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How to Choose a Primary Care Physician

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By Susan M



Having worked in the Quality Management Department of a hospital where I was responsible for credentialing 123 physicians, I learned a lot about what to look for when choosing a primary care physician. Your primary care physician will be your principal provider of routine healthcare and will provide referrals to specialists should you need one.

Choosing a new physician can be a stressful process especially if you are new to an area and can’t rely on friends or family to make recommendations. But choosing your primary healthcare provider should be something that you take care of before you have an emergency. You want to have the time to research your doctor and make an informed decision about who you will hire (that’s right – a physician is someone you hire – you are paying them for a service).

The first thing you should do is contact your health insurance company and get their list of approved providers in their network (physicians, nurse practitioners, physician assistants) that they will cover. Then, if you absolutely have no one you trust to ask for advice you should call the hospital nearest you that you would utilize in an emergency and ask to speak to someone in their Medical Staff Department. This department, in addition to credentialing all of the physicians on staff at the hospital, also keeps a list of which practices are currently accepting new patients. There is no need to research a physician only to find that they are not currently accepting new patients.

This phone call will accomplish two things for you: not only will you find out which physicians are accepting new patients, you will also know which physicians are on staff and have privileges at that hospital. Your primary healthcare provider must have hospital privileges at the hospital you use in order to treat you if you should be admitted there.

So, now you have a list of providers that your insurance company will cover, who have hospital privileges, and are accepting new patients. Now what do you do?

You want to make sure that your physician is Board Certified in his/her specialty. Board Certification means that your physician completed a residency program in his/her specialty area and passed a rigorous exam to become board certified. Physicians must retake this exam every few years (it varies by specialty) in order to maintain their certification. A good hospital requires all of its physicians to be board certified.

Then, you can access your physicians profile online by going to the AIM (Administrators in Medicine) website at www.docboard.org. From here you can choose your state and then type in your physicians name to access particular data about him/her. You will want to make sure that their license is current with no restrictions and that they do not have a long list of pending or past issues with the State Medical Board. You will also be able to see where they went to medical school, where they did their residency and how long they have been practicing.

By now you should have a list of a few doctors who you think might be right for you. At this point you should make an appointment with the first physician on your list. When you call, make sure you tell the scheduler/receptionist that you are a new patient and you would like to meet with Dr. so and so to see if they might be a good fit for you. A well run physician practice will have no problem scheduling this for you and should be courteous with you on the phone. If you are not comfortable with how your request is handled by the front office staff or if you are being treated rudely, then you should rethink choosing this practice because the way the office is run is almost as important as the physician you will see. (think trying to get a prescription refilled, calling for an emergency, rescheduling an appointment etc….)

Once you have your appointment, make a list before you go of what you would like to discuss so that you don’t forget anything. Remember, you are interviewing this physician to make sure that they are a good fit for you and your healthcare needs. Does your physician listen attentively to what you say? Does he/she take their time with you or do they seem preoccupied and anxious to move on to the next patient? Make sure that you are comfortable and that your healthcare concerns are being addressed and appropriately taken care of.

If you are not happy with the first physician you see, continue with your list and interview additional physicians until you find the right doctor for you. Your healthcare is something that needs to be taken seriously not just by your physician but by you.

 


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RGraf profile image

RGraf  says:
13 months ago

I have found some of my best by word of mouth, too. When a patient sings your praises it goes a long way.

Susan M profile image

Susan M  says:
13 months ago

Oh absolutely - if you can get a referral to a good doc by word of mouth that is always the best. But even with a recommendation it does pay to do a little research on the person who will be taking care of you. Thanks for the comment!

pgrundy  says:
12 months ago

This is a really helpful hub--thank you for writing it. The last time I had to find a primary care physician I had a very hard time finding one who was taking new patients. Recently I lost my health insurance and my new job doesn't provide it, so I'm uninsured. I had to get a waiver to get the job and that cost me $80 at my forner primary caregiver, which I thought was pretty exorbitant. He didn't do a physical or anything, just wrote a one sentence note in longhand. The whole 'exam' took less than five minutes.

Right now I'm pretty negative about medical care in the U.S. If I can calm down enough I'll write a hub about it sometime. Haven't had many good experiences, especially not recently. Thanks again though for some good advice. (o:

Susan M profile image

Susan M  says:
12 months ago

Pam - I know how frustrating it can be to see a doc (esp after waiting forever for an appointment) only to have them spend a cursory amount of time with you. Thats why I always emphasize that patients are the consumers - we are paying for a service and if we are not happy we can negotiate or file a complaint. Since you don't have health insurance you should speak with the business office of your physician or other health care provider to negotiate a rate that is reasonable. You would be surprised how many offices are willing to do this. The amount that they bill insurance for an exam and the amount that they bill uninsured patients is dramatically different...hmmm....could this be part of the reason why health insurance rates are so high??? (I won't even get started on my issues with health insurance because I could write all day about that!)

Thanks for the comment (I was so excited to see that you commented on one of my hubs because I am such a fan of yours!)

pgrundy  says:
12 months ago

Wow, what a nice thing to say! Thank you! Also, I have heard of that--of negotiating an uninsured rate. I'm going to give your advice some serious thought and see if I can find a physician who will do that and who I can trust. The group I go to now has turned into a horrid 'mill.' I've gone in there and waited two hours for a three minute visit that was interrupted repeatedly with phone calls and questions from other patients. And I'm NOT exaggerating! It's just horrible. I do still have an HSA I kick a little money into when I can, so if I could just find the right caregiver, maybe I'd feel better about the whole thing. Thanks again. I actually do feel like I have sort of a gameplan now. (o:

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