Five Tips on How to Pick a Primary Care Provider

Recently, I found myself searching for a new primary care provider. As a woman over fifty, I decided to have a physician of record for preventive maintenance.

Tip number one

Find out if your physician is board-certified. Board certification is an important yardstick. A physician must keep up with the current medical trends. Board certification is a standard test that determines that. Before the 1990s, board certification was done only once. It was valid for the entire professional career of a physician. However, with the rapid changes in the medical landscape, the American Board of Medical Specialties decided to require re-certification every 8-10 years. Many patients do not know this, but this information is public knowledge. To check on the board status of your physician, click here.

Tip number two

Ensure that the physicians' office hours align with your schedule. This is very important, especially if you have a job that is not very flexible. If you need to be at work 8-5 PM and your physician's office is also open from 8-5 PM, that is not a good match. If office hours are essential to your decision-making, ask the receptionist what the hours are before deciding to schedule an appointment. You may want to look for an office with evening or weekend appointments.

Tip number three

Know how long it typically takes for your doctor to return your calls. I can't tell you how often I hear this complaint as one of the reasons that patients get upset and leave a medical practice. May I suggest you 'establish the ground rules' on your initial visit with your new healthcare provider? That way, both parties know what to expect- no surprises. For instance, your doctor may have a policy that if it is not urgent, it takes up to 24 hours before they get back to you. Or they might have their nurse get back to you with more information before they answer your question. Sometimes, your healthcare provider may need to see you back in the office. For example, an office visit is required if your sugars run high for some time. But it is essential to know this ahead of time.

 Tip number four

Know how the results of tests will be communicated to you ahead of time. These days, with the availability of the patient portal in most large practices, it's no longer a challenge to obtain your test results. However, knowing how your healthcare provider communicates abnormal test results is essential. Just because you can see the test results in the portal does not mean you can interpret them. Find out whether your healthcare provider expects you to schedule a return visit. Knowing this ahead of time cuts down on any misunderstanding. Also, please realize that the adage 'no news is good news' does not apply to your healthcare. Always expect some form of communication regarding any tests performed on you.

Tip number five

Verify if your provider is in-network. Based on my experience, this can prove pretty tricky as neither the insurance company nor the primary care provider's office may take the time to update the online database. Case in point: I did my due diligence and checked the insurance website when I booked an appointment with a new provider late last year. It showed that she was an in-network provider. However, two months after my visit, I received a $670.00 bill for the visit. The billing office rudely informed me that my provider was out of network, so I was responsible for the full payment. My best tip would be if in doubt, to contact the business office ahead of scheduling a visit with a provider and obtaining that information.

Introducing Direct Primary Care

After my experience with an insurance-based model, I began to consider the possibility of setting up a practice that allows people to access a provider without the hassle of dealing with insurance. 

That is when I began to examine and research the Direct Primary Care model. Direct Primary Care- also known as DPC for short- is a new way of obtaining healthcare that eliminates the hassle of dealing with the insurance-based model of care. DPC, however, is not a form of insurance.

Direct Primary Care allows you:

• Prompt access to your primary care physician.
• Longer appointment time with your physician.
• Direct access to your physician in between visits.
• Focus more on health promotion and disease prevention.
• No confusing paperwork.
• No surprise insurance bills.

If you are in Illinois and would like to learn more about my practice, click here.