Personal Health

Choosing a Primary Health Care Provider (PCP): General Information

Going to a primary health care provider (PCP) is a very important part of taking care of yourself. This guide will help you choose a provider that is right for you.

Who are PCPs?

A PCP can be a doctor, nurse-practitioner, or physician’s assistant (PA). Nurse-practitioners and PA’s are trained to perform many parts of primary care.

Nurse-practitioners are required to work with a doctor or physician in some states, but can work alone in others. PA’s are required to work with a doctor. They perform regular check-ups and help address your problems.

Why do I need a PCP?

  • You need a PCP so that your health can be checked regularly to catch any problems early on (so that they don’t become worse).
  • Your PCP can help you make smart choices to stay healthy. He or she can talk with you about health risks which result from your decisions about smoking, marijuana, alcohol, sex, sunscreen, seat belts, and nutrition, and give you advice about healthy behavior and/or treatments.
  • If you have a serious or unusual medical problem, your PCP can refer you to a specialist, someone who knows much more about that specific kind of problem.

What should I look for in a PCP?

  • Think about whether you want your health care provider to be a man or a woman, or if that doesn’t matter to you.
  • You should feel comfortable with your PCP.
  • It’s important for your PCP to listen to your concerns, answer your questions, and explain things clearly to you.
  • Find a health care provider who has an office near where you live or go to school.

What if I’ve turned 13 and I want a provider who sees teenagers?

You should ask your provider if he or she sees teenagers, or if there’s another provider in the office who does. There may be special clinic hours for teens to be seen in the office. Talk with your provider about how to let your parents know about your health care needs.

How do I find the names of health care providers?

Here are some ways to find a health care provider:

  • Ask your parents, friends, and relatives for the names of health care providers who they go to and like.
  • Check the “Doctor Finder” service of the website of the American Medical Association.
  • You can call a doctor referral service at a hospital or a local medical society, or your insurance company may have a list of providers they cover.

What if I belong to a health plan?

If you belong to a health plan, your choice of health care providers may be limited to providers that are part of the plan. Sometimes you can choose to see any provider. You should check the plan’s list of health care providers by either checking your health plan’s website or by calling your health plan (phone number and website should be on your health plan card). Ask friends or relatives who have the same plan as you for names of their health care providers that they like.

What if I don’t belong to a health insurance plan?

If you don’t belong to a health plan, your choice of providers may be much greater. You may want to think about which provider you’d like to use before making a decision. Check out how much a typical office visit and lab tests cost. If it doesn’t fit your budget, check on public health clinics, family planning clinics, health centers, and hospital clinics. Also, check whether they have sliding scales (adjusted cost for visits) or free care.

Is there a way I can check on a provider’s qualification?

  • Yes. You can ask friends or relatives for a recommendation.
  • You can check with your health insurance plan or search the internet
  • You can also call the provider’s office and ask the office staff about the provider’s credentials. Providers should be licensed to provide care by the state in which they work.

A way to find information on the quality of care of different providers is to visit docboard.org.

You can find out if a provider is board certified by calling The American Board of Medical Specialties at (800) 776-2378 or checking the web site abms.org. You can also check for board certified pediatricians at the American Board of Pediatrics website at www.abp.org. “Certified” means that the provider has finished a training program in one area of medicine and has passed an exam (board) that tests her or his knowledge, skills, and experience to provide quality care.

How do I decide on one PCP?

Once you’ve made of list of providers covered by your health insurance plan, you can call their offices to ask some questions. See if you like the way the staff answers your questions. You’ll need to find out if the provider is taking new patients. If you don’t know if the provider is board certified or what their training is, ask. Some other questions you might ask include:

  • Which hospitals does the provider work with?
  • What are the office hours (when is the provider available/when can I speak to office staff)?
  • Does the provider or someone else in the office speak the language that you’re most comfortable speaking, or do they have a translator?
  • Are there other providers can see me when my primary care provider isn’t there? Who are they?
  • How long does it usually take to get an appointment with the provider?
  • What happens if I am late for an appointment?
  • What are the provider’s fees? Do I need to pay when I am at the provider’s office or will they send me a bill?
  • What do I do if I need to cancel an appointment? Are there any fees for canceling appointments?
  • What do I do if I have an emergency or if I need medical help after-hours?
  • Does the provider give advice over the phone, email, or online portal for common medical problems?
  • Can I contact my provider by e-mail?

The answers to these questions should help you decide which provider you want to handle your care. Once you like what you hear, make an appointment with that provider for a general check-up.

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