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The Primary Care Practitioner

by Michael R. Wasserman, MD

Typically, the entry point into the health care system is a primary care practitioner, usually a doctor but sometimes a nurse practitioner or physician’s assistant. The primary care practitioner provides general medical care and is responsible for overall care, including the coordination of medical specialists and supportive care. Having a primary care doctor has many advantages that can lead to better care. People who have a primary care doctor are less likely to go to an emergency department unnecessarily and less likely to be seen by a doctor they do not know. When people see a doctor they do not know, the doctor may not have all the background information necessary to diagnose and treat the problem. Consequently, the doctor may repeat tests or do unnecessary tests.

Communication is often better and medical decisions are more easily made when people have an established relationship with a primary care doctor. People are more likely to trust a doctor they know and to experience less anxiety when a medical problem develops. Primary care doctors often have long-standing relationships with their patients. They are familiar with what their patients want and value, how they best receive information, how they cope with adversity, whether they are able to purchase prescribed drugs, and which family members they rely on.

Primary care doctors explain what type of care is needed, why it is needed, and how often visits should be scheduled. They can refer people to specialists when needed and coordinate care with other health care practitioners. Some health care plans require people to see their primary care doctor to get a referral before they see a specialist. Although this practice may be seen as an obstacle to specialty care, it can be helpful. For example, having to make a referral ensures the primary care doctor is informed about all of a person's health care needs. It also ensures that people see the proper specialist.

To find a primary care doctor, people can begin by asking friends and relatives for recommendations. Or they can call a medical school and ask for a department, such as pediatrics, internal medicine, or family practice. Older people may want a doctor who specializes in treatment of their age group (a geriatrician) as their primary care doctor. Many health insurance plans limit the choice of doctors and other practitioners. In such cases, people should consult the plan to obtain a list of participating practitioners. Sometimes people cannot see the doctor they have chosen because the practice no longer accepts new patients.

For information about a doctor’s credentials, people can call the American Board of Medical Specialties (866-275-2267 toll-free) or check that organization’s web site ( ) or book, which is available in many public and medical libraries.

When choosing a primary care doctor, people should consider what is most important to them in a doctor (for example, friendliness, thoroughness, patience, or promptness). Some people prefer a doctor who spends extra time with them, even if doing so tends to make the doctor run late keeping office appointments. Other people prefer a doctor who keeps appointments on time, even though doing so may limit the time the doctor spends with them. People should look for a doctor they feel comfortable with and have confidence in.

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