What you should know about your primary care physician

If you haven’t already, you will someday see a primary care physician (PCP).

It’s practically unavoidable.

The reason for this self-declared truth is that PCPs are the shape shifters of medicine, assuming various roles at different stages of an adult’s life and wellbeing.

These responsibilities range from treating various health conditions, ushering patients in and out of hospitals, coordinating long-term medical decisions, and consulting with other specialists to better optimize patient care.

Given that you are either currently seeing a PCP or are likely to see one in the future, there are a few things you should know about the career of a PCP that may help improve communication between you and your doctor and provide insight into this extraordinary field of medicine.

1. Primary care physicians want to spend more time with you. Fact.  Even if you are in a grouchy mood or perhaps forgot to shower that week, PCPs definitely want to see more of you.  The reason for this is twofold. First, they signed up for this career specifically to develop a lasting relationship with their patients.  Second, the more time spent with each patient, the better a PCP can truly understand his or her health needs.

Take this simple case as an example:  a 60-year old male patient who is obese, smokes, and has diabetes comes in for a 15 minute visit with the complaint of toe pain from stubbing it last night while getting into bed.  Where a PCP can invariably handle this one complaint visit in the appropriately slotted time, he or she may have missed the opportunity to uncover through conversation the low-grade chest pain on exertion that this patient may have been experiencing but reluctant to disclose.

Many reasons exist why many PCPs have limited time to see patients, including various incentives and competing roles (some of which we will cover below).  Regardless, I guarantee that most PCPs would ideally like to see their patients more frequently.

What simple steps can you do as a patient to promote adequate time with your PCP?

When calling for an appointment, let the scheduler know if you have more than one complaint to discuss so they can carve out adequate time (whether it be one longer visit or a series of smaller visits).  Remember to bring in a list of complaints to present to your PCP so he or she can adequately prioritize the visit.

2. Primary care physicians have to do more administrative work than any medical specialty. One of the most common complaints of a primary care provider is the vast amount of extra work required beyond the scope of direct patient care.  Most of these obligations revolve around clinical documentation, coding/billing and filling out various forms (work, disability, home health needs).

Despite the fact that the direction of primary care practices in this country are moving towards a cooperative and integrative care system where physicians, nurses and other ancillary staff work in coordinated effort to take care of many of these needs, many health care providers may be experiencing an even higher demand for more precise documentation and billing that presumably will require even more time away from the patient.

What can you do to help minimize this extra effort spent away from the examination room?

Truthfully, not much.  However, making sure to fax/email all paperwork from outside hospitals, specialists and former primary care practices to your current clinic office can help the flow of your future PCP visits.  Bringing a list of current medications to any and every visit is imperative as it shaves off unnecessary time spent searching for prescriptions and also prevents medication errors.

3. The field of primary care is in flux. The classic structure of primary care and the foundational concepts of what it should represent and how it should be delivered are acutely being put into question, and for good reason.

Our health care system has historically focused on treating late-stage disease and acute illness in comparison to preventative care and the management of chronic health conditions.  In order to better treat our populace, it is imperative that more resources are allocated to treating disease as early as possible in their manifestation and avoided altogether through well-researched public health measures such as universal screening and vaccination programs.

This movement of highlighting comprehensive care away from the hospital in an efficient and financially solvent manner is currently creating a massive experimentation phase in our country with regard to just about ever aspect of primary care.

Given that many primary care practices across the country are involved in these novel care structures, you should be aware that your experiences in outpatient medicine might become completely different from your expectations based on previous encounters in primary care.  You should be open to these new care structures and find one that best fits your preferences.

Take home point

The practice of primary care medicine is not an easy one.  In fact, it is often characterized as one of the most challenging careers within the field of medicine.  Despite this, the immense pleasure and personal reward that is intrinsically involved in longitudinal and holistic patient care is what often drives future PCPs into the field.

How would you describe your experiences with primary care and outpatient medicine?

Hopefully, they have been positive ones.  If not, I hope the few insights and unsolicited suggestions provided above will help better facilitate an improved patient experience.

Brian J. Secemsky is an internal medicine resident who blogs at the Huffington Post.  He can be reached on Twitter @BrianSecemskyMD

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