The right choice
Finding the right primary care physician for you is not always easy and it shouldn’t be taken lightly. It is one of the most important relationships you will ever have. This is the person who will monitor and direct all your care. You need to be sure. There are many factors to consider.
the CEO of your health care
If you’re making a list and checking it twice this holiday season, why not jot down a few ways to improve your health? Let’s see — there’s quitting tobacco, exercising regularly, eating well, losing extra pounds, getting enough sleep, defusing stress and taking medicine as prescribed. If this looks a tad too ambitious, don’t despair. Your primary care provider can help you select one healthy goal and recommend steps that will set you on a path toward achieving it.
Who are your primary care providers?
Primary care providers (PCPs) are medical professionals trained to handle common injuries and health problems. They act as a hub for all of your medical information, too. That’s true whether you come to their offices, get referred to a specialist, go elsewhere for tests or take an unexpected trip to the hospital. By providing this oversight, a good PCP helps ensure that your health care isn’t fragmented.
Often, PCPs work in a team. Heading it up might be an internal medicine doctor (internist) for adults, a pediatrician for children, a geriatrician for older people or a family practitioner who can help children and adults. Also, you may find a registered nurse or nurse practitioner with training in a particular area, such as pediatrics or internal medicine. Social workers, pharmacists and other clinicians may be team members, too.
The best primary care strives to focus on the whole person, rather than responding to health needs illness by illness. Central to this philosophy are wellness care and preventive health measures, such as vaccines that prevent illness, appropriate tests and exams and advice on self-care and healthy habits that you can apply at home. Long-term health problems, such as heart disease, obesity and depression are treated, too. So are acute illnesses and injuries like pneumonia or a sprained ankle. Referrals to specialists and community services are made as necessary.
A fresh concept in health care is the patient-centered medical home (PCMH or “medical home”). It builds on the existing strengths of primary care practice. Contrary to what you might picture, a medical home is not the office you visit to see a doctor. Much as described above, it’s a comprehensive team approach that can be shaped to address most of your health issues.
Care differs depending on your health needs, values, culture and preferences — even your family situation may come into play. Electronic medical records and extended hours of availability are the norm, speeding access to care and advice.
Although this sounds like costly concierge medicine, it’s not. Nor does it use gatekeepers to restrict access to specialists as managed care often does.
Demonstration projects of medical homes are being studied in multiple sites around the country. Some early results — fewer hospitalizations and modest improvements in care, according to recent research — are promising.
While you await further developments, you can do much to improve your own health. That’s right: work toward quitting tobacco, exercising regularly, eating well, losing extra pounds, getting enough sleep, defusing stress and taking medicine as prescribed. Your PCP will be happy to help.
Ways to help you save money
Often, your primary care provider can suggest ways to help you cut costs while getting high-quality health care. Try asking a few simple questions:
Can you prescribe a generic drug?
When your doctor prescribes medicine, ask about generic options. Generic drugs contain active ingredients that are equivalent to brand name drugs and usually equally effective at far less cost.
How will this test or procedure help me?
Has it been done before? If so, is it necessary to repeat it now? It’s true that certain tests and procedures are recommended at regular intervals to see if treatment is needed or check that your current treatment is working well — for example, tests to check blood sugar or cholesterol and triglycerides. Avoiding unnecessary tests or procedures saves you money and exposure to risks, however.
Is there a high-quality, lower-cost site where I can have this test or procedure?
If you need imaging tests, such as an X-ray or MRI, a freestanding lab facility may charge less than a hospital. Ditto for a community hospital versus a specialty hospital.
Want more suggestions? Check your health insurance policy or call member services to learn where else you might cut costs. For example, Blue Cross Blue Shield of Massachusetts offers a plan with a hospital choice cost-sharing feature. Each hospital listed has met quality benchmarks. Members pay less or more depending on which hospital they choose for certain planned procedures and tests. Interested members can get a list of lower-cost and higher-cost hospitals in their locale by calling 888-636-4808 or checking online at www.bluecrossma.com/plan-education/pdf/hospital-list.pdf.