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How to Choose a Primary Care Doctor

By Melissa Pandika | October 19, 2016 | Rally Health

Choosing a primary care doctor is one of the most important health decisions you’ll make. Think of your doctor as your partner in wellness, someone who can help you stay healthy and be there for you in case you need treatment. It’s a relationship that’s likely to last for many years, and may even extend to other family members.

Finding the right person to fill that role can be a challenge. Where do you start? How do you pick the right one? What do you do if you if something feels off? Here are a few tips for making the decision process a little easier.

Think about your requirements

Find someone in your insurance plan’s network. Since most of us want to avoid paying doctors from our own pockets, start by checking your health plan’s website and searching the list of providers in your area. Some plans will let you go out-of-network for a higher copay and coinsurance, others will only cover in-network doctors, labs, and hospitals.

Decide what’s important to you. Everyone else’s favorite doctor may not work for you. Sure, she’s popular and highly skilled, but it might take weeks to get an appointment. Take a moment to list the qualities you value most in a physician.

  • Provider type. If you have kids, it might be convenient for the whole family to see the same family doctor. If you have a condition like diabetes, do you want your primary care doctor to have expertise in your condition, or will you see a specialist?
  • Age and gender. Many people feel more comfortable seeing a doctor of the same gender. It can also be easier to connect with a doctor near your own age. Plus there are practical concerns: If you’re looking for a long-term relationship, an older doctor may want to retire in a few years.
  • Language. If you or someone in your family speaks limited English, it can help to have a doctor or staff member who speaks your language. They may have an easier time developing a rapport, understanding cultural concerns, and avoiding risky communication errors.
  • Convenience. How far is the office? How long does it take to get an appointment? Do the hours fit with your schedule? Are they open on weekends, and can you reach someone after hours? Do they take walk-ins for urgent issues? Can you email your doctor?
  • Technology. Besides email access, does the office have electronic records that they can transfer to other offices or hospitals easily? Can you get email or text reminders for appointments? Can they send prescriptions electronically to your preferred pharmacy?
  • Affiliations. Does the doctor have admitting privileges at your preferred hospital? Is that hospital in your plan’s network? This could make a big difference in your bills if you need surgery or other treatment. In case you need it, what is the process for handling a hospitalization?
  • Other services. Do you want a primary care doctor who can provide in-office procedures and screenings, like joint injections or lab tests? Are other services important to you, like nutrition and behavioral health counseling?

Do your homework

Ask your social circle. If people you know and trust love their doctors, chances are you will, too. “There is nothing more valuable than getting referrals from friends and people who you trust,” says Cathy Sikorski, an elder-care lawyer in Pennsylvania and author of Showering With Nana: Confessions of a Serial Caregiver. Ask friends, relatives, and others in your social circle about their primary care doctors, and whether they’d recommend them.

Read reviews – with a grain of salt. Physician rating websites like Healthgrades and RateMD might offer a starting point, but they’re not always reliable. Often driven by extreme satisfaction or dissatisfaction, the few people who do write reviews usually don’t reflect the average patient. Consider them, but in the context of other factors.

Do a background check. Visit your state medical board’s website to make sure the doctor you’re considering is board certified and doesn’t have a history of malpractice.

Next steps

Pick up the phone. Once you’ve narrowed your options down to a few doctors, call their offices to confirm they’re accepting new patients and take your insurance plan. Even if their websites say they do, the information may be out of date.

Schedule an interview. In a way, you’re the “hiring manager” — so why not do an in-person interview? Some doctors offer a quick “get-to-know-you” visit so you can come in and chat in person. (Since this isn’t a typical doctor visit, ask the office staff about cost and other details.)

Scope out the staff. “Staff can make or break an office,” says Douglas Harley, MD, who practices family medicine in Akron, Ohio. “You can have a wonderful doctor but horrible staff.” Or vice versa. Since you might even end up interacting with receptionists, nurses, and other staff members more than the provider, they’re part of the package. Are they friendly and engaged? Do they seem unhappy or overworked?

The staff “is a reflection of the physician,” says Stephan Fihn, MD MPH, head of the division of general internal medicine at the University of Washington. “A physician who is surrounded by good staff, that says something.”

At your first visit — and beyond

Look for a good listener. A doctor who listens will take time to review your history and medications at each visit – and ask whether you have any questions. You want “someone who will…engage in a discussion of joint decision making,” Fihn says. “‘Here’s what I think is going on. Here are my thoughts on next steps. What do you think?’” Look out for warning signs, like frequent interrupting, speaking in a curt tone, not taking notes or asking follow-up questions, or staring at the computer screen without making eye contact.

Identify some goals. Think about your goals, whether it’s quitting smoking or losing weight. During your first visit, “It’s fair to ask, ‘Given my goals, how are you able to help me? Is this something you can work with me on?’” says Joy Lee, a postdoctoral researcher at Johns Hopkins Bloomberg School of Public Health.

Build trust. You should feel comfortable asking your primary care doctor questions, as well as sharing personal details about your health. “We probably dive into parts of people’s lives they never share with anyone else, including even their spouses — their mood, anxiety, depression,” Harley says. “At the same time, we’re asking about sex.” You should be feel comfortable being honest with your doctor and trust them to respond with compassion and sensitivity. “You want your physician to be able to have difficult conversations,” Fihn says.

Form a relationship. After a few visits a primary doctor should know you well enough to spot any sudden changes, “so when you come in and look terrible or have lost 15 pounds for no reason, they can say, ‘This hasn’t been the same Cathy who’s been coming here for the past five years,’” Sikorski says. And when you do raise a concern, a doctor should take the time to respond and problem solve, not dismiss what might actually be a serious medical problem.

Be willing to compromise. Insurance plans sometimes offer limited choices for primary doctors, and you might find that many within your network are no longer accepting patients. “You can wind up with a doctor that feels like a forced marriage of sorts,” says Colleen McBride, chair of the department of behavioral sciences and health education at Emory University's Rollins School of Public Health. But “that can be OK and workable.” Someone with a serious illness, for instance, might settle with a primary care doctor who comes across as aloof but has a reputation for excellent clinical judgment. Remember, you’re not looking for a new best friend.

“Don’t get hung up on personality, because they can literally save your life,” says Carol O’Dell, author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir and her mother’s caregiver for many years.

Breaking up, moving on

At the same time, “Go with your gut and don’t force it too long,” McBride says. If your doctor communicates poorly, doesn’t listen, or doesn’t seem to have your best interests at heart, it’s time to move on. While it might leave you feeling guilty, remember that, “Yes, you are their patient, but you are also their client and you have a right to good service,” O’Dell says.

Often there’s nothing you or your doctor could have done differently to preserve the relationship. Harley tells his residency students not to get upset when a patient decides to switch doctors. Sometimes, “it just doesn’t meld,” he says. You might not even need to notify your doctor directly of your decision. When Cathy Sikorski decided to make a change, she simply asked the office staff to transfer her medical records to her new doctor. Plus, “it doesn’t have to be a breakup forever,” she says. “You can go back to him or her.”  
If you do find someone great, having a relationship with your primary care doctor can pay off in many ways — timely preventive care, better management of your conditions, if any, and possibly even lower medical bills. It’s worth the effort.

Editor: Deepi Brar

Melissa Pandika is a freelance writer based in Oakland, Califonia.

Melissa Pandika
Rally Health