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Who’s on first: Primary care physicians or specialists?

If you have a headache that lasts for days, should you call your primary care physician or a neurologist? In almost any situation you could think of that’s not an emergency, the right answer is to see your primary care physician first.

We call them primary care physicians (PCPs)[1] for a reason. They are on the front line of helping you get well and stay well. While specialists are highly trained and have very deep knowledge in their areas of expertise, here are 7 reasons to consider consulting your PCP first.

  1. In many cases, PCPs can help with whatever is wrong with you. They are highly trained experts and practitioners who can provide treatment and guidance across a broad range of health issues.
  2. PCPs probably know more about your health than any other doctor could. They have all your medical records, know your family history, and are looking out for the “whole” you.
  3. If you need a specialist, PCPs will direct you to the right specialty. Trying to refer yourself may lead you to pick a specialist who can’t actually help you. For example, you may think lower back pain is due to a muscular problem (orthopedist), but it may actually be related to a kidney problem (nephrologist).  
  4. In many cases, your PCP can help you get in to see a specialist faster than you could on your own.
  5. It’s less expensive to see a PCP than a specialist. Depending on your medical coverage, it can cost a lot more (if you pay a percentage, called coinsurance) or just a little more (if you pay a flat fee, called a copay).
  6. A course of treatment with a PCP is usually cheaper than with a specialist.[2],[3] Why? The tests that a PCP would do to narrow down what’s wrong (e.g., a blood panel) are typically a whole lot cheaper than the more involved tests that specialists would likely do to test a specific hypothesis (e.g., an MRI).
  7. PCPs can act as the coordinator for your care if you end up seeing multiple doctors, needing multiple prescriptions, etc., like when someone has a complex health problem.
 
[1]Pediatricians are PCPs for children. Some specialists act as PCPs for patients with very serious illnesses, such as multiple sclerosis, cancer, or rheumatoid arthritis.
[2] Friedberg, Hussey, and Schneider, Primary Care: A critical review of the evidence on quality and costs of health care. Health Affairs, 29, no. 5 (2010): 766-772.
[3] Phillips and Starfield, Why does a U.S. primary care physician workforce crisis matter? Am Fam Physician. 2004 Aug 1; 70 (3): 440-446.

 

Benefits and services available may vary from plan to plan—please refer to your plan’s Summary Plan Description for exact coverage details. This article is not intended to provide medical advice. Aon does not recommend or endorse a particular course of medical treatment. If you have any questions concerning your medical condition or any drugs, treatment plans, or new symptoms, consult your health care provider.
 
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Tags: doctor, primary care physician, specialist