A primary care physician, or PCP, is considered your main doctor. Your PCP is responsible for dealing with the majority of your health care issues. Depending on the type of health insurance you have, your insurer may require you to have a PCP.
In the past, these physicians were known as family doctors or general practitioners. Today they are called primary care physicians or primary care providers.
What Do PCPs Do?
Your PCP is a generalist and can address most of your healthcare needs. In the event that you have a problem that's more complex than she can manage, your PCP will refer you to an appropriate specialist. This may include a surgeon, a psychiatrist, or a cardiologist, for example.
You’ll go to your PCP for your yearly physical exam and preventive health care. She will help you determine any medical concerns you’re at risk for developing in the future. She will also give you advice on ways you might be able to prevent those problems or decrease your risk.
You’ll also go to your PCP for non-emergency problems that arise unexpectedly. For example, your PCP will fix you up when you have a miserable cold that settles in your chest and just won't go away after a week. Did you tweak your back while giving your dog a bath? Your PCP’s office should be your first stop.
Managing Chronic Conditions
Your primary care provider is also good at managing most chronic medical problems. If you have high blood pressure, diabetes, acid reflux disease, or osteoporosis, your PCP will help you keep these under control.
In some cases, your PCP may work together with a specialist to manage chronic medical problems.
Take rheumatoid arthritis as an example. A rheumatologist may be involved in the initial diagnosis and treatment of the disease. He may turn routine care over to your PCP once the disease is well controlled by medications. Your PCP will then follow up on routine blood tests and prescription refills. She may send you back to the rheumatologist if you have a flare-up, your symptoms get worse, or you develop complications.
In these situations, your PCP is the key member of your healthcare team. Quite often, she is your primary contact who can help guide you along the way.
PCPs Can Coordinate Care
Perhaps the most valuable role primary care physicians fill is also the least understood by the general public. PCPs are experts at coordinating care.
If you’re healthy, this won’t mean much to you. But if you develop complicated medical problems, need multiple specialist physicians, or are in and out of the hospital, you’ll appreciate good care coordination.
In the role of care coordinator, your PCP is the team captain. She knows what each of the specialists is doing and makes sure they’re not duplicating tests or procedures that have already been done by another specialist.
Do you have 20 active prescriptions from different doctors? Your PCP makes sure they’re all absolutely necessary and compatible with each other. Recently hospitalized for heart problems and now ready to start cardiac rehab? Your PCP will help keep your arthritis and asthma under control so they don’t prevent you from participating in the cardiac rehab program you need.
If your health insurance is an HMO or a Point of Service (POS) plan, your insurer will require you to have a PCP. If you don’t choose a PCP from the plan’s list of in-network PCPs, the plan will assign you one.
In most HMOs and POS plans, your PCP acts as a gatekeeper to the other services included in the health plan. For example, in an HMO, you won’t be able to see a cardiologist or get physical therapy unless your PCP refers you.
Even if your health insurer doesn’t require you to have a PCP, it's a good idea to choose one. Having a family doctor—even if you don’t have a family—is an important part of keeping yourself healthy in the long run.
When you do get sick, your doctor already knows you and your medical history as well as how you look and behave when you’re healthy. Your PCP also understands you’re not a hypochondriac or just looking for narcotics, which can be very helpful.