Finding a Primary Care Provider

Recently I got an email from a prospective first time mother with a question about how to go about finding a Primary Care Provider in the setting of a busy traveling life and, although not totally specified, I imagine, the ever changing healthcare environment. It made me realize, this is often a super difficult question and specifically as a Locum Provider, I have seen the ups and downs of being a temporary provider for patients as well as their struggles with finding consistent care, and even more importantly, a connection with the person they choose to take care of their health or that of a family member.

From a personal perspective, just because I’m a doctor doesn’t mean I’m not a Patient! When I decided to become a full time Locum Tenens doctor, and therefore my own employer, I jumped into the HealthCare MarketPlace for my health insurance. I was immediately overwhelmed with the process, from finding the right plan for Me, understanding which services I really needed, and the fact that I had to actually choose a Primary Care Provider (PCP) to go to myself. I remember scrolling through the map and seeing at least 200 different names of people I had no idea about. Being in the healthcare system in Houston at the time, I knew which institutions were affiliated with the Academic Hospitals and have the technological savvy to at the least look up the practices that the others were affiliated with, but overall I was at a Loss.

Eventually, I just chose one and hoped he’d be helpful. I was fortunate enough to pick an amazing Internal Medicine doctor by shear luck but also to already be able to basically triage some of the medical questions or situations for myself by the fact that I myself am a Doctor. So, after all of this and thinking about the question lately, here are a few of the tips I’ve come up with from the side of a Patient and a Doctor to help with starting off the search for a new Primary Care Provider – a lot of this will be tailored to Pediatrics in particular, since, well, Duh.

1. the search and referrals

Just figuring out the NAME of a good Doctor can be hard! For new babies specifically, these days, it’s fairly rare that the Pediatrician in the hospital will be the same one you see for the Clinic follow-up, and thus the way things are done may seem different. In some of my smaller communities I work at as a Locum, I am lucky to see a baby literally the second they’re born and then send them to see myself in clinic afterwards; but the country is moving towards the former. My advice is to talk to Friends, Family and other HealthCare Professionals for their recommendations/referrals. It’s ok to shop around. But, take online rating systems with a grain of salt! That includes ALL of the websites (eg: Yelp, ZocDoc, HealthGrades, Google. While I agree this is a place you probably HAVE to start at, remember that in general for any reviews, unhappy people are always more likely to make their voices heard, and ONE bad experience should not color a Lifetime.

2. FIT and connection

By far, one of the hardest parts in finding a Doctor is finding someone that understands you and listens to you, a lot goes into this. Being sure you’re on the same page about certain things, requires a little self-searching for what you in particular NEED – what’s your Language so to speak. For example, some of my patients want a FULL explanation of every little detail, while some want NONE and just to be told what to do. Some like the way that I’m blunt and the way I speak towards my teenagers, and some may want something a little less direct. You won’t like everyone you meet and you may NOT meet eye to eye. It’s OK, but can be Frustrating. Be patient with the Search if your first encounter isn’t the best lasting impression. In the world of Pediatrics, SOME private Pediatricians will offer Prenatal visits – so, if one does, it’s not a bad idea to check it out and see if you jive.

3a. availability and scheduling

Everyone wants the ease of being able to see their Doctor quickly, realistically the world is so busy that this may be hard. Some options that exist are Online Portals, Text Messaging, Walk-In Availability and (although I’m not a huge fan) Concierge/Boutique Medicine. To elaborate on the last point, these are Doctors/Clinics that do NOT accept insurance AT ALL! If you have the financial freedom to afford it, you can pay Cash Only for these services but are often privy to quicker more direct correspondence and scheduling (eg: Some doctors in very prestigious sectors/areas have been known to text directly with their clients), think about that TV show Royal Pains. Also, a doctor in a BIG PRACTICE may mean that even if they’re not available, hopefully someone else can help them. As a Locum Tenens I have learned the hard way for my patients that if I am not available, they have Noone, and this is very hard.

3b. Telemedicine

I hate to say it, but Telemedicine is here to stay. One office I worked in as a Locum had the ease of online Video Telemedicine visits, some will just have Telephone abilities. If this is important to you or if you are traveling often, consider asking if this service is provided to you.

4. cluster of care/logistics

I included this mainly for those that are somewhat Nomadic as myself, but also stems from my recent glimpse of an all inclusive medical center that offered 8 different specialties under one roof connected by one long hall way. If there’s a way to schedule your appointments all for one day, even if you have to travel, it gives you a better bang for you buck. My dentist, for all intents and purposes now, is in Houston, Texas; where, I hardly work now. But, I’ve thought about a plan to go back and see them, get some Dim Sum in Chinatown and touch bases with ex-coworkers. My favorite part as a Locum in general, make a trip out of it (if you can)! I’m only off 4 days a month, so I try to make them count. For my complex kids, it’s not uncommon to make 4 or 5 visits for one day to save on travel and time in the long-term.

5. insurance and your needs

As mentioned above, and something that should be more obvious, check with your insurance for who is covered. It may be worth it to go with a big group or someone that is part of one if you need multiple specialists. It is SUPER convenient when a complicated patient can have all of their information within one hospital system. What people don’t realize is that I CAN’T SEE ALL OF YOUR RECORDS FROM YOUR LAST DOCTOR IN ANOTHER STATE!!! One of my biggest pet Peeves. So, it is best to provide Holistic care if the system you enter has ease of access for all the charts. In California there was Kaiser, in New Orleans we had Ochsner, in Houston I had Memorial Hermann – look around and see whats near you. Some Primary Care Providers have a special interest in Diabetes, or in complicated ex-Premature babies, take this into account when finding a new PCP.

At the end of the Day, The Doctor-Patient/Family relationship, like any other sort of relationship, takes work from both sides but can have a natural chemistry or lack thereof. I’ve felt it as a patient AND a doctor. The first person you see may not be the best fit for you, it doesn’t mean they’re a Bad Doctor or you’re a Bad Patient/Parent, it just means they weren’t the right match. But taking some of the above into consideration, I think, can help with establishing care with someone that can help keep you healthy and take care of you and your loved ones for a lifetime.

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