Your primary care provider is your partner for preventive, routine and acute care. Many health insurance providers and health initiatives, including those started by the Centers for Medicare and Medicaid Services, encourage patients to choose a primary care provider.
"Your primary care provider is the quarterback for your health care team," said Laura Nelson, M.D., Marshfield Clinic. "He or she is important because of the care they provide and as a guide to other physicians and health care resources you may need."
A primary care provider helps maintain your health by ensuring you take advantage of preventive services and treatment plan monitoring, and by approving and coordinating lab tests, X-rays and referrals. If you need specialty care, your primary care provider will assist you in finding a specialist and in communicating your health problem to the specialist.
Primary care providers include:
- Family medicine physicians – their practices specialize in caring for family members of all ages, and may include obstetrics services and minor surgery.
- Internal medicine physicians -- their practices focus on preventive and primary care services for adults.
- Nurse practitioners (NPs) and physician assistants (PAs) - these "advanced practice providers," may serve as your primary care provider.
- Pediatricians - their practices care for children from infancy through adolescence.
- Obstetricians/gynecologists - their practices focus on caring for women, particularly those of childbearing age.
If you need a primary care provider, or are looking for a new provider, consider what matters most to you:
- Would you prefer a primary care physician who is a man, or a woman?
- Is the clinic in a convenient location and open days and hours when you are available to come?
- Does the doctor's office use an electronic health record?
- Is the office staff friendly?
- Is it difficult to get a timely appointment?
- Is there a lengthy wait at the clinic even when you have an appointment?
- Is the provider you want to see covered on your health insurance plan? (Check with your health insurance provider to know for sure.)
- Is the provider permitted to practice at the hospital you prefer?
- Does the provider take steps to prevent illness and focus on keeping you well? Does he or she talk to you about exercising more or quitting smoking?
- Is the provider available for after-hours calls and emergencies? If not – how are these situations handled?
You may find that friends, family, co-workers or other trusted health care providers will recommend a primary care provider to you. Your state medical society or other resources can verify a provider's credentials or describe the health system or clinic where the doctor works.
"You want a partnership with the entire team that your primary care provider leads," Dr. Nelson said. "You are likely to respond better to a provider who encourages you to ask questions, listens to you, explains things clearly and treats you with respect."
Urgent care and emergency room care, isn't primary care
It's common to confuse having a designated primary care provider with having a provider that you may see frequently at an urgent care or walk-in clinic, or in the emergency room at the hospital.
Urgent care services are intended to provide a gap between an injury or an illness that is too urgent to wait for an appointment with your primary care provider. Life-threatening situations should be seen in the emergency room. Neither is a substitute for having a primary care physician who sees you routinely enough to know what is normal health for you.