5 tips for choosing a new primary care provider

Choosing a primary care provider (PCP) is an important first step toward managing your health care. There are several benefits of a PCP – this person isn’t just another health care provider, they’re someone you work with on your health goals and challenges. 

A PCP can be nurse practitioner, clinical nurse specialist, or physician assistant who is allowed by law to serve as the hub to your health care. They are who you connect with for most medical needs, including wellness visits and routine screenings, non-emergency illnesses like earaches and sore throats, and the person you speak to about your health questions and concerns.

Your relationship with your PCP is important. You’ll want to select someone you feel comfortable having honest conversations with, someone with expertise in the areas that meet your health needs, and someone who is in-network with your health insurance plan.

Most health plans have negotiated special, discounted rates with certain health care providers and hospitals in your area. You will pay less out-of-pocket for visiting them because they are considered in-network.

Selecting an in-network PCP will help you avoid an out-of-network charge or having to pay in full out of pocket because the doctor you’ve selected doesn’t accept your insurance plan. Learn more about in-network vs out-of-network in our Knowledge Center.

To find a list of “in-network” doctors and hospitals, search our Find Care tool¹ or call the 1-800 number on the back of your member ID card.

There are several different types of health care providers who will be identified as a PCP – typically Family Practice, Internal Medicine, or General Practice. There are also PCPs who focus on providing care for children, called pediatricians.

Family Practice – Family practice physicians are able to treat patients of all ages, from newborns to the elderly. They are generalists who can treat a wide variety of conditions, and often can also treat ailments you’d normally see a specialist for, like sports injuries or some women’s health needs.

Internal Medicine – Internal medicine physicians typically treat adults and specialize in the prevention, diagnosis, and management of disease and chronic conditions.

General Practice – General Practice physicians are like family practice physicians and can treat patients of any gender or age. This category is one area where you might also find osteopaths, which are physicians that practice a type of alternative medicine with special focus on the musculoskeletal system and are distinguished by the DO after their name instead of MD.

Many people feel most comfortable visiting a provider who is recommended by someone they know, like a family member, co-worker, or friend.

Ask around and see which providers your friends and family visit. You can also ask another health care professional with whom you have a relationship, like a gynecologist, pharmacist, or dentist for a recommendation.

If you’re moving, ask your current doctor if they have a recommendation for your new location.

Do you want a doctor located close to your home or office? Resources like our Find Care tool allow you to search for providers with a location that is convenient for you to visit.

You’ll also want to consider office hours – what days and times does the doctor see patients? Will you need to take time off work to visit the office, or can you go after work or on weekends? It’s also a good idea to check what hospital the doctor admits patients to.

Language is another important factor to check. You need to be able to communicate clearly with your doctor, so check which languages they speak to be sure you’ll be able to understand each other. Many doctors now use email or an online portal to communicate with patients, which may be another item of importance to tech-savvy communicators when selecting a PCP.

Nothing can really give you a feel for whether you’ve selected the right PCP like an office visit and a face-to-face meeting. Be sure you feel comfortable in the office and with the physician and nurses.

Your PCP should be someone you trust and can rely on to help manage your health care. Talk with them about any current medications you are taking and your medical history to be sure you are on the same page when it comes to managing any chronic conditions.

When in the office, you should evaluate other environmental factors. Take into account the demeanor of the people who answer the phone and greet you when you walk in:

• Are they efficient and friendly? 
• Are the phones answered in a timely manner?  
• How far in advance do you need to schedule an appointment? 
• How long is the wait to see the doctor after you arrive for your appointment?
  

If for any reason you're not happy with your choice, most Blue Cross and Blue Shield of North Carolina plans allow for you to change your PCP anytime during the plan year.