In this article , we explore how to pick your primary care: tips and biggest mistakes. Most people struggle with how to pick their Primary Care provider and office, often end up simply going somewhere because a friend or family member referred them or they were passed along by another doctor. This article explores tips and as well as how to avoid the biggest mistakes people make. Much of this article was gathered from articles on-line such as this Wall Street Journal article from February 2014.
There is simply no method of finding out how “good” that provider really is. The analogy I like to use is with a basketball player whom you have to pick purely on his or her postgame interview. You are not allowed to know any statistics.
Part of the problem is that healthcare has not been able to track population or practice wide metrics until fairly recently. Even now, the jury is out as to what the best metrics should be. For instance, is it the number of patients with an LDL or blood pressure at goal? What if the problem is patient compliance with medication or visits? Or maybe folks in Washington DC are more likely to follow up and take their meds than say folks in New York City?
The problem becomes even more clear when you look at smoking or obesity. Providers are limited in how much control they can exert over someone once they’ve gone home.
We could look at hospitalization rates as that is a fairly indicator that a physician is available enough that a person can be seen when they needed to be seen, the provider had enough time to spend with their patient and that they were knowledgable enough to handle whatever caused their presentation.
In an example we have previously put forward, a British Medical Journal study showed that using Direct Primary Care, patients had 35% fewer hospitalizations, 65% fewer emergency department visits, 66% fewer specialist visits and 82% fewer surgeries. Personally, those are absolutely some stats I would want for my team.
Postgame interview, though, is very important in medicine. This equates the bedside manner–that is, how does the provider interact with a patient. In fact, how a provider interacts with a patient can be the most important component. Many studies have shown that if a provider doesn’t spend enough time, doesn’t effectively communicate the diagnosis and/or treatment that patients do not get better as quickly or are more likely to have a relapse of their presentation. “How well your provider listens matters as much for your health outcomes and well-being as your satisfaction with care delivery,” according toDr. Kathleen Potempa, Dean of the University of Michigan School of Nursing.
Dr. Potempa also adds, “Don’t stick (or get stuck) with someone you don’t respect. It is your health and your life at stake.” Many of us fall into that trap where we don’t feel comfortable with the person we are seeing or have the confidence we should have with someone in whom we are entrusting our life.
Another important and often overlooked aspect can be labeled “Pick the team”. “No physician can provide outstanding care on his or her own. The quality of their office systems, colleagues and supporting staff are important. According to Dr. Elliott S. Fisher, Director of the Dartmouth Institute for Health Policy and Clinical Practice and the James W. Squires professor of medicine at the Geisel School of Medicine at Dartmouth. He adds, “There is growing evidence that emerging new models of primary care can deliver better care than traditional, small office practices. So choose a great doctor who has a great team.”
“The biggest mistake is not having a primary-care doctor in the first place…Primary-care doctors have a holistic perspective. Having the right primary-care doctor is like using a general contractor to help you build a house. You could individually hire the bricklayer, carpenter, plumber, etc. to do the work, but then coordination and oversight becomes your responsibility and things can be missed. A good primary-care doctor will guide you through the medical maze, advocate on your behalf and help you find the right course of therapy when specialty opinions differ,” says Dr. Drew Harris, the Director of health policy at Thomas Jefferson University’s School of Population Health in Philadelphia.
According to a nice article in KevinMD, the provider should be “…humble, but confident…listen quietly to a patient’s story, and never really rushed…stoic yet responsive, and treated nurses, technicians and even field medics as a valued part of the team.”