Medical Edge Newspaper Column

Much to Consider when Looking for a Primary Care Physician

August 27, 2010
Dear Mayo Clinic:
How do I go about finding a primary care physician? I've read that it is important to have a good relationship with your doctor, but what if you haven't been to a doctor for years? A cold call seems strange considering it's someone I will be sharing personal information with.

Answer:
Finding a primary care physician can be a challenge. Some groundwork is a good investment to find a doctor with whom you feel secure sharing personal information and also someone you are confident will meet your needs.

Primary care physicians are specifically trained to provide first-contact care for people, regardless of their medical concerns or needs. They can manage the vast majority of concerns and coordinate specialty care as needed.

You can think about your physician search in two phases. The first is focused on fundamentals: insurance, location, office hours and the physician's credentials. The second aspect focuses more on your comfort with the provider.

Basic research can be done via the Web or with some phone calls. Resources might include friends, your insurer, state medical associations, your local hospital and the doctor's office or clinic. Factors to consider are:

• Insurance: Your insurance coverage, including government programs, may dictate the pool of physicians available to you.
• Location: Factoring in convenience, you'll likely want to have a physician who practices near your home or work.
• Type of primary care provider: Primary care specialties include general pediatrics, general internal medicine and family medicine. Pediatricians take care of the health needs of children through the teen years. General internists take care of adults but do not provide obstetrical or surgical services. Family practitioners provide care to the widest range of ages and for the widest range of conditions. Many &mdash though not all &mdash family physicians provide obstetrical care. Some primary care providers have specific interest and training in sports medicine, geriatrics or other areas. Anticipating your needs can help you narrow the selection.
• Board certification: This certification indicates that the physician has had at least three years of training in his/her specialty after graduating from medical school and has passed a board-certification exam. Pediatrics, internal medicine and family medicine each require ongoing education to maintain certification.
• Access: How long does it take to get an appointment? How are acute needs handled? How likely are you to see a partner (another care provider in the medical practice) rather than your personal physician? Does the doctor offer consultations via phone or online? Can you be seen in the evening or on weekends?
• Hospital affiliation: A doctor's hospital or nursing home affiliation can be important.
• Personal preferences: Consider your preferences for male or female doctors or languages spoken.

This information will help you hone the search to a few physicians who seem like they could meet your needs.

Then comes "comfort and communications" research. You really can't know if you'll feel comfortable with a doctor until you talk. I'm happy to meet with new patients to discuss how we would work together. I think you'd find other doctors are willing to have a similar "get to know you" visit.

Another approach is to schedule an appointment for a physical or an acute need. If you'd like extra time to talk, let the scheduler know. If communication goes well, you've found your primary care doctor. If not, schedule the next appointment with the next doctor on your list.

Now is a good time to consider how to find a primary care doctor. As health care reform legislation is implemented, there will be an increasing shift toward a primary care-based system. Already, there's a shortage of trained primary care physicians and that may worsen with increased demand.

— Gregory J. Anderson, M.D., Family Medicine, Mayo Clinic, Rochester, Minn.