Do you have a primary care doctor?
The Affordable Care Act relies on the trusted family doctor to help transform the country’s health care system. Along with boosting Medicare and Medicaid payments to primary care providers and investing in their work force, health reform puts primary care doctors and nurses at the heart of efforts to improve care while lowering costs. While questions remain about the readiness of the primary care system to adapt to these changes, studies show it’s a critical underpinning to the health care system overall.
Primary care helps to prevent illness and death, research tells us. A 2011 study found that Medicare patients with good access to primary care had lower death rates and wound up in the hospital less often for preventable conditions.
Dr. Sam Zager, a family medicine physician with Martin’s Point in Portland, describes primary care as “one of the only parts of our health care system that’s actually on offense.” American health care is geared toward defense, reacting to health problems when we’re already sick.
Many of us rely on word of mouth in choosing a doctor, but what else should we consider? For most patients, fit is paramount. A trusting, honest relationship with a provider who’s part of a top-notch practice tops the list, Zager said. Some people ask to meet with him before becoming a patient or when they’re newly established, with no other agenda than getting to know each other, he said.
“I’m quite aware that they’re sussing me out, and I think that’s appropriate,” Zager said.
Lisa Letourneau, executive director of Maine Quality Counts, a coalition working to improve health care in Maine, seconded the idea.
“It’s OK to try out providers before making a final decision, and leave if needed,” she said.
Also think beyond your individual provider. Much of your interaction with a practice will be with someone other than your primary provider, such as front office staff and specialists, Zager said. Ideally, you’ll feel comfortable with all of them.
A few other suggestions:
- If you’re unhappy with your current doctor, consider another who works within the same practice. “It’s must easier to switch providers within a practice than to go from practice to practice,” Zager said.
- Consider a nurse practitioner or physician assistant. Unlike physicians in primary care, their numbers are on the upswing and you may be able to get an appointment sooner, particularly in rural areas. While “mid-level providers” can address a variety of health needs, patients with complex health issues may be better off with a doctor.
Do your homework
- Visit the GetBetterMaine website to see how practices rate on several quality metrics — care for diabetes, heart disease and high blood pressure, as well preventing medical errors.
- What do other patients think? Check out Maine Patient Experience Matters to review public patient survey results on the doctor you have in mind.
- Has the doctor you’re considering ever been disciplined by the state licensing board? Here’s how to find out. You can also learn other details, such as where you doctor attended medical school.
- If you have health insurance, make sure the provider you’re eyeing is in your plan’s network. (Most health plans negotiate discounted rates with certain doctors and hospitals.) Otherwise, you could face high costs out of pocket. If you’re uninsured, paying for a primary care doctor might seem out of reach, but some physicians and clinics offer flexible payment plans.
These suggestions are just a start to finding the right provider. What do you look for in a primary care doctor?