Portland Direct Primary Care
PDPC logo small.png

Beyond 7 minutes

I trained as a Family Doctor so that I would be ready to help patients with any challenge. The old school family doc used to take that skill set out into the community on house calls, sports sidelines, and town hall meetings. At some point the job description was boiled down into a job that started and ended with a 7 minute office visit. That setup is not good for patients, and it's not good for doctors. In this column I hope to start to push the boundary of where the doctor patient interaction takes place - onto the page, into the community, and beyond 7 minutes.

Finding the Right Primary Care Doctor

Choosing a doctor can be a daunting and sometimes confusing process. Many people look over the list provided by their insurance company and understandably become overwhelmed. There are many great doctors out there, but each will have their own style. Finding a doctor whose practice style fits your needs and personality can make a big difference in how helpful the healthcare experience can be. Just because you chose a practice off a list years ago doesn’t mean you are stuck there. Here are a few tips to consider when choosing a primary care provider.

cell phone.jpg

Accessibility

There are a few layers to accessibility. The first layer includes how easy it is for you to get to the place your doctor practices. If you live in a rural area, driving 50 miles might be the only option. If you live in a more urban area finding a doctor in your neighborhood can make office visits much easier. Some offices even offer home visits, where the doctor comes to you.

The next layer includes how easy it is to access care when you get sick. Some practices will offer a certain number of same day sick visits. It's nice to know you will be seen right away if you’re not feeling well. Not every malady needs an office visit to diagnose. Some practices offer virtual visits or phone calls with a provider. Another thing to consider is what the after hours coverage is like. It’s good to know who you will reach if you have a questions on a weekend or evening.

The last layer to accessibility is what the coverage system is like if your doctor is unavailable. No doctor can work 24/7 365 days per year. If you take the time to get to know your doctor it is helpful if you will see them for most, if not all, of your visits. In the event that your doctor isn’t available, you’ll want to make sure whoever is covering for them is also a good fit for your needs.

degree.jpg

Training

There are many different people who can fill the role of a primary care provider. It's important to understand the different levels of training, and what may work best for you. A primary care doctor will have either an MD or DO degree. DO doctors have a little extra training in osteopathy - which includes adjusting people's bodies when they are out of alignment. Both MD and DO doctors have completed an undergraduate degree and at least 4 years of medical school training.

Most people will look for a board-certified doctor, meaning the person has completed residency training after medical school and is in good standing with the board that oversees their particular specialty. Primary care doctors are traditionally trained in either Family Medicine, Internal Medicine, or Pediatrics. Pediatricians take care of children only, Internists take care of adults only, and Family Medicine doctors are trained to take care of both. Family Medicine doctors receive a breadth of training in procedures and women's health including things like minor skin surgery, contraceptives, and sports medicine. Every provider will be different in terms of what services they can provide, which is why it's important to ask.

Primary care is also seeing many skilled Nurse Practitioners functioning as primary care providers. Where doctors have to master everything from emergency medicine to delivering a baby, many NP training programs focus exclusively on primary care, creating a real depth of knowledge. NPs in general also care for a smaller panel of patients and therefore are often easier to schedule with.

piggy bank.jpg

Cost

The last, and often overlooked aspect of choosing a doctor is how much it will cost you. Most people use insurance to pay for their care; however, you can still get excellent care with or without your insurance. People often assume that if they have insurance they will have good health care. On the other hand, people also assume that if they don't have insurance, or if they have a high deductible plan, there is no way they can afford to go to the doctor. The truth of the matter is insurance and healthcare are two different things.

This is where Direct Primary Care stands out from the crowd. A DPC doctor looks out for their patient’s physical, mental, and financial well-being. Because we are not beholden to the insurance company, we can set our own affordable prices for things like labs, medications, as well as the primary care membership. In a direct primary care visit, your doctor can share with you the cost of things before they are ordered - that way you can make an informed decision together.

Even if you don't have a Direct Primary Care doctor, you can still use resources like GoodRx.com to shop around for deals on medications. Some imaging centers will offer cash pay discounts for MRI’s and CT scans, which end up being cheaper than paying the deductible to your insurance company. Many hospital-based clinics will have payment plans or charity care programs to help people who can't afford to pay for care. No matter where you choose to get your care, remember to be an informed consumer and don't be afraid to ask questions.

Oren Gersten, MD