Choosing a Primary Health Care Provider (PCP): All Guides

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

female doctorsLooking 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. He or she can talk with you about health risks which result from your decisions about smoking, marijuana, alcohol, 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 PA’s are trained to perform many parts of 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 matter. 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 and 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 he/she sees teenagers or if there’s another provider in the office who does. There may be special clinic hours for teens to be seen in the office. Talk with your provider about how to let your parents know about your health care needs.

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. You can check the “Doctor Finder” service of the Web Site of the American Medical Association, at ama-assn.org. You can 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. 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.

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 or relatives say. 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 her or his 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 he/she is taking new patients. If you don’t know if the provider is board certified or what their training is, 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 for common medical problems?
  • Can I contact my provider by e-mail?

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.

Choosing a Primary Health Care Provider (PCP): Check-Ups

female doctorsDo I need to bring anything to my first check-up?

You should take a copy of your health records, including your immunization record (a list of all the vaccines you have had and the dates you received them). You can get these records from your old primary care provider, or maybe from your school. Also, bring any medicines you are taking, or bring a list of them. Ask your parent(s) if you have any allergies and if you’ve ever had any allergic reactions to any medicines you’ve taken in the past, so that you can tell your new PCP.

What will happen at my check-up?

Your PCP will ask you questions about your:

  • General health, such as if you have headaches, sore throats, infections, and stomach aches.
  • Gynecologic history, such as when you started your period, how often you have them, and whether you’ve ever had a sexual partner or sexual intercourse.
  • Health habits, such as if you smoke, drink, use recreational drugs, and wear sunscreen and seat belts.
  • Nutrition, stress level, your mood today, and whether you have had problems with anxiety, depression, cutting, or attempting suicide.
  • Family history, such as whether any of your parent(s), aunts, uncles, brothers, sisters, or grandparents has high cholesterol.

Check-ups will also include measuring your height, weight, and blood pressure. Your ears, eyes, throat, neck, heart, breasts, and abdomen (stomach) will also be checked.

During your teen years, you’ll get:

Girls and boys should get the human papillomavirus vaccine series to protect against the virus that causes several types of cancer (including cervical, penis, and throat cancer) and genital warts.

If you haven’t already gotten 3 hepatitis B shots, 2 mumps, measles, and rubella (MMR) vaccines, 2 hepatitis A vaccines, and 2 chickenpox vaccines (if you haven’t had the disease), you will get these also.

Before traveling abroad to countries in Latin America, Asia, or Africa, find out if you’ll need to get any additional vaccinations.

What should I do at my first check-up?

Be open and honest with your health care provider. You need to decide if you feel comfortable talking to and sharing information with him/her. You also need to ask any questions that you may have. Write them down before your appointment, so you don’t forget! See how well the provider listens to you and answers them. Are you happy with the provider at the end of your visit?

How do I ask about confidentiality?

Before or at your first visit with your PCP, ask about confidentiality. This is very important and can be hard to bring up. Ask if your health care provider will keep information private about your sexual history, contraception, and other worries. Discuss what your health care provider and you will do when there’s something important, such as a serious illness, depression, or life-threatening condition, which should be shared with your parents or someone else. Your provider should bring up the subject but if not, you can start a discussion when you’re about 12-13 years old, or at the first visit.

Practice some questions to ask your provider, such as:

  • What happens to the bills from my visits here or to a gynecologist in the community?
  • If I’m covered by my parents’ insurance, will they find out about examinations and tests that are done on me?
  • What if I need birth control?
  • Can you tell me what happens to my lab test results? Who do you call?
  • What happens if I want to be tested for sexually transmitted infections (STIs) or HIV?
  • What happens if you find out that I have a STI?
  • What happens if you find out that I am pregnant?
  • Is there any information that you have to tell my parents?
  • What happens if I have a big problem and need help telling my parents?

Do all PCPs also see adolescents and young women for reproductive health issues or Pap tests?

Some PCPs do, but not all. You should talk about any reproductive health questions that you have with your provider. If your provider doesn’t see adolescents and young women for reproductive health issues, menstrual problems, contraception, pregnancy, or Pap tests, she/he will help you find someone that does. This might be a gynecologist or an adolescent medicine specialist, a family medical provider, nurse practitioner or internist.

If you’re referred to a gynecologist, check to make sure she/he is an expert in providing care to teens. If it’s important to you, make sure he/she provides confidential care (be prepared to ask those confidentiality questions again), contraception, and STI screening. Depending on your beliefs, you might also want to make sure that he/she gives non-judgmental pregnancy counseling and gives you all the facts, so that you can make an informed decision about what you want to do.

How often should I see my PCP?

You should see your primary health care provider once a year for a regular check-up and more often if you have other health problems or you are taking medication.

Women who are 21 years of age or older should have Pap tests. A pelvic exam is needed any time you have symptoms of a vaginal infection, such as a new and unpleasant vaginal discharge, new lumps or bumps, or other problems. A Pap test should be done at age 21 to make sure that there are no warning signs of cancer of the cervix.

What if I don’t like my PCP?

Switch to a different PCP! You should go to a provider that you trust and you feel comfortable with. Your provider should be patient and should show you respect.

Go through the same steps listed above to find a new PCP. Make a list of names, check on qualifications, and call the providers’ office to ask questions. Remember to check and see if the provider(s) is a member of your health plan. You should let your current PCP know that you are changing providers. Make sure that you get any medical records that your PCP may have, so you can bring them to your new provider.