Family Medicine Vital Signs

 by Theadora Sakata

It is graduation time in Residency Land, and my time as a family medicine trainee is coming to a close. I am off to the Eastern time zone for a fellowship in sports medicine and find myself in a position common to many geographically mobile members of today’s workforce: a patient in need of a primary care physician.

For some people, finding a primary care physician (PCP) is a very simple thing: just call up the local clinic and make an appointment. Often, this is the no-nonsense approach taken by sensible young women with insurance and a need of birth control refills or other quotidian medications. However, for some people finding a new PCP is as mysterious in procedure as it is in necessity. It is for those people that I write today’s blog post on how to find a PCP.

Thea’s To-Do List for Finding a New Primary Care Doc:

1. Get records from my old provider. These can be requested later, but I’ve been on the empty-handed end of a medical records request enough times to know that sometimes the best way is to show up with hard copies in tow.
2. Establish that I have health insurance. For me, this necessity will be provided by my future employer, but not all people are so lucky. Going to Healthcare.gov would be my first move if I didn’t have health insurance because even if I can’t afford a policy on the insurance exchange, I could at least find out about where to look for an assistance program.
3. Call my insurance company or go to their website for a list of health care systems or individual doctors who are covered. Also make sure that all labs and imaging done within the system or within the doctor’s preferred lab or hospital are covered. It’s another hurdle and headache to always mule lab reports if your doctor can get results directly into their electronic medical records system.
4. Find out if the doctors on my “covered” lists work in a Patient Centered Medical Home (PCMH). There is a lot of literature out there on what a PCMH is, but a functional user-end description is this; a PCMH is a type of clinic where the doctors and staff have gone through a series of tasks to get their clinic a certification that means they’re all about you, the patient, rather than other things that wedge themselves between you and your care. This doesn’t mean that there aren’t any barriers, but it means that the staff are committed to working on reducing these barriers over the long run. This is a good thing.
5. I’d also call potential clinics to ask the following questions:
   1. Is there an after-hours phone call option and how do I access it? If going to the emergency room is the only way to get medical advice after hours, then I might try a different clinic. Sometimes the advice on the phone will be to go to the emergency room or make a clinic appointment the next day, but at least one can rest assured that doing so is the right choice.
   2. Does the clinic have same-day appointments available? Sometimes issues come up that are not emergencies, but they should be evaluated the same day or, at the very least, the next day. If your PCP’s office can’t get you in for 2 weeks, then it’s harder to save the emergency room for true emergencies.
   3. What other services are available under the same roof? Is there a psychologist? Social worker? Clinical pharmacist? Are you able to get X-rays done in-house? Or labs? Or do you need to run all over town? Different clinics will have different services readily available.
6. Finally, make an appointment for a physical and to establish care while I am feeling well. In addition to getting reminded of the health maintenance activities I should do in order to stay well, whenever I do get sick I can take advantage of those other services like phone advice or same-day appointments, which depending on the clinic, may be saved for returning patients only.

These issues are critical to continue caring for my health, and to have someone who can assist and guide me in such important decisions. If you don’t have a PCP, hopefully these steps can help you too better manage your health.

Theadora Sakata, MD is graduating from the University of Utah Family Medicine Residency and will soon start a Sports Medicine Fellowship at the Cleveland Clinic