Choosing a Primary Health Care Provider (PCP): General Information

Looking for information on how to find a primary health care provider (PCP) is a smart decision, because routine check-ups are a very important part of taking care of yourself.

Why do I need a PCP?

You need a PCP so that your health can be checked regularly to catch any problems early on (so that they don’t become worse). Your PCP can help you make smart choices to stay healthy. They can talk with you about health risks which can result from your decisions about smoking, marijuana, alcohol, vaping,  sex, sunscreen, seat belts, and nutrition, and give you advice about healthy behaviors and/or treatments. If you have a serious or unusual medical problem, your PCP can refer you to a specialist, someone who knows much more about that specific kind of problem.

Who can be a primary care provider?

A PCP can be a doctor, nurse-practitioner, or physician’s assistant (PA). Nurse-practitioners and PAs are trained to provide primary care.

Nurse-practitioners are required to work with a doctor or physician in some states, but can work alone in others. PA’s are required to work with a doctor. They perform regular check-ups and help address your problems.

What should I look for in a PCP?

Decide if you want your health care provider to be a woman or a man, or if it doesn’t . You should feel comfortable with your PCP, since it’s important to share personal information and any health problems with him/her. You’ll need to find a health care provider who will listen to your concerns, answer your questions, and takes the time to explain things clearly to you. It’s a good idea to try to find a health care provider who has an office near where you live or go to school.

What if I’ve turned 13 and I want a provider that sees teenagers?

You should ask your provider if they see teenagers or if there’s another provider in the office who does. Some PCP offices will have special clinical hours dedicated for teen appointments. It’s important to talk with your provider about how they will discuss your health care needs with your parents. What will they tell them? What do they have to tell them by law?

How do I find the names of health care providers?

You should first make a list of names of health care providers. You can do this by asking your parents, friends, and relatives for the names of health care providers that they go to and like. Make sure that the person has gone to that health care provider more than once.

There are other ways to find a provider. Talk with your current health care provider, they may be able to provide you recommendations in your area. You can also check the “Doctor Finder” service of the Web Site of the American Medical Association, at ama-assn.org. Or call a doctor referral service at a hospital or a local medical society, or your insurance company will have a list of providers they cover.

What if I belong to a health plan?

If you belong to a health plan, your choice of health care providers may be limited to providers that are part of the plan. Sometimes you can choose to see any provider. You should check the plan’s list of health care providers by either checking your health plan’s website or by calling your health plan (phone number and website should be on your health plan card). Ask friends or relatives who have the same plan as you for names of health care providers that they like.

What if I don’t belong to a health insurance plan?

If you don’t belong to a health insurance plan, your choice of providers may be much greater. You may want to first think about which provider you would like to use. Check on how much a typical office visit and lab tests cost (often you can find this information online or by calling the office). If it doesn’t fit your budget, check out public health clinics, family planning clinics, health centers, and hospital clinics. Also, check whether they have sliding scales (adjusted cost for visits) or free care or whether they can help you get health care through insurance companies or Medicaid.

Is there a way I can check on how qualified a provider is?

Yes, you have a few options. You can go by what your friends, relatives, or current health care provider says. You can also call the provider’s office and ask the office staff what the provider’s credentials are. Providers should be licensed to provide care by the state in which they work.

A way to find information on the quality of care of different providers is to visit docboard.org.

You can find out if a provider is board certified by calling The American Board of Medical Specialties at (800) 776-2378 or visiting abms.org. “Certified” means that the provider has finished a training program in one area of medicine and has passed an exam (board) that tests their knowledge, skills, and experience to provide quality care.

How do I decide on one PCP?

Once you’ve made a list of providers, you might want to try calling their offices and asking a few questions. The way that the staff answers your questions can say a lot about the provider. You first need to find out if the provider is covered by your health plan and if they are taking new patients. If you don’t know if the provider is board certified or what their training is, you can ask!

Some other questions you might ask include:

• Which hospitals does the provider work with?
• What are the office hours (when is the provider available, and when can I speak to office staff)?
• Does the provider or someone else in the office speak the language that I am most comfortable speaking or do they have translators available?
• How many other providers can see me when my primary care provider is not there? Who are they?
• How long does it usually take to get an appointment with the provider?
• What happens if I am late for an appointment?
• What are the provider’s fees? Do I need to pay when I’m at the provider’s office or will they send me a bill?
• What do I do if I need to cancel an appointment? Are there any fees for canceling an appointment?
• What do I do if I have an emergency or if I need medical help after-hours?
• Does the provider give advice over the phone, email, or online portal or telehealth for common medical problems?
• Can I contact my provider by e-mail or through a patient portal?

The answers to these questions should help you decide which provider you want to handle your care. Once you like what you hear, make an appointment with that provider for a general check-up.