Navigating the World of Primary Doctors and Specialists

Written by Amedisys

Navigating your or your loved one's healthcare can sometimes feel like a daunting task with so many kinds of doctors or providers. In this resource, we've compiled some useful tips on what type of provider you need. 

What's the difference between a primary care physician (PCP) and a specialist? 

Primary care physicians are your home base for health care. You'll see them for most of your non-emergency needs, including preventative care, routine check-ups and most illnesses. Specialists center on one aspect of care, such as cardiology or surgery. Patients typically need a referral from a PCP for initial appointments with specialists. 

PCPs are able to provide comprehensive care as their focus is on the personal health of an individual. They are the professionals with whom patients first interact when entering into the medical system. Specialists will hone in on one piece, like an organ system or problem area.

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How do I find a PCP? 

As important as they are, choosing a PCP takes a little bit of research. The first step is asking around. Ask your friends, neighbors and relatives who they see and if they are happy with that provider. You can also check with your insurance provider for directories that can help you make the right choice. 

Once you've narrowed it down, schedule a preliminary meeting with your top choices to get a feel for the care style. The Mayo Clinic recommends you choose a provider who: 

  • Makes you feel comfortable discussing health topics
  • Answers your questions
  • Communicates well, speaking in terms you can understand
  • Doesn't make you feel rushed
  • Suggests ways to improve your health
  • Recommends screenings and exams appropriate for your age and sex
  • Treats common illnesses and injuries
  • Involves you as a partner in your care - asks what you think, listens to your concerns and expects you to follow through with action when required
  • Explains the options when you need treatment
  • Offers referrals to highly qualified specialists when necessary
  • Has a convenient location from your work or home
  • Offers convenient hours and appointments without long waits
  • Is board certified, indicating the provider has had additional training after medical school and has passed an exam in a medical specialty

I've made an appointment to meet with a potential primary care physician, what are some things I should ask during my appointment? 

  • Make sure you feel comfortable with the doctor. You'll want to develop a trusting, long-term doctor-patient relationship - and so do all good primary care doctors. One of the best things you can do for your health is to establish a strong working partnership with your PCP and his or her healthcare team. 
  • Find out whether the doctor uses electronic health records (EHRs). Personal electronic health records make it easier to share important health information quickly if you need to be seen at another medical facility, or in a home health setting. 
  • Consider where the doctor's office is located. While most healthy adults only need a checkup every one to five years, it's more convenient to have a doctor located close to your home or work. 
  • Ask how easy it is to get in to see the doctor. Be aware that some practices have a policy that enables patients to see a primary-care doctor the same day they call for an appointment. 
  • Does your insurance or health plan cover your physician choice? Often doctors need to be plan-approved or affiliated with a specific group in order to be covered by health and insurance plans. 
  • Ask if the doctor is board certified. All general practitioners must be board certified, having completed a medical residency. 
  • Is the doctor accepting new patients?
  • How long will you have to wait for an appointment?
  • Who sees patients when the doctor is not available? 
  • Is there a 24/7 nurse line available?
  • What hospitals does the doctor have privileges at? 
  • Does the doctor have experience with your medical condition? 
  • What home health and hospice providers does the doctor work with? 

How do I find a specialist? 

Typically, your PCP will refer you to a specialist. But, that doesn't mean you don't have a choice. Consider the following when selecting a specialist physician:

  • Who does your PCP suggest?
  • Have your PCP and the specialist worked together before?
  • What are the specialist's credentials?
  • How do you feel about the facility where the specialist works? 
  • Does the specialist answer my questions and make me feel comfortable?