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PCP
Physician assistants, nurses, doctors, and nurse practitioners are examples of “primary care” professionals. “Primary care physician” (PCP) plays a crucial role in maintaining patients’ health throughout time. PCPs are proficient in both “initial” and ongoing care for your medical issues.
If you are enrolled in a “managed care plan,” your PCP serves as your first point of contact with the healthcare providers. As the first point of contact in the healthcare system, they are capable of “diagnosing, treating, and managing” a wide range of common ailments. Typically, most HMOs (Medicare Advantage Plans (Part C)) require you to select a PCP.
PCPs may specialize in treating a particular age group, such as “children (pediatrics) or elderly individuals (geriatrics),” or they may be able to handle the medical needs of a full family. PCPs can provide care that includes “administering vaccines, ‘performing or ordering bloodwork,’ and treating mild to moderate infections.”
A PCP’s annual wellness checkups and other health screenings can aid in the early detection of “many disorders” (like prediabetes, high blood pressure, etc.). This can help the patient avoid “going into the hospital or requiring more intense treatment,” by giving the patient more time to “think about their health goal” and “create a care plan in collaboration with PCP to which it can stick to.”
A skilled “primary care” provider can act as a liaison with other specialists and doctors, which may postpone the “development or advancement” of a chronic illness. “Primary care” providers now have to coordinate with 80% more physicians, up from 52 to 95 over the 2000–2019 period, while the proportion of Medicare enrollees visiting five or more physicians annually climbed from 18% to 30%.
When you have a medical issue that isn’t an emergency, you should “contact” your PCP first. “Urgent care” may be available to assist you “in situations where your PCP isn’t available” or “if you require medical attention right away due to an injury.” Although it’s not an emergency, “urgent care” can treat any health issue that requires prompt attention.
Why do I require a PCP -
A strong relationship with a PCP has many advantages, including the following:
- Ensures the effectiveness of your “yearly wellness examinations, screenings, vaccinations, and personalized health advice.”
- Helps in the “early detection and treatment” of pre-existing chronic illnesses like “high cholesterol, high blood pressure or diabetes.”
- Assists in connecting you with an expert/specialist. A formal directive from your PCP to see a specialist or “obtain certain medical services” is known as a “referral.”
- Aids with making appointments for non-emergency conditions like the flu, rashes, or normal infections — either virtually or “on the same day.”
- Helps to expedite your treatment because he/she is “more” familiar with your medical background, preferred course of treatment, prescriptions, and way of life.
- Helps in reducing your “sick” days by maintaining routine Thus, less trips to the emergency department.
Choosing a PCP -
Considerations for selecting your PCP:
- It should be simple for you to go to the office of your PCP. Generally, you should try for a doctor within “30 minutes or 15 miles” of your place of “employment or residence.” These will be your “in network” doctors.
- Your PCP may be an internist, family physician, pediatrician (child specialist), gynecologist (woman specialist), geriatrician, physician assistant, allergist, immunologist, or “nurse practitioner who collaborates with a physician.”
- You can get a “list of PCPs” who speak your language from your health insurance provider. Alternatively, you can ask for a translator.
- Continue to be “flexible” when you select a PCP i.e., you must have freedom to see any other physician who accepts Medicare/“your insurance”.
- Request a PCP list from your health plan. It can take several calls to different doctors before you locate one who is accepting “new patients.”
- Find out the names of doctors that your friends and coworkers “prefer or dislike” by asking them.
- You have the “freedom” to designate a new medical specialist as your PCP whenever you’d like.
- To confirm a doctor’s “licensure”, go to the website of your state’s medical/health department. Also, you can go to the “American Board of Medical Specialties” (ABMS) website to find out if a physician is board-certified. A list of participating physicians, together with details about their “certification and license,” may be available through your health insurance provider.
Preparing for your first PCP visit -
It may be useful to keep the following along:
- the “numbers and names” of additional physicians you visit.
- photo ID.
- list of all the medications you use, including over-the-counter “medications and supplements,” along with the dosage of each you take.
- the location and phone number of your “preferred” pharmacy.
- any recently done laboratory test.
- list of your queries and worries for the physician. If necessary, record the symptoms, when they seem to occur, when they are better or worse, and “what appears to cause the problem.”
- a “family member or friend” to lend you support.
- to ensure you “comprehend,” tell yourself in your own words what the doctor said.
Prior to the visit:
- arrive twenty to thirty minutes “early.” You may be requested another date if you come more than ten minutes late.
- consult the front desk personnel to check-in.
- complete the necessary paperwork.
- pay the “agreed-upon amount”/copayment, if applicable.
- prepare yourself for a “wait.” Unavoidable delays do occur occasionally. Talk to a “staff member” if you have been waiting for more than fifteen minutes.
While at the visit:
- the physician will speak with you to get to know you and “symptoms you have.”
- enquiries concerning your “medical history, family history, and personal details” will be made.
- seeing with “new” patients might last up to 30 minutes.
- to help with care coordination, questions concerning medications “you use that were prescribed by other physicians” will be asked of you.
- lab tests may be ordered by the physician and can be performed “either in-office or off-site.”
Following the visit:
- perhaps PCP will ask you to “schedule” a follow-up
- you may have laboratory tests to complete.
- a prescription filling at the “pharmacy” can be necessary. Try to get all of your medication from a single “pharmacy or drugstore.”
Rights that you should be aware of -
- All of your treatment “options” — even those that aren’t covered by your plan — must be disclosed to you by your doctor.
- In order for you to receive the “care” you require and comprehend it; your physician must assist you.
- Before beginning any “specified, non-emergency medical procedure or treatment,” provide informed consent only after your doctor has thoroughly explained the intended “procedure or treatment,” its risks, the expected recovery period, and any viable alternatives.
- Request your physician to submit the “claim” to Medicare even if they tell you that Medicare would not cover concerned “goods or service.” Medicare “notifies” you of what it will and won’t cover after a claim is submitted.
- It is mandatory by law/regulation that you can get an “appointment” for primary care within the specified number of business days.
- Call 911 if you think you may be in “danger” for any reason — a serious accident, an unexpected illness, or an illness that is rapidly getting worse. Anywhere in the US, you can access “emergency care.”
- Engage completely in all choices pertaining to your health care. Ask “a friend, family member, or someone” you trust for advice on the best course of action if you are unable to engage completely.
- Always be treated with honor and decency.
- Gain access to healthcare without having to deal with discrimination based on your “age, color, religion, national origin, sex, sexual orientation, diagnosis, disability, financial situation, or mode of payment.”
*the aforesaid data came from “fairfaxcounty.gov/community-services-board/prevention/primary-care-doctors”, “cms.gov/priorities/innovation/key-concepts/primary-care”, “dmhc.ca.gov/HealthCareinCalifornia/YourHealthCareRights/YouandYourDoctor.aspx”, etc.
That’s all friends.
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