Does anybody out there actually have a primary care doctor who coordinates your care and is really up on your overall health?

I’m in good health & I credit my doctor for keeping good open communications with me. He’s wonderful. I had my annual appointment in May. We went over my meds & we made some changes. I had a heart instance in March & he was able to pull my records from the hospital up on the computer. Thankfully, they are all connected. I look things up concerning my health on the internet & he commended me for doing that. I take charge of my health & it shows. Thankfully, I’m not just another number to my dr. We have a great relationship & it makes it easy to keep up with things.

@jbfletcherfan That is wonderful. Can I ask what city you live in?

My primary is listed among the best in Boston (according to Boston Magazine). While he is very knowledgeable (his diagnosis are almost always spot on), his bedside manner, communication skills and follow-up ability is non-existent. He never personally returns phone calls, doesn’t accept patient eMails and rushes you in and out of the office in a flash.

So why stay (despite his pedigree)? His staff – plain and simple. The four women that work for him are amazing. They recognize your voice on the phone, return all calls immediately, call in scripts upon request, and practically have you medical records memorized. They coordinate beautifully with Mass. General and follow up fairly well.

Whatever he pays them is not enough by a mile.

I go to a PCP affiliated with Loyola Medical Center in Chicago. They have branch locations throughout the suburbs. When I needed to see a specialist for my prostate condition, she found me a good one in the same system. All of my records are kept in a central location, so my urologist had no problems accessing my medical records from my PCP, including some recent blood work that saved me a trip to the lab.

I’m fortunate to live in an area with several large teaching hospitals that have satellite locations like this. Overall, I have been very satisfied with the care I have received. I would recommend this type of care to anyone similarly situated. There are some great doctors in independent private practice, but the advantages of having a doctor closely affiliated with a hospital system are considerable, if you have any chronic or serious conditions that need attention.

Primary care doctor? No. But there is something near me called Atlanta Care thats like an emergency care place. Its great, you dont need an appointment or anything, just go in when your sick, wait usually around 30–45min(on a busy day) and you see the doctor. The main doctor there is one of the nicest doctors i’ve ever met. He is very caring and has no problems answering questions (unlike most doctors that seem to just rush you out.) He’ s never been wrong about what my aliment was, but i think the thing that really sets him apart is, he will always call you the next day to ask how your feeling. If you dont pick up, he’ll even give you a call back later. That to me says he really cares.

I used to have one before we moved. In fact, he was so wonderful I used to drive the 45 minutes to go see him when I needed a doctor, but it became too difficult after I had a child. He was up on everything, had no problems referring me right away, and always brought me back in to talk about the results of the referral. I miss him. My doctor now made my cry because he was so rude to me one day.

I feel really lucky. I have a great primary care doctor. I don’t know how he can afford it since he does accept insurance (and you all know how poorly insurance companies treat doctors and tie them up in paperwork!) There are never more than 2 people in the waiting room and he goes over the details of every single test with me. He is amazing.

I have a Primary Care doctor and several specialists, most of which I chose, some I was advised to see by other doctors I have . Whenever I see a specialist or have a test done, I will either file the event and info away and I bring it to my Primary when I next see him, OR, more often then not, I have the results faxed to me and I fax them to the doc myself. And I’ll call the office to confirm receipt.

Except for my Primary, all of my other doctors are in the same medical group so each gets a copy of my test results whenever I get tested for something by any of them.

Similarly, I make sure to get ALL of my prescription meds from the same Pharmacy so that the Pharmacy can pick up possible interactions.

@JLeslie I live near Ft. Dodge, Iowa. That’s where he is.

My father (who is an ER physician) insisted that I see an Internist when I had a health concern that required coordination of care. Apparently, Internal Medicine doctors are specifically meant to coordinate care and trained more specifically to focus on interactions between medications and “bigger picture” problems.

So, for example, if you have hypertension (high blood pressure) your PCP might just prescribe medication and see if that resolves it for you.. Where as an internist would be focused not just on treatment, but also on the root cause and whether the hypertension is simply a symptom of a separate condition.

Family Medicine training (what used to be knows as GP – General Practitioner) is intentionally broad in scope—so that your family practitioner can send you along to a specialist if something is complex. Regular healthy folks should see GPs or Family Practitioners. Patients with more complex medical concerns (e.g. chronic life altering conditions such as MS or ALS, or complex co-morbidity such as diabetes + chronic heart failure) would be better served with an Internal Medicine doctor coordinating their care.

My first rule of thumb in picking doctors is always what hospital they are permitted to attend to patients in.. because I have strong preferences for which hospitals I trust in my town (Twin Cities, MN).
So, if you’re looking for a good doctor, a good place to start is with the hospitals you would be willing to receive care in—then find out which doctors are in their system (ability to admit / treat patients in their facility).

Good luck!

I seem to be the coordinator of my care. I make sure all my docs send reports to my primary. I think he might skim these reports in about a minute before he sees me for my annual checkup (which I should set up now—I try to set it up sometime around my birthday).

I don’t know what would happen if I ended up in the hospital or had something complicated that required serious coordination of care.

I used to have one of the highest rated doctors in town. He was the personal doctor of the CEO of the major teaching hospital, too. However, he got an eye disease, and couldn’t keep on practicing because of his vision problems. I also think that he wanted to get out of primary care. He has moved into the area of stress reduction and is managing a major stress reduction program that uses a lot of meditation. He’s also a Buddhist.

I have another physician friend who has cut down his practice to a the minimum allowable in order to be insured. He is more interested in becoming a researcher.

Over my life, I think I’ve had about four or five physicians get out of practice in order to do something else. I think they hated dealing with the paperwork and being forced to see more and more patients per hour. I think the good primary care professions are being chased out of the profession. They have options to do other things. Also primary care is becoming less prestigious and less remunerative. So the remaining doctors are not as good; not as competent as those who are good enough to get out of it and into fancier medical jobs.

I inherited my current doctor from the same practice as my old doctor. Of course, my old doctor had been seeing me for almost twenty years. He knew me well. The new doctor has none of that knowledge, so I feel just like another patient in a harried doc’s life. I was thinking of leaving, but am too lazy to try to find someone better. I’m also not sure there are any better physicians out there any more.

@geeky_mama thanks for those explanations.

And everyone else who gave tips thanks.

I am glad to see that many people are happy with their primary physician. I have not felt that a primary was coordinating specialties or really pursuing my health care since I was a teenager (I had a very good adolescent doc at Bethesda Naval) and I felt like she knew me and remembered me.

I have been so furstrated with health care that it was starting to feel adversarial to me, part of this is my own fault, my inability to overcome bad health care I have had in the past.

I am thinking I might make an effort to find an internist who I like; I have felt for several years now there was no point.

I’ll wait to see some more responses.

Thanks again.

I’ve been going to the same practice for over 10 years now, so he’s taken care of me since I was a child. There is one main doctor (it’s his practice) and he has other doctors coming and going every few years.
My mother sees the main doctor, and I usually see the other doctors (it’s hard to get into the main guy) He is very thorough with my mother, and always follows up. He helped discover her appendicitis and visited her in the hospital while she recovered. He knows of any surgery she has, and he usually recommends the specialist, and she sees him as a follow up. She doesn’t go to the doctor too often, but it does seem like something is always wrong with her (they’re trying to figure it out, she’s seeing a rheumatologist soon) But, the doctor is very involved, and helps coordinate her care.
But, at the same time, you still have to be very proactive in your own health care. You cannot expect a doctor to do it all. If you don’t keep telling them the issues, then nothing will get fixed. That’s been my experience.

@casheroo do you feel like the practice you go to is accepting of new information or questions you bring to your appointment? I am refferring to your comment about being pro-active.

I do. It took about 3 tries but he is great!

@JLeslie Oh yeah. It’s a great practice, they try to get you in as soon as possible, and listen to whatever the issue is.

As far as notifying our doctor of visits with other specialists, it’s required here that all reports go to him. It’s a very good practice, of course. The right hand has to know what the left hand is doing. I think that’s how medical treatments get all fussed up. All doctors involved need to know what’s going on.

Actually, my orthopedist kind of keeps up with my overall care. I had a small town GP who I went to for years and years who died a few years ago and since then my orthopedist is the one who I see the most. We never had the kind of reporting back doctor-to-doctor, but I would tell my old GP what was going on with this or the other thing, mostly with my feet. I go to a new GP for things that I need an antibiotic or other basic prescription for, but when I needed my tonsils out it was my ortho’s office that did a referral for me to see someone (and who). I’m only 25, but I’ve literally been going to see this doctor for half my life for my feet… So its not just primary care in the traditional sense that can keep up with your overall health (and what’s going on in your life), but some specialists can become that kind of support as well. I think it all depends on who you see the most and who you’ve seen the longest and, mostly, who you like the most and can give that kind of time for care.

My former GP (back when he accepted insurance and I could afford him) was excellent in his due diligence with regards to my care, and when I had my thyroid operation, he was one of the first to contact me to find out how I was doing. Two thumbs way up!

He helped me find a good gyno and ENT as well, bless him.

I have an excellent PCP. I came to him from a terrible PCP, so I was used to having to fight for my own care, and I don’t have to do that anymore. He’s a internist, a generalist, and when I’ve had issues that suggested a referral, he laid out the options and let me choose what path I wanted to pursue—whether I wanted to consult another doctor or keep working with him on the issue. And he’s always been willing to explain the rationale behind everything he’s suggested that I do. (This was a big one for me—my former doctor used to think “because I have an MD degree, and I say so” was a good reason for me to do things.)

He’s never followed up with me personally on the phone, but he has a physician’s assistant that I’ve talked to more than once.

For the record, I’m in generally good health, but have family predispositions to a couple nasty conditions, and I’ve had a couple interesting health events in the past few years.

@cwilbur I have to say your post really really got to me. “And he’s always been willing to explain the rationale behind everything he’s suggested that I do. (This was a big one for me—my former doctor used to think “because I have an MD degree, and I say so” was a good reason for me to do things.)” That is what I want in my primary. The specialists I care less about bed side manner, I want them to be great medical men, but my primary, I want him to help me understand what is going on with my health if I have a question, tell me my options, and help be my advocate if I need it with the specialists. I have had some mysterious illnesses, that took time to firgure out, and I think sometimes the docs get tired of me, and think I am being hypochondriacal or trying to control my health care, but if I had a realtionship with at least one doctor who knew my entire history he could emphasize that I am not crazy, just have been through the ringer.

My doc is fabulous. I’ve been seeing him for about 15 years, and have twice had to leave his practice due to insurance changes. After the last time that happened, and I was able to come back to his practice, I swore I’d never switch again and I haven’t.

He has helped me through many, many health crises. He refers when necessary, and has the results copied to him. I have several chronic issues, and don’t see a specialist for any of them at the moment because he does such a good job with my overall health. I prefer to have him monitor those issues until/unless something goes seriously wonky.

When I am without insurance, he and the staff help me in any way that they can… discounting my office visits, giving me free samples of expensive medications I’ve been taking for years, helping me figure out how to get lab work done in the cheapest way, etc.

His bedside manner is terrific, too. He knows me, he cares, and he’s funny as hell! I’ve recommended him to several friends, and every one of them loves him as much as I do. I now live a state away (about a 50 minute drive) from their office, and I still won’t switch docs!

My suggestions: Ask all of your friends and neighbors to recommend a good doctor. “Interview” several docs to find one that you click with. When making appointments that will require a lot of talking, mention it when booking the appointment with the receptionist… they’ll schedule extra time. I hope you find the doctor for you.

My PCP is an internal medicine doctor and she is wonderful. She is the central point for all my medical care, referring me – as necessary. She stays in touch with my oncologist, when I have my lab work, and has been great with my other specialist, as well. She doesn’t just hand me a name, and tell me to go see someone, she tells me about different doctors and lets me select the one I feel most comfortable with (referring to specialist). The last round of lab work that came back indicated a spike in one of my labs that would need my oncologist’s attention – she faxed it to his office, before I even left her office, just to be sure he didn’t want me to start on something before he sees me in August.

I’ve noticed that when it comes to labs and responses from her, they don’t come back in days, I get a call – the next day. I know a few of the labs require a little longer, but I no longer have a long wait on all labs.

This doctor took the place of my last doctor. I didn’t think I would adjust to her, but I’ve found that she is more informed, more in-depth and generally shows more of a caring side. She doesn’t just rush you in and out of the office. She even gave me homework to do, the last time I was in there! She believes like I do, if you have something, it’s in your best interest to understand the disease and to stay informed. I really appreciate her caring enough to help me be a better patient.

Yes, I do.

We have Kaiser, and all our visits and medications are in the computer. Every person who I have had to deal with discusses my history with me, and asks relevant questions. They are all very polite and helpful, and they can see what medications I’m taking, who I have seen lately, what the results of my tests are, and everything else related to my medical care. I have never felt more comfortable with my health care.

My son also has his family on Kaiser, and they paid $200 (total) for the delivery and care of each of their babies. His medical deductions are very high every month, but it has paid itself back 10 fold at least. I babysit over the weekends, and I have had to take my grandson in twice. nothing serious With his medical number, and the signed medical release Sonny gave me, they take us right in.

I’m a women’s healthcare nurse practitioner, and I’m a defacto PCP for many of my patients, especially the under 60 year olds if they don’t have chronic health problems like hypertension or diabetes. A big part of my practice is annual exams – we talk about their relationships and stress levels, eating habits and exercise routine, smoking, alcohol, caffeine intake. If they’re interested, we strategize about weight loss, parenting, sleep problems, whatever. I nudge them to update their immunizations, order age appropriate screening tests for everything from cholesterol to osteoporosis, share information on herbal or alternative remedies they’re taking, make referrals for colonoscopies or breast biopsies. I diagnose and treat some “primary care” type problems like depression and low thyroid in addition to more typical GYN issues.

Our group uses EMR (electronic medical record) which makes it easier to review my dictation from the last time I saw her along with notes from other care providers, lab, and meds. It’s a great tool.

You may have the option of choosing an AHCNP (adult health care nurse practitioner), FNP (family NP) or GNP (geriatric NP) as your official PCP, and if so, I would encourage you to give it a try. NPs typically spend more time with each patient and tend to have a more holistic approach. NPs are usually very comfortable working with their patients as partners. And NPs always work in a system that allows for consulting with physicians as needed.

@MagsRags My doc’s practice uses electronic medical records too, and it really does make a difference. Welcome to Fluther!

My doctor uses electronic medical records. It’s definitely a good thing, but I’m not sure it’s adequate to explain the difference in attitude.

@MagsRags I use an NP for endocrinology, and I recently has went to an NP for a GP type of need, and I was thinking of trying her as my “primary.” I was going to give her an outline of all the crap going on with me, and ask her if she is willing. Would that scare you off?

My endo office has electronic records and I have a question about that. My thyroid is very difficult to control; very sensitive. I change one day and with a few mons I am moving out of normal, and then I change the one pill back, and I am sliding out the other direction in 3 or 4 months, so right now I am changing it very 2 to 3 weeks to see if that will work. Anyway, the np is great about letting me get my TSH tested when I think I need it, and she has agreed to give me the result without having to see it, becuase we both know I am only going to change one pill a week from 88 to 100 or the reverse. If I thought anything unusual was going on I would talk to her before I did anything more than that. The thing is, they NEVER call me with the result right away. That test comes back in a day, why does it take a week? I need to know even if it is normal because if my TSH has gone from 1.5 to 4, they are both normal, but at 4 I feel like crap, and worse within 3 weeks that means it will be at 7 – I am sliding! I feel like if it was a paper chart I could give her a pink piece of paper that says It’s ok to tell JLeslie her results before the doctor has signed off, and then if I call the next day I won’t hear, “well, the doctor has not reviewed it yet.” Is there some way to note that on the electronic chart? I am so flippin’ “jealous” that diabetics are trusted to monitor themselves and basically no other condition can.

Wow, your thyroid is sensitive. Maybe a pill splitter to make it an extra half tab per week?

Dictation on visits usually has the plan as the last part of the note. If the NP or doc dictates in her plan that you’re going to call for results and you’ll adjust your dose based on the result, you should be able to ask the nurse to look at the dictation to confirm that it’s OK to give you the information you need.

Even better, in our EMR, the option exists to create a pop-up note for important information about a particular patient that appears whenever you go into their record – so if they speak Arabic and will always need an interpreter, or they are MRSA carriers, or they’ve signed a release that allows you to speak freely to their family about their care, you are reminded in the moment. Maybe their system has something like that?

@MagsRags Half tablet is too much. Remember, I am only changing by 12mcg a week. Half the lowest does is 12.5, so it is the same thing as what I do, and I only need two different pills this way, unless I am not thinking of something that you might be?

Thanks for the rest of the info :).

Oh, I think I misunderstood. I was thinking you were taking 7 tabs most week, but some weeks taking 8 – that’s a typical way to tweak dosages that need to be a little different than the standard. But you’re saying you usually take 88mcg 7 days a week, but you adjust up by substituting a 100mcg tab one day per week? You’re right, there’s no simple way to fine tune that anymore than you have. You could alternate the 100mcg dose every other week, I guess, but with synthroid having a half life of 7 days, there’s stilll going to be a little up and down.

No, I take 4 – 88 and 3 – 100 a week or 5 – 88 and 2 – 100 a week. I alternate/space out the days. 100 are either M,W,F or M,TH Depending which dose I am doing.