What Is a Primary Care Provider? Why Having a PCP Is Important

What You Need to Know 

A primary care provider is your first contact for health issues.

PCPs help you get the services you need.

People with PCPs are more satisfied with their healthcare overall. 

What Is a Primary Care Provider? 

Who do you call when you have a health issue? For most people, it’s your primary care provider, also called a primary care doctor or primary care physician (PCP). 

A primary care doctor is usually your first stop whenever you need healthcare. PCPs provide preventive care as well as diagnosis and treatment of new health problems and ongoing issues. If it’s required by your insurance, your PCP can also refer you to specialists when you need them and help coordinate your treatment. 

What Are the Qualifications to Become a Primary Care Provider? 

Primary care providers can be medical doctors (MD) or doctors of osteopathy (DO), nurse practitioners, or physician assistants, depending on state laws.¹

There are different requirements for each type of PCP. All providers must go through extensive educational programs and get practical clinical training. 

Primary care doctors complete college, medical school, and usually a three-year residency in a field like family medicine, internal medicine, pediatrics, or obstetrics-gynecology. Doctors may take a board-certification exam in their specialty.²

Nurse practitioners (NPs) must be a licensed registered nurses with a Bachelor of Science degree in nursing, hold a master’s or doctoral degree in nursing, and pass a national NP board certification exam.³

Physician assistants are educated in accredited programs that teach a medical model of clinical practice, like a condensed version of medical school. Many physician assistants also have master’s degrees.⁴

What Conditions Does a Primary Care Provider Treat? 

PCPs see patients for regular health maintenance and preventive screenings as well as to diagnose new health issues and help manage ongoing conditions. 

In addition to routine checkups, common reasons for primary care visits include upper respiratory tract infections, coughs, fevers, earaches, high blood pressure, heart disease, diabetes, asthma, anxiety and depression, arthritis, back pain, skin problems, headaches, abdominal pain, fatigue, and urinary tract infections.⁵

Pediatricians see children for allergies, asthma, headaches, gastrointestinal issues, rashes, aches and minor sprains, behavioral issues, and developmental delays. 

Geriatricians treat older adults for balance issues and risk of falling, cognitive impairment, dementia, depression, and functional decline that may accompany the aging process.⁶ 

You can also choose an OB/GYN as a primary care provider. In short — you can choose any doctor you like as long as they are in network with your insurance plan and are accepting new patients.

What Does a Primary Care Doctor Do? 

Primary care doctors are your first point of contact and ongoing partner in your care. 

They help you stay well through preventive care like cancer screenings and vaccinations (such as flu shots). They examine you, order and interpret tests, and provide counseling and education. 

Primary care doctors treat acute illness or injury, diagnose new conditions, refer you to specialists if needed, write prescriptions, and help manage symptoms. They help patients manage chronic issues like asthma, diabetes, or heart disease, and coordinate care with specialists like cardiologists for heart disease. 

What Are the Types of Primary Care Doctors? 

Several different types of medical providers can be PCPs. Family doctors offer general treatment for children and adults. Internists, or internal medicine doctors, primarily treat adults. Pediatricians specialize in treating children. Geriatricians focus on older adults. Obstetrician-gynecologists focus on pregnancy and reproductive health. Nurse practitioners and physician assistants can also be PCPs, depending on state regulations. 

Why Is a Primary Care Doctor Important? 

Most Americans (75%) have a primary care doctor, though that number has gone down in recent years and only 64% of adults under 30 have one. That may be in part because of the convenience of retail or urgent care clinics.⁷ 

People with PCPs say they’re more satisfied with their healthcare experience than people who don’t have one, reporting more diagnostic and preventive care and better communication with doctors.⁸

Having a primary care doctor gives you the opportunity to establish a working relationship with a partner in achieving and maintaining your health. Because your PCP understands your health history and has access to all of your health records, he or she is in the best position to make recommendations for your care. And, chances are, you’ll feel more comfortable discussing your health issues and asking questions with someone you’ve seen for years and who knows your risk factors. 

On the other hand, if you only get care at a retail clinic or an urgent care clinic, you don’t have one doctor overseeing your care. Even if you routinely go to the same urgent care clinic, for example, it’s likely you won’t see the same provider.  In most cases, these providers can’t refer you to a specialist or the hospital unless it’s an emergency. Without that coordination, different providers might offer conflicting treatments or make the wrong diagnosis. Also, you might inadvertently be prescribed a medication that interacts badly with something else you’re already taking.

How Do You Choose a Primary Care Doctor?

Feeling comfortable with your primary care doctor is essential to getting the best care. To start your journey to finding the right doctor, ask friends or family for recommendations or visit your local hospital’s website to find affiliated doctors. If you’re new to an area, you could even post on your community’s Facebook page, if one exists!

You can also check the “Find a Provider” section of your health plan website and look at whether:

• They accept your insurance. It’s not enough that they participate with your insurance company. They must accept your specific plan.
• They accept new patients;
• They are convenient for you — look at 
  • Their location
  • The days and hours they’re open 
  • Whether they practice in more than one location
• There are other doctors in the practice. If so, check that they also accept your insurance in case you ever need to see them.

Consider your needs or preferences. 

• Do you have a specific condition or health history? Most primary care doctors are generalists, but some have specific interest areas or expertise. For example, if you have diabetes, you might be able to find a PCP who is also an endocrinologist. 
• If you speak a language other than English, does the doctor speak your primary language so you can talk easily and avoid misunderstandings?
• Do you have a holistic approach to healthcare, or are you open to alternative treatments? If so, you’ll want a PCP who has the same mindset. 

You may not be able to meet the primary care provider before you actually need care, but when you do, assess their style, bedside manner, and approach. Use your first visit to see if you feel comfortable with them. You should be able to talk to them about any health concerns. 

Do they listen and give you their full attention? If you feel rushed or brushed aside, you may need to keep looking for the right doctor. Also consider how long you were kept waiting before you were seen by the provider, and how friendly and helpful the office staff were. You may also want to ask if you can arrange telemedicine visits if necessary, and if their practice has a portal where you can access your health records and test results, and ask questions of the staff.

Next Steps

If you need a PCP, decide what medical experience, philosophy and approach are most important to you and research doctors who fit those criteria. Call their office to ask basic screening questions. Confirm they take your insurance and are accepting new patients. See how easy it might be to get a first appointment.  

When you meet the primary care doctor, listen to your gut. If you feel like you can trust them, you’ve found your match. If not, keep looking. They won’t take it personally, because they also want you to have the right fit.