If you’ve ever needed medical care and asked yourself, “How do I find a family doctor near me?” you’ve come to the right place.
Health Maintenance Organization plans gained ground with the advent of important provisions of the Affordable Care Act in 2010. In terms of these health insurance plans, members must have a primary health care doctor within the plan’s network.
Where necessary, the primary care doctor will refer patients to a specialist operating within the plan’s health care provider network. This seeming return to a time when family doctors were the norm, and the general practitioner handled everything from the birthing of babies to bone setting and treating common ailments is not a bad thing as it allows for a degree of familiarity with the family’s general health.
This article provides an overview of how primary care practitioners (PCP) work and what to look for when seeking a PCP.
Who is a primary care doctor?
3P4Care believes that community-based general practitioners or family physicians working outside a hospital are the only primary care doctors. Traditionally, patients have easy access to primary care doctors without having to be referred, whereas specialists can only see a patient after the primary care doctor has authorised a referral.
What is the difference between a general practitioner and a family physician?
Until the 1970s, most medical graduates completed a year of internship after medical school, which qualified them to be a general practitioner. However, it was soon felt that such short training was not sufficient to produce a well-qualified family doctor. While most European countries began to require four to five years of training after medical school for a doctor to qualify as a family doctor, they retained the term ‘general practitioner’. Although the United States requires only three years of residency for the future family doctor, it tries to distinguish the three-year-trained ‘family physician’ from the ‘general practitioner’ without such formal training. 3P4Care believes that all family doctors should have received at least three years of formal training in family medicine, and there is no need to distinguish between ‘general practitioners’ or ‘family physicians’.
Does a specialist know more than a primary care doctor and why should a patient not see a specialist right away?
A specialist knows more about less (depth); a general practitioner knows less about more (breadth). In the community setting, a patient often presents with undifferentiated (vague) symptomatology not fitting any textbook definitions of diseases, and a general practitioner, on account of his/her breadth of clinical skills and personal knowledge of the patient, is the best primary care doctor to partner with the patient to decide whether to use symptomatic relief or to pursue more diagnostic testing.
What are the special features of primary care?
There are core values unique to primary care:
● serving patients of all ages (children, young adults and elderly)
● serving patients of genders (female, male and other)
● covering all organs of pathology (both medical and surgical approaches)
● easily accessible
● ensuring appropriate referrals to specialists and subspecialists
● competent dealing with uncertainty of undifferentiated presentations
● managing patients based not just on diagnosis but on patients’ cultural values and preferences
● competent providing acute care, preventive services and chronic disease management
● possessing personal knowledge of patient through long-term relationship
Are physicians (internists), paediatricians, obstetricians and gynaecologists primary care doctors?
According to the criteria above, internal medicine (which excludes children and surgical organs), paediatrics (which excludes adults and surgical organs), and obstetrics & gynaecoogy (which excludes men and non-reproductive organs) cannot be classified as prrimary care. In late 19th century, in both Europe and North America, specialists in these fields worked as consultants and not primary care doctors. Such a system is still largely adhered to in Europe and Canada. However, in the US, after the Second World War, as the number of general practitioners/family physicians dwindled, many of these consultant specialists began to present themselves as primary care doctors to bypass the referral process. The late Dr John Fry, consultant to World Health Organisation, coined the term ‘specialoid’ to describe this US phenomenon of consultant specialists functioning as primary care doctors. 3P4Care, therefore, defines primary care doctors as only general practitioners or family physicians working in the community-based offices.
Primary Care Doctor with Insurance
Although anyone with health insurance coverage can opt for a primary care provider as their go-to doctor, only those with a Health Maintenance Organization plan are required to choose a specific doctor to see to their primary care needs and ensure that common health issues are diagnosed early and properly managed.
Most Health Maintenance Organization plans will cover urgent or emergency care regardless of whether the doctor is “in-network” or not. But you will need to check your plan’s small print.
Plans that don’t require a designated primary care provider include Point of Service plans, Exclusive Provider Organization Plans, or Preferred Provider Plans. With a Preferred Provider Plan, you will not need a referral before seeing specialists.
Important Considerations When Seeking a Family Doctor
Comprising both curative and preventive medicine, primary care aims to ensure the patient’s overall well-being by treating the person as a whole rather than concentrating on a specific disease, organ, or system.
The primary care doctor has a broad overview of the patient’s health record and can prevent harmful medication interactions since they keep files on your care. Annual visits to your primary care provider can help you improve your lifestyle, identify potential problems and treat them before they escalate.
Find an “In-network” Healthcare Provider
Your health insurance plan will dictate that you can only use certain providers with whom they have negotiated special rates. Visiting a doctor who is “in-network” will ensure there are no surprise out-of-pocket charges. Check your provider’s directory for their approved list of primary care doctors, then confirm with insurance and the provider whether they’re in-network with your plan.
Do your Homework
Friends, family members, or co-workers may have good suggestions for primary care providers they have used in the past. It is not unusual to ask your present doctor for a referral if you are moving. Some people even turn to social media for recommendations. Look for reviews online if you are unsure. Hospitals may furnish you with referrals to staff doctors who meet certain criteria – whether it is the amount of experience they have, a particular specialty, gender, or location.
Be Mindful of the Logistics
Consulting a doctor whose rooms are conveniently situated in case of emergency makes perfect sense. Your decision may also be affected by the office hours they keep and the hospital they tend to admit their patients to.
Building a Relationship
Finding someone you can relate to, trust, and feel comfortable with is essential since they will be your first port of call for medical treatment. You will need to have frank discussions with them about your health concerns and those of your family, so someone who intimidates or does not listen to your concerns is not the right person for the job.
Visit the doctor, and talk to them about your medical history and the medications you may be taking. If you have certain health questions, ask about these and ensure your outlook is similar to that of the doctor. Ask yourself if you like the atmosphere and the way the staff interacts with patients. Take note of whether they seem efficient. Ask about the wait times for appointments and pay attention to whether the phones are left to ring for long periods.
Do they Know their Stuff?
Ensure that the doctor you choose knows how to deal with specific health issues you may be facing.
Understanding One Another
To avoid misdiagnosis, your doctor should be able to understand your language. Health insurance providers often offer a list of doctors who speak other languages, including Spanish.
Tech-savvy Providers
Some doctors are more willing than others to use telemedicine to consult with patients. Take this into consideration if you live in a remote area or don’t have time to travel for a consultation.
Family Doctor Available in Chicago, IL
If you or a loved one are in need of a family doctor, reach out to 3P4Care today! Our team can assist you with preventive care, treatment for acute illnesses, and chronic disease management. For more information, visit our contact page or schedule your appointment online today!
