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Primary care physician: The CEO of your health

Karen Miller
Primary care physician: The CEO of your health

Of all the health care choices, one of the most essential is choosing a primary care provider. That’s no easy task.

Primary care — considered the portal of entry to the health care system — is responsible for the health of the greatest number of patients and provides the widest array of services. People flock to their doctors for colds, aches and pains, immunizations, screening tests and medication. Coughs that don’t abate, rashes that persevere, even broken bones all wind up in a doctor’s office or clinic.

PCPs have their hands full. They diagnose everything from high blood pressure to diabetes to cardiovascular diseases and make referrals to other providers. In a sense, PCPs are CEOs, having the overall responsibility of managing their patients’ total care.

The problem is choosing a PCP that fits your personal needs and personality.

Not only is it difficult to find a PCP that is accepting new patients, what to look for in a doctor can be equally daunting. Personal preferences prevail. Gender and age can be a factor. People might have a higher comfort with a doctor of the same sex. Some might prefer a younger doctor more likely to be up-to-date with newer treatments while others may relish the attention of a more experienced doctor.

Hospital affiliation, location and access are also important. Even race or ethnicity often plays a role. People are sometimes more comfortable with someone who looks like them.

Further complicating a choice in PCP is that there’s more than one type.

An internist is a doctor of adult medicine, while a pediatrician tends to the needs of children. Geriatricians confine their care to the elderly. Family practitioners, on the other hand, provide comprehensive medical and surgical care for the individual and family regardless of age. In some organizations the gynecologist is considered the PCP for females.

Non-physician providers, such as nurse practitioners and physician assistants, round out the PCP players.

All doctors must be licensed to practice in their state. State medical licensure sets the minimum competency requirements to diagnose and treat patients, but it is not specialty specific. Board certification on the other hand, is an indicator of a doctor’s expertise in a particular specialty or subspecialty.

To become board certified a doctor must pass a written and sometimes an oral examination administered by the member board in his or her specialty, such as family practice and pediatrics.

Several sources are available to help choose a PCP. Word of mouth and recommendations from family and friends are often reliable. Other sources are one’s health plan and local medical societies. In Massachusetts, consumers can contact the Massachusetts Board of Registration at (800) 377-0550 to examine a physician’s profile. Another source is the Massachusetts Health Quality Partners, a coalition that helps consumers take an active role in making informed decisions about their health care. The MHQ Partners recently launched a new user-friendly website that enables patients to search and compare over 400 primary care doctors’ offices across the state.

Step number one is to identify a provider. It’s the second step that gets tricky and often cannot be completed until the first visit.

Ask questions. The answers will let you know if this relationship will work.

Sample Questions to Ask

  • How long have you been in practice?
  • Are you board-certified? If so, in what field of medicine?
  • Do you have particular clinical interests, such as diabetes or nutrition?
  • With what hospital(s) are you affiliated?
  • What insurance plans do you accept?
  • Do you have evening or weekend hours?
  • Are you available by e-mail or text?
  • Is there someone to cover for you when you are not available?
  • Is the office accessible (parking, elevators or ramps)?
  • Is it possible to get an appointment for urgent care?
  • How long a wait is it to get an appointment?
  • Can I be involved in decisions regarding my care?

A closer look

To check a particular doctor’s background, contact the Massachusetts Board of Registration in Medicine at (800) 377-0550 or visit http://profiles.ehs.state.ma.us/Profiles/Pages/FindAPhysician.aspx.

The profile will give:

  • Date of licensure in Massachusetts
  • Education and training (residency)
  • Medical specialties
  • Board certification(s)
  • Address and telephone number
  • Insurance plans accepted
  • Hospital affiliations
  • Availability of translation services
  • Awards, research and publications
  • Malpractice claims paid, hospital discipline and criminal convictions
  • Criminal convictions, please and admissions
  • Disciplinary actions by a health care facility or any medical state board