Can My Health Insurance Help Find Me a Primary Care Physician?
Most major health insurance companies have a list of primary care physicians who fall within their network. Patients can choose one from the designated list or can opt to pay a higher amount if the doctor they prefer is out of network.
According to the Wall Street Journal, many people seek recommendations from their friends and co-workers if they are looking for a new doctor. This often happens when people move to a new city or job, their doctor moves, or their physician no longer accepts their existing insurance. In such cases, people seeking new primary care physicians are likely to combine recommendations from trusted people and insurance company network lists to make affordable choices.
While it is important to find a doctor who comes highly recommended, patients must take into account that the process of finding a primary care physician could take a long time, depending on whether or not the doctor’s office is accepting new patients.
What is a primary care physician?
Traditionally, a family physician used to undertake general checkups and oversee treatment of everyday issues such as dispensing medication for common ailments and fixing to broken bones, among others.
Nowadays, a primary care physician, who helps maintain the overall health of their patient through preventative care, also plays that role.
According to the American Academy of Family Physicians, a primary care physician is a generalist doctor who provides oversight of all the patients’ medical and health care needs from the first point of contact with the medical system, and then takes continuing responsibility for providing health care without being limited by specializations. Specifically, primary care physicians act as advocates, who guide their patients as they coordinate the labyrinth of the entire healthcare system.
A growing number of primary care practices are engaged in providing a combination of services that include coordinating with specialists; overseeing a patient’s overall health and tracking their need for specific diagnostic tests, medications, etc.; health promotion and maintenance; disease prevention through diagnosis and treatment; and patient education and counseling.
Given their efficacy, a noticeable number of health insurance companies are requiring their policyholders to opt for a primary care physician. Patients should talk to their insurance company or check their policy to see if they are required to choose a primary care physician.
What are the qualifications of a primary care physician?
A medical professional needs to be specifically trained to act as a primary care physician. Some of the specializations that work as primary care physicians are family or general practitioners, internal medicine, and pediatrics. As the name indicates, a family practitioner is qualified to treat a family. He or she can carry certifications in obstetrics and gynecology, internal medicine, and psychiatry, among others.
An internist is trained to diagnose and treat diseases with medicine. While they are not qualified to perform surgery, they can specialize in areas such as specific organs, diseases, or age groups.
And the final group is pediatrics, who are doctors specializing in the treatment of children, from birth to adolescence. Pediatrics also has multiple specializations such as surgery, diabetes, etc.
How can I find a primary care physician?
Finding the right doctor can be a tedious and challenging process. While one can pick a doctor out of a phone book, it makes more sense to do your due diligence through research and recommendations.
The easiest way to find a primary care physician is to talk to your insurance company. They are likely to provide you with an extensive list of in-network doctors who are accepting new patients.
Another route is to talk to your family, friends, and colleagues about their doctors. Recommendations from someone you know can help you find a doctor that meets all of your needs.
If you are moving away or if your doctor is losing his or her network status, they might be able to refer you to a respected colleague. Another great resource could be your local area hospital, which can provide you with the names of their own doctors.
Do I need a primary care physician?
Preventative care is the best way to maintain your health, and primary care physicians are trained to do just that. Since they usually perform annual exams and see patients regularly, primary care physicians have access to complete health records. In other words, they are likely to uncover unhealthy signs such as high blood pressure or cholesterol before they take on gargantuan proportions and need expensive specialized care.
Primary care physicians are also trained to educate and guide their patients towards healthy lifestyle choices, which can prevent medical issues in the long run. Additionally, if preventative care is not helping, primary care physicians will be able to refer you to the right specialists. And catching early warning signs can literally mean the difference between life and death.
So choose your primary care physician carefully and develop a healthy relationship with him or her. After all, they are your trusted gatekeepers of healthy living.