Discover how to find the right doctor (primary care physician) for yourself.
View this short video to find out if your doctor is within your network, and if your doctor is covered by your health plan.
What is a Primary Care Physician?
In the past people relied on family doctors for everything from broken bones and the common cold to the delivery of babies. Family practitioners knew the medical history of the entire family because they treated both the children and the parents. Primary Care Physicians (PCPs) have brought this tradition back. Instead of specializing in a specific area of medicine, PCPs help patients maintain overall health by focusing on preventive care. Some insurance plans, particularly health maintenance organizations (HMOs) require patients to choose a Primary Care Physician. Check with your insurance company to see if you’re required to select a PCP.
Which doctors qualify as Primary Care Physicians?
There are many specialties in medicine, but typically only three qualify as PCPs. In most cases only doctors with the following three specialties are considered PCPs:
- Family Practice or General Practice: A family practitioner is qualified to care for the entire family. A family practitioner can be board-certified and have training in a variety of subjects including Obstetrics and Gynecology, Pediatrics, Internal Medicine, or Psychiatry. This specialty was more common in years past but can still be found to treat the entire family.
- Internal Medicine: An internist can diagnose and treat disease with medicine. An internist is not a surgeon. There are several sub-specialties an internist can have, including: specializing in a particular organ, like the lungs or the kidneys; a particular disease, like diabetes; or a particular age group, like the elderly.
- Pediatrics: A pediatrician specializes in the overall well-being of children. Most pediatricians treat children from birth until adolescence or about 14 years old. Pediatricians can have sub-specialties such as surgery or pediatric cardiology.
How can you find a Primary Care Physician?
Choosing a doctor can be challenging. You might not want to just pick a name out of the phone book. If your insurance plan requires you to choose a PCP, you may want to take time to research your options. Here are some ideas to get you started:
- Your health insurance plan. Your health insurance plan may have listings of doctors in its network who are accepting new patients. Choosing a PCP is often the first step in seeking treatment under an HMO or PPO plan. PCPs will handle any referrals to specialists you need.
- Personal referral. People often ask their friends, families, and co-workers for referrals to Primary Care Physicians. If someone you respect and trust has a positive experience with a doctor, it’s possible you may like that particular physician.
- Current physicians. If you are moving to a new area, you could ask your current physician to help you find a PCP in your new neighborhood.
- Hospitals. It is common for hospitals to offer a referral service that can provide you with the names of staff doctors who meet certain criteria you may be seeking, such as specialty, gender, experience, and location.
Why should you choose a Primary Care Physician?
Don’t wait until you get sick to choose a PCP. Primary Care Physicians may see their patients regularly and look for symptoms a patient may not notice. For example, a routine health exam may uncover conditions such as high blood pressure or even hormonal imbalances due to glandular problems. Health problems like these can go unnoticed by the patient for years and could result in serious chronic health issues. Annual exams may help your PCP guide you toward healthy lifestyle habits that may decrease the likelihood that you’ll need expensive specialty care. Also, in HMO plans, a PCP will usually have to refer you to a specialist should you need one.
Developing a relationship with your Primary Care Physician can help keep illnesses at bay. Remember the old adage: An ounce of prevention is worth a pound of cure.
To ensure that you have the right coverage before seeing a doctor, let us help to find the right health plan for you. Enter your zip code where requested on this page to see a personalized health insurance quote.