Issue 3 Stories

Finding the Right Fit

What to Look for When Choosing a Primary Care Doctor

Let’s say you’ve just moved into town. You’ve started a new job, settled into your new home and located the nearest grocery store. Now it’s time to find a primary care physician (PCP).

Or maybe you’re just thinking it might be time to switch doctors.

“Some people like to keep the same PCP for years, whereas others prefer to change doctors every so often,” says Judy Tobin, executive director of Sentara Martha Jefferson Medical Group. “Sometimes it’s a good idea to get a fresh perspective on your health issues from a new physician—especially if you’re struggling to find lasting relief.”

So, how do you go about finding a new PCP?

“Patients should take the time to find a physician who will be the best fit for them,” says Bruce Clemons, MD, FACP, vice president and executive director of Sentara Martha Jefferson Medical Group.

Of course, having a good comfort level with your doctor is an important consideration, but other factors should guide your decision, too.

The PCP: Your Healthcare Manager

A patient’s PCP provides long-term, personalized care and oversees a patient’s total well-being, which may include preventive, chronic and acute care in both inpatient and outpatient settings. PCPs coordinate their patients’ access to the entire healthcare system, including interactions with specialists.

“When the system is working correctly, the primary care physician has extensive knowledge of patient medical histories and makes appropriate referrals to specialists, as needed,” says Dr. Clemons, who is also a primary care physician. “The PCP, who acts much like a healthcare manager, should have a good grasp on a patient’s overall care needs.”

Having a doctor with such comprehensive understanding is especially true for patients dealing with a number of different conditions and treatments—particularly the elderly. For patients who see multiple specialists, for example, medication prescriptions from more than one doctor can make for complicated interactions.

“For instance, if a patient is seeing a cardiologist and gastroenterologist, some of the heart drugs can cause gastrointestinal issues,” says Dr. Clemons. “So you want a PCP who is overseeing the whole picture of a patient’s care.”

These days, electronic records make this kind of coordination easier, since all of a patient’s records are accessible in one place, so the PCP can more efficiently keep track of medications and procedures.

Types of PCPs

PCPs typically belong to one of three types of physicians, according to Tobin.

“A PCP can be a pediatrician, family doctor or internist,” she explains. “The pediatrician treats babies and children. A family practice, on the other hand, can see patients of all ages, and internists are for adults only.”

Each type of PCP has its own advantages.

A pediatrician will have more specialized knowledge of children’s health, focusing on the physical, emotional and social health of children from birth through adolescence, with an emphasis on prevention.

A family doctor will be able to treat children beyond their teenage years, as well as provide primary care to all members of the same family. Being familiar with the medical histories of all family members, as well as the family’s emotional and social issues, enables family doctors to provide highly personalized care.

Internists, or internal medicine physicians, are specialists who apply their scientific knowledge and clinical expertise to the diagnosis, treatment and compassionate care of adults. They are trained across a broad range of medical conditions, from general health issues to complex illnesses.

Remember that PCPs can take care of gynecological issues as well, so they can provide a one-stop checkup for women. However, some obstetrician/gynecologists also provide primary care, so they may offer a convenient PCP option for women, too.

Locating a Good Match

If you’re looking for a PCP, start your search by checking your insurance company’s network in their handbook or on their website. While most insurance plans include all providers in an area, you could inadvertently choose one who isn’t in your insurance company’s network.

Tobin says you should also decide whether you want to stay within a healthcare system. If you decide to do so, it’s important to align with the specific system you prefer.

“At Sentara Martha Jefferson, PCPs tend to refer to specialists within the system,” Tobin says. “That helps with transferring charts and ensuring smooth collaboration. Other doctors in other systems can share that information, too, of course, but being in the same system makes it easier.”

Proximity is another major consideration in choosing a PCP, says Tobin. Fortunately, most PCPs are located in communities where people live and work.

“Many people like to have their doctor near their workplace, so they can get to appointments conveniently during the day,” Tobin says. “But with children, you may want a doctor who is closer to home, in case you need to pick up your child from school for an appointment.”

Another question to ask is: Can you get an appointment when you need one? While a busy practice may be a sign that a PCP is a well-respected doctor, make sure they’re not so busy that you can’t get an appointment when you need one. When a PCP isn’t available, an established back-up physician, nurse practitioner (NP) or physician’s assistant (PA) may see the patient instead.

“Many practices today have an NP or PA to help out with acute care or chronic follow-up,” Tobin says. “That makes it easier for patients to get appointments.”

If it’s necessary for your schedule, you may also want to find out if the practice offers hours during evenings or on Saturdays.

Getting Personal

Tobin and Dr. Clemons agree that the most important part of finding a PCP is making sure that the doctor’s relational style is a good fit for you.

“Some doctors are nurturing and tend to spend a lot of time with patients,” Tobin says. “Some patients, however, just want to get in and out quickly.”

If you have several chronic conditions that require frequent checkups, you’ll probably want a doctor who can spend time with you, she says.

No matter what your needs are or what your personality may be, though, according to Dr. Clemons, good PCP care is all about the doctor/patient relationship.

“The benefit of having a PCP is most pronounced when a good relationship has been established between patient and PCP,” he says.

The best method for determining your comfort level with a PCP, according to Tobin, is to schedule a visit and actually meet the physician—that’s a good way to learn about how the doctor will engage with you as a patient.

Dr. Clemons also encourages patients to ask about the doctor’s health care philosophy, to be sure it lines up with their expectations.

From a physician’s standpoint, Dr. Clemons believes that high-quality primary health care relies heavily on good communication, and that physicians should listen more to help them understand what patients are looking for in their care.

“Some physicians, due to having decades of experience, make assumptions about what most people want—for instance, regarding how patients would like to receive test results,” he adds. “In making a treatment plan, however, doctors need to take each patient’s preferences into account.”

This is where the comfort level in the doctor-patient relationship plays an important role.

“People sometimes have to make tough choices about their health care,” Dr. Clemons says. “PCPs often serve as guides through times, when patients are facing important decisions that may affect the rest of their lives. I help patients wrestle with those decisions and assist them in making choices that make the most sense for them. A large part of my job is to listen, and then give professional advice and direction.”

“Patients place a lot of trust in their primary care physicians,” he adds, “and we do our very best to provide them with compassionate, expert guidance and the highest-quality care possible.”

New Clinic Coming to Fifth Street Station

Sentara Martha Jefferson Hospital is opening a new primary care practice, Sentara Fifth Street Station Family Medicine, in the recently launched Fifth Street Station shopping center in Charlottesville, which is also a mixed-use neighborhood.

“The new practice will be close to where many people live and work,” says Bruce Clemons, MD, FACP, vice president and executive director of Sentara

Martha Jefferson Medical Group. “That’s a big advantage. We want medical care to be accessible.”

The Fifth Street Station Clinic, which will be staffed with two physicians and a nurse practitioner, is scheduled to open on May 1. In addition to its accessible location, the clinic will offer extended hours in evenings and on weekends.

“A lot of people in that area will now have easier access to health care.” says Dr. Clemons. “And families with kids will certainly benefit from after-hours care.”

Having its own X-ray capabilities will be another major advantage of the clinic. People who sustain injuries over the weekend, for instance, will be able to get acute care right in their own neighborhood—without necessarily having to go to the emergency room for care.

“The new Sentara Fifth Street Station Family Medicine clinic will offer advantages for everyone,” Dr. Clemons says.

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