go to the appointment prepared with the right questions to facilitate the process.
How long are routine physicals?
Do you spend one-on-one time with patients?
How can I contact you outside of office hours with an urgent question?
How do you communicate with patients? Through email or an online patient portal?
Do you coordinate care with other providers and specialists? If so, how is that information communicated?
How can I keep you informed if I see a specialist or have a procedure done?
How quickly can I expect a response when I call with a concern?
How can I submit feedback or address any issues that may arise?
How to Choose a Primary Care Provider, Your Partner in Health
Figuring out how to get a primary care physician is a worthwhile investment of your time, as a compassionate, attentive PCP who views their job as your health advocate is a valuable partner in your overall health and wellness. With the right questions and planning, you can create a valuable relationship with a healthcare professional that will benefit you for many years to come.