And What to Do When Your PCP Isn’t Available
Your primary care provider (PCP) is that professional you see every year or so for preventive screening or more often if you are managing ongoing health concerns. S/he’s also the one you call when you get sick or develop concerning new symptoms. But, what if your PCP isn’t available? Your options depend upon the circumstances.
Wait, Back Up!
Why is it important to have a primary care provider? A PCP is the quarterback of your healthcare—the person you trust to guide you towards the right care in the right setting in a way that is consistent with your preferences and values.
Your PCP gets to know you over time, tracks your vital health information, notes changes and oversees your care. Having your PCP manage your care means problems are more likely to be identified early, before they become serious or lead to other major illnesses. For example, catching high blood pressure early and getting it under control could prevent a stroke in the future.
Having a PCP is known to help avoid non-life-threatening visits to the emergency room, which costs at least four times as much as other outpatient care. As many as 65% of ER visits are considered unnecessary according to the Centers for Disease Control.
Need a Primary Care Provider?
Finding a PCP
If you don’t have a PCP or if you’re not comfortable with yours, here are some tips. Research shows that people who develop strong partnerships with their PCPs report more satisfaction with their care. Reasons to leave your current PCP include feeling uncomfortable in anyway; maybe you are rushed through appointments or can’t easily get an appointment, or feel that s/he doesn’t listen carefully, maintain eye contact or explain information so you can understand it.
Consider what qualities you’d like to have in a provider. Do you want a male or female? Is it important that he or she speak the language you are most comfortable speaking? How far are you willing to travel? Does the practice offer extended or weekend office hours?
There are many types of PCPs to consider. A primary care provider can be an internist (internal medicine), family practice doctor, pediatrician for children, physicians’ assistant or a nurse practitioner. In areas where PCPs are in short supply, it may be possible to have a specialist oversee your care.
Check your health insurance company’s list of in-network providers. If you use an in-network provider, you will pay less for care because your insurer has negotiated lower prices with those doctors.
Does your employer offer an on-site clinic? That’s an excellent place to seek care because those providers are familiar with your work environment, which often has an impact on your health, and it will likely be convenient to your workplace and accommodate your work schedule.
Much information is available online about providers and their practices. Check their websites for provider background information, insurance plans accepted, hospital affiliations and office hours. Also, you may be able to watch videos of providers describing their approach. Co-workers, friends and family are another great source of information about providers they recommend and those to skip.
Once you’ve narrowed down your list of potential providers, call each practice to confirm that the provider is accepting new patients and takes your health insurance plan. Ask how long it will take to get a new patient appointment and any other questions you have about provider availability, after hours services, wheelchair accessibility, etc. Find out if you can have a short consult by phone or in person with the provider (ask what the charge will be). This will shed light on the provider and practice so you can decide if the situation meets your needs.
Let KnovaSolutions Lend a Helping Hand
KnovaSolutions can help you become an informed and engaged consumer of healthcare services.
KnovaSolutions 800/355-0885 Monday through Friday 7 am – 7 pm, CST
KnovaSolutions is a confidential health information service offered to you at no cost by your employer or benefit organization. It is available to you and members of your family.
Your Provider Isn’t Available?
It may not be your first choice when you have a medical concern, but if your provider isn’t available, you may be able to talk to or see another provider in the same practice—who has access to your medical records. This is a major advantage to having an established PCP!
If the practice offers telehealth services, consulting with a provider may be possible by telephone or through video chatting (FaceTime or Skype, for example). With video chatting, it’s possible to talk to a provider and show visible concerns like a cut or rash. Some employers offer telehealth or teledoc services as a benefit of employment.
Over weekends or at night, the practice’s on-call doctor will be able to guide you. Your PCP practice should always be your first call, unless you have an emergency. If you have a life or limb/life or death situation, call 911 or get to an ER right away.
If you don’t have a life or death situation, but feel the ailment can’t wait, an urgent care facility or in-store, pharmacy-based clinic may be a better choice than the ER. Providers at these clinics treat ear infections, minor cuts and burns, sprained ankles and other non-life-threatening conditions. Urgent care clinics may have an x-ray machine and the ability to do some lab testing, and some publish their wait times online.
ERs perform vital services in any community; they are equipped for medical emergencies, such as heart attack, stroke and severe allergic reaction. However, ERs (and stand-alone emergency centers affiliated with hospitals) are very expensive places to seek non-emergency care. According to the Healthcare Bluebook, the average 25-minute PCP office visit for an established patient costs $105 in the southwest U.S. The average urgent care clinic visit costs $130 and the average emergency room (ER) visit for a minor problem is $514, in the same area.
Your KnovaSolutions clinician is a resource for non-emergency health questions. We can explain medical terminology, describe your options, and help you prepare questions for your provider so you get the most out of office visits. Sometimes an empathetic ear can make all the difference if you’re facing difficult healthcare decisions. We’re here to help. Call us at 800/355-0885.
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The information contained in this newsletter is for general, educational purposes. It should not be considered a replacement for consultation with your healthcare provider. If you have concerns about your health, please contact your healthcare provider.