Choosing Your Primary Care Doctor

“Patients should remember that they have a choice in doctors. While some insurance plans limit those choices, patients can still interview, compare and select the physician best suited to their needs by asking the right questions.” Elisabeth Russell, President, Patient Navigator LLC

Your goal is to choose a primary care doctor who will meet your needs and give you quality care. This information also may be useful in choosing any specialists you might need. Primary care doctors are especially trained to serve as your main doctor over the long term. They provide your medical and health care, help you stay healthy, and help to manage your care. Your primary care doctor can refer you to specialists if you need them.

Check for Quality

Look for a doctor who…

• Is rated to give quality care
• Has the training and background that meet your needs
• Takes steps to prevent illness – for example, talks to you about quitting smoking
• Has privileges at the hospital of your choice
• Is part of your health plan, unless you can you afford to pay extra
• Encourages you to ask questions, listens, explains things clearly and treats you with respect

Internists and family physicians are the two largest groups of primary care doctors for adults. Physician assistants, nurse practitioners, and certified nurse midwives are trained to deliver many aspects of primary care. Physician assistants must practice in partnership with doctors. Nurse practitioners and certified nurse midwives can work independently in some states, but not others.

Doctors and Health Plans

If you already are in a health plan, your choices may be limited to doctors who participate in the plan. But if you have a choice of plans, you may want to first think about which doctor(s) you would like to use. Then, you may be able to choose a plan that has your choice of doctor(s).  Our “Understand Your Insurance Coverage” roadmap can help you with this.

Decide What You Want and Need in a Doctor

What is most important to you in a doctor? A few ideas are listed below if you are looking for or wish to change your doctor.

• My doctor must be highly rated by a consumer or other group. You will want to find out who did the ratings. Is the information reliable? Who collected it? Does the group have something to gain from the ratings?
• My doctor needs to have experience with my condition(s). Research shows that doctors who have a lot of experience with a condition tend to have better success with it.
• I want a doctor who has privileges at the hospital of my choice. You need to ask.
• My doctor must be part of my health plan. Do not assume; make sure to confirm.

Make a List of Doctors

• If you are in a managed care plan, check the plan’s list of doctors first.
• Ask doctors or other health professionals who work with doctors, such as hospital nurses.
• Check the “Doctor Finder” service of the website of the American Medical Association. Here you can find lists of doctors, by specialty, who practice near you as well as information on their training and board certification.
• Call a doctor referral service at a hospital. But keep in mind that these services usually refer you to any of the doctors on the staff of that hospital. The services do not have information on the quality of care these doctors provide.
• Some local medical societies offer lists of doctors who are members. Again, these lists do not have information on the quality of care these doctors provide.
• Ask family, friends, neighbors, and co-workers.

Check on Credentials

Once you have a list of doctors, there are several ways to check on their skills and knowledge, and the quality of care they provide:

• Find out if a consumer or other group has rated doctors in the area where you live. Again, you will want to find out how reliable the ratings are.
• Information on doctors in some states is available at Doc Board.  This website is run by Administrators in Medicine – a group of State medical board directors.
• The American Board of Medical Specialties (1-800-733-2267) can tell you if the doctor is board certified. “Certified” means that the doctor has completed a training program in a specialty and has passed an exam (board) to assess his or her knowledge, skills, and experience to provide quality patient care in that specialty.
• Primary care doctors also may be certified as specialists. You can also check the Certifacts Online website. (While board certification is a good measure of a doctor’s knowledge, it is possible to receive quality care from doctors who are not board certified.)
• Call the American Medical Association (AMA) at (312) 464-5000 for information on training, specialties, and board certification about many licensed doctors in the United States. This information can also be found in the “Doctor Finder” service of the website of the AMA’s website.

Contact the Doctors’ Offices

When you have found a few names of doctors you might want to try to call their offices. The first thing to find out is whether the doctor is covered by your health plan and is taking new patients. If the doctor is not covered by your plan, are you prepared to pay the extra costs?

In addition, many offices now provide the information below on their websites. Be sure to check first.

Below are some questions you might want to ask the office manager or other staff. You may have some additional questions. Some of these items might have more to do with the health plan than with the doctor’s office.  For more tips, read the “Successful Medical Communication” roadmap.

Things to find out from office staff:

• Which hospitals does the doctor use?
• What are the office hours (when is the doctor available and when can I speak to office staff)?
• How many other doctors “cover” for the doctor when he or she is not available? Who are they?
• How long does it usually take to get a routine appointment?
• Once I arrive for my appointment, how long might I need to wait in the office before seeing the doctor?
• What happens if I need to cancel an appointment? Will I have to pay for it anyway?
• Does the office send reminders about prevention tests?
• What do I do if I need urgent care or have an emergency?
• Does the doctor (or a nurse or physician assistant) give advice over the phone or use email for common medical problems?

You may also want to talk briefly with the doctor by phone or in person. Ask if you are able to do this and if there is a charge.

Schedule a Visit

The next step is to schedule a visit with your top choice. During that first visit you will learn a lot about just how easy it is to talk with the doctor. You will also find out how well the doctor might meet your medical needs.

Ask yourself:  Did the doctor…

• Give me a chance to ask questions?

• Really listen to my questions?

• Answer in terms I understood?

• Show respect for me?

• Ask me questions?

• Make me feel comfortable?

• Address the health problem(s) I came with?

• Ask me my preferences about different kinds of treatments?

• Spend enough time with me?

Trust your own reactions when deciding whether this doctor is the right one for you. But you also may want to give the relationship some time to develop. It takes more than one visit for you and your doctor to get to know each other.

Talking with Your Doctor

Research has shown that patients who have a good relationship with their doctors tend to be more satisfied with their care-and to have better results. Here are some tips to help you and your doctor become partners.

Give information. Don’t wait to be asked!

You know important things about your symptoms and your health history. Tell your doctor what you think he or she needs to know. It is important to tell your doctor personal information – even if it makes you feel uncomfortable.

• Bring a “health history” list with you (and keep it up to date).  The “My Patient Navigator” medical planner is designed for this purpose.
• Always bring any medicines you are taking, or a list of those medicines (include dosages, when and how often you take them). Talk about any allergies or reactions you have had to your medicines.
• Tell your doctor about any natural or alternative medicines or supplements you take.
• Bring other medical information, such as x-ray films, test results, and medical records, if applicable.

Get information

• Ask questions. If you don’t, your doctor may think you understand everything that was said.
• Write down your questions before your visit. List the most important ones first to make sure they get asked and answered.
• You might want to bring someone along to help you ask questions. This person can also help you understand and/or remember the answers.
• Take notes. This is important if you are dealing with a complicated medical situation.
• Let your doctor know if you need more time. If there is not time that day, perhaps you can speak to a nurse or physician assistant on staff. Or, ask if you can call later to speak with someone.
• Be considerate of the doctor’s time as well. The more you prepare, the better your visit will be for both of you.

Take information home

• Ask for written instructions if necessary.
• Your doctor also may have brochures, audio or videotapes or website suggestions that can help you. If not, ask how you can get such materials.

Once you leave the doctor’s office, follow up

• If you have questions, your symptoms get worse, or you have problems with your medicine, call.
• If you had tests and do not hear from your doctor, call for your test results.
• If your doctor said you need to have certain tests, make appointments at the lab or other offices to get them done. Make sure the results get sent to your primary doctor.
• If your doctor said you should see a specialist, make an appointment.
• It is important to stay organized with your medical records.  Our “Manage Your Medical Records” and “Organize Your Financial Records” Roadmaps will help you with this task.

Websites We Suggest for Additional Information

Agency for Healthcare Research and Quality

The information in this Roadmap was drawn from the Families section of this Department of Health and Human Services website. There are documents on many topics of interest to health care consumers and patients, including Staying Healthy, Choosing Quality Care and Staying Safer.