The secret to finding a primary care provider: Be flexible
Be open to seeing a physician, nurse practitioner, or physician assistant for primary care.
- Reviewed by Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
Forget being finicky if you're looking for a new primary care physician. It's hard enough just finding one who's taking new patients. That's due to a doctor shortage in the United States, fueled by such factors as population growth, low pay, physician burnout, a lack of required postgraduate training programs, and a wave of retirements.
The shortage is becoming so serious that some states are trying to make it easier for doctors to practice there, or they're creating new medical schools. And Congress is debating how to increase the number of training programs in the country. Those measures aren't going to help you get a new primary care physician anytime soon. So you need to be flexible about the type of health professional you seek. Fortunately, you have options.
Primary care physicians
This category includes several kinds of primary care doctors. They've all earned a bachelor's degree (which takes three or four years), graduated from medical school (which takes four years), completed a training program (which takes at least three years), and passed licensing exams. They all promote wellness and preventive care and treat a wide range of conditions. But each doctor's focus is a little different.
Internal medicine specialist. An internist treats adults only and has completed training in a hospital and subspecialty clinics (such as cardiology or gastroenterology) for every organ system in the body.
Internal medicine-pediatrics. A "med-peds" physician treats adults and children and has trained in both internal medicine and pediatrics.
Family practitioner. This doctor can treat children and adults and has a broader scope than an internist or med-peds physician. For example, some family practitioners can perform minor surgery and even deliver babies.
Geriatrician. A geriatrician deals with the medical complexities of older patients with many chronic conditions. Geriatricians also consider the many issues that affect older adults, such as social or functional limitations.
Resources to find providersTap into these resources when looking for a primary care provider Referral lines. Hospitals often have referral lines that can direct you to primary care providers taking new patients. Your family, friends, and doctors. They may have recommendations for providers they trust. Online reviews. Look at physician review sites, but take reviews with a grain of salt unless there's a large number of comments pointing one way or the other. |
Other primary care providers
You can also turn to an advanced practitioner for primary care: a nurse practitioner (NP) or a physician assistant (PA). Both are licensed and can diagnose and treat patients, order medical tests, and prescribe medication. But there are differences in their training and autonomy.
The NP becomes a registered nurse first (with a two- or four-year degree), and then earns a master's or doctorate degree in advanced practice nursing (which takes two to three years). NPs can practice medicine independently in about half of the United States. In many states, however, they must collaborate with a doctor.
The PA has a health- or science-related bachelor's degree and a master's degree from an accredited physician assistant program (which takes two to three years). Unlike NPs, PAs are not permitted to practice independently. They must work in collaboration with a doctor.
Doctors vs. advanced practitioners
Is there a difference in the quality of care you'll receive if you go to a doctor versus an advanced practitioner? "It's difficult to say. Studies comparing the quality of care between the two groups are inconclusive. But if you spend four years in medical school and three-plus years in a training program, it's probably true that you'll perform better than advanced practitioners in some regards, since you have more training," says Dr. Anupam Jena, the Joseph P. Newhouse Professor of Health Care Policy at Harvard Medical School and co-author of the new book Random Acts of Medicine.
Still, Dr. Jena notes that NPs and PAs are skilled clinicians who can spot medical problems and, if they can't treat them, connect you to the care you need. So don't fret about the type of primary care provider you see.
"The priority is establishing the relationship. Otherwise, if you're sick, and you don't have someone you can call, you'll have to go to an emergency department or a walk-in clinic. That's not optimal," Dr. Jena says. "You want a relationship with someone who knows you and can make recommendations you'll listen to. And ideally it's important to have that in place before a serious problem develops."
Image: © Solskin/Getty Images
About the Author
Heidi Godman, Executive Editor, Harvard Health Letter
About the Reviewer
Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
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