How to Choose (and Get Maximum Mileage From) Your Primary Care Doctor

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"When was the last time you had a check-up?"

These words can be the last thing most guys want to hear. More often than not, we end up in a doctor's office only because we were forced to, by a cold that wouldn't quit, a stomach pain that became unbearable, or a sore knee that threatened our ski getaway.

For some of us, a check-up happens only by ultimatum from one's employer. In fact, it's possible your car gets better care than you do.

Think about it: you probably shop around for the right garage to service your car. The mechanic has to understand the car's unique system. And through a series of visits, you'll probably have the chance to develop a pretty good understanding with this person.

After all, your mechanic sees your car on a regular basis, changing the oil, rotating the tires, and generally keeping your "wheels" in good working condition. Your car's "health" can become a source of pride, and a symbol of freedom and independence...keeping you "mobile" and responsive to life's many opportunities.

But what about your health?

Do you give your own body the same treatment? Most men who do are the ones that have found the right person to help keep their bodies healthy. If they're lucky, their doctor is just as familiar with their body and its needs as the mechanic is with their car. These guys are probably seeing a primary care physician to maintain or enhance their health, and have established an ongoing relationship with their doctors.

What is a primary care physician?

Primary care physicians include family physicians, general- internists, general-pediatricians and general practitioners. Their "specialty" is comprehensive care of a patient, either on a short or long-term basis. A family doctor is trained to recognize common health problems in the patient as a whole. He or she is the doctor you see for everything from an acute illness and annual check-up to preventive "wellness" care.

Why is having a primary care physician so important?

Choosing a primary care doctor is a great way to get healthy and stay that way. A primary care doctor is more than a quick fix for acute illness; he or she can become your healthcare partner over the long haul...helping you to establish your health goals and evaluating how you're doing while treating any illnesses that come up along the way. Over time, this can translate into continued health and well-being, and enhanced quality of life.

What can a primary care doctor offer you?

A good starting point in the healthcare system: Whatever your concern or problem may be, your primary care doctor will either be able to treat it or determine when and where to send you for specialized help. In either case, you have the advantage of a physician's expertise, and any trips through the healthcare system will be less confusing for you...and less of a hassle.
Preventive healthcare: Many health plans are beginning to pay for preventive services, such as screenings and checkups to monitor conditions that can lead to serious trouble if not promptly diagnosed and treated. Your primary care doctor can help you with disease prevention, as well as illness intervention.
Continuity of care: You and your doctor will have an ongoing health partnership. He or she will get to know you and your concerns, and you won't have to repeat your history and fill out forms for a string of healthcare providers each time you get sick or need treatment. Your primary care doctor will know your history, any chronic problems or potential troubles you may have, your family, and your long-term health goals.
One stop shopping: You can use the same doctor for a variety of conditions, and often the same doctor can treat both you and your family. Good health begins at an early age. A family doctor can take you and your family through pregnancy, childbirth and pediatric care.
Lower cost and convenience: Primary care doctors serve large populations of patients, so they see and know the most common medical maladies, and have been trained to diagnose and treat a wide range of conditions most cost-effectively. And, in most cases, it's easier to get in to see a primary care doctor than a specialist, since general practices are usually geared up for maximum efficiency.
Continued health and vitality...the biggest benefit of teaming up with a good primary care physician. Your doctor is an important resource for your health. There are, however, steps you can take to ensure that your lifestyle will contribute to your well being in the long run. This includes choosing to take responsibility for your body by being aware of the roles that stress, nutrition, and exercise play in your health. You and your doctor can define your health goals, examine your habits and get started on the basics to maintain or improve your health, now and in the future. Your working relationship with your doctor can help prevent serious illness from developing down the line and enhance your well-being, quality of life, and independence for years to come -- the biggest benefit of all.

How to choose a primary care physician

Many health plans and managed care organizations are now asking members to choose a primary care physician. If you don't have a doctor, it's a good idea to start looking for one now. Many big-city family practices are already jammed with patients and the rest are filling up fast.

More often than not, most of us end up with a doctor through default. We were referred to him or her by someone else, or the ad in the phone book got our attention. Sometimes it's easy to stick with a physician you may not feel entirely comfortable with because it's too time consuming to find another. But choosing a doctor is like selecting a business partner or even a mate -- you have the right and the responsibility to shop around and find someone who's best for you now, and who has the qualities and attributes conducive to an enduring relationship which you can trust.

There are many resources available to help you find the right doctor. An excellent method is word of mouth. Ask your friends and coworkers who they see and if they are satisfied with their respective doctors. Call your hospital's physician referral service. Look at your health plan's provider directory and see if you recognize the names of any physicians included on the list. Asking the nurses who work in a hospital or in the community is another way to narrow down the field of possible primary care physicians. Nurses usually see these doctors up close in a variety of situations, and can tell you who they think is highly skilled with a relaxed and friendly bedside manner.

If you want to find out more about a doctor, call his or her office to schedule a short appointment for an interview. Many doctors will give you 15 minutes or so at no charge to discuss philosophy of care, but not specific medical questions. Be sure to tell the receptionist the purpose of your appointment.

Check out the office from top to bottom -- was the receptionist friendly and helpful on the phone? Was it easy to make an appointment? When you get there, note how long the wait is. Does the doctor seem organized or disorganized? Be aware of the doctor's style: is it compatible with yours? Some people prefer a doctor who is brief and to the point, while others are more at ease with a relaxed, friendly approach. If you have any special concerns about your health, ask the doctor how he or she would approach treatment. Remember, you need to feel absolutely comfortable with a doctor so you can ask any question, present any symptom, and openly discuss the full range of possible healthcare concerns.

Questions to ask a prospective primary care doctor

What is your education?
What did you study as an undergraduate?
Where did you attend medical school?
When and where did you do your residency? Any training beyond that? (You can also look up a doctor in the Directory of Medical Specialists at the library for certification and training information.)
What is your primary hospital affiliation?
How many partners (if any) do you have? If you are unavailable, will they be able to see me?
Do you respond to calls at night or on the weekend?
What are your office hours, and are extended hours available?
What is your primary patient mix? Typical age range of patients? Do you see more women or men? Are you comfortable treating men? Do you have any special training, experience or interest in men's health care?
What hospital emergency department do you recommend?
What health insurance plans do you accept, and are you familiar with my health insurance plan?
Will you treat other people in my family as well?
Do you offer any special or specific treatments or procedures in your office or practice?
If I get really sick and end up hospitalized, will you be able to treat me there?
Do you make hospital rounds personally, or does someone else in your practice handle it?
In your opinion, what makes you and your practice different or better in any way?
How to get the most from your primary care physician. Once you've chosen a physician, there are specific steps you can take to optimize your healthcare partnership with your doctor.

Additional activities you can do for better healthcare

Request a baseline health assessment. To assist your doctor, check into your family's medical status and history. Include your parents, grandparents and siblings and note any history of heart disease, diabetes, cancer, depression, alcoholism, or other illnesses. Mention any pre-existing conditions you have or serious illnesses for which you were treated in the past.
When you make an appointment, tell the receptionist exactly what you think the problem is so he or she will be able to schedule the appropriate amount of time with your doctor. If your concern is private and personal, you can say so to the receptionist. Most practices will respect a patient's need for privacy, even if it sometimes creates scheduling problems.
Do your homework before your appointment. List your concerns and questions in order of importance so that you'll be sure to get an answer. Save the minor troubles, an old rash or athlete's foot, for later or make an extended appointment to discuss them with your doctor. There's nothing worse for a busy doctor with a full waiting room than a patient with an endless succession of minor concerns. Respect his time and he'll respect yours.
Don't be shy about discussing details. A symptom that seems to be unrelated may prove to be a key element in your diagnosis. And remember to tell your doctor what medications you're currently taking, including over-the-counter drugs, vitamins and nutritional supplements. Sharing information about your diet is important as well.
Assert yourself. If you don't understand something your doctor says, speak up. Ask him or her to explain so that you are an informed (and equal) player in the healthcare process. Health issues can be complex and information can sometimes come too fast during an appointment. It's acceptable to take notes during a consultation.
Respect your doctor's knowledge and experience, and your own. While your doctor has had years of training and experience, you know your body best and will be most sensitive to anything different or strange happening to you. Point out any changes or unusual symptoms you notice -- your doctor should know about them.

Building a working relationship with your doctor

You should be able to communicate your needs and concerns. You should feel comfortable discussing almost anything with your primary care physician, from a problem with sexual function or a change in bowel or urinary habits to a mole on your shoulder that has changed in appearance or even feeling "stressed out" and depressed.

If you've had trouble in the past discussing personal health issues with a doctor, now is the time for a fresh start. A primary care doctor is trained to serve as a resource for any of your questions or health concerns, including those of a sexual or psychological nature.

If you're having a hard time communicating with your doctor, schedule an appointment and bring it up. It's wise to give your present doctor the chance to respond to your concerns before switching doctors. After all, he or she already knows you, and breaking an existing healthcare partnership is not always necessarily in your best interest.

At times, however, changing doctors is the right thing to do, and you shouldn't feel obligated to "hang in there" to protect your doctor's feelings. Doctors lose and gain patients all the time. It's part of being a medical professional, and they usually don't take it personally. Their main concern is your continued health and well-being, and if you will be best served by another doctor, they will usually step aside gracefully and wish you well.

Take responsibility. Finally...remember that you're in a partnership. That means you're responsible for your health as much as, or more than, your physician is. He or she doesn't have to be your sole source of information. Educate yourself on special concerns -- the library and bookstore are excellent sources of additional information. So are medical and healthcare associations, support groups and educational organizations, local hospitals, and also health-related CD ROMS and the Internet.

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