Healthy Habits: Eight Questions and Answers Why Everyone Needs a Primary Care Doctor, How to Find One and What to Ask When You Are Seen

In the age of specialties, drive in care and telemedicine does anyone really need a primary care physician? If so, why and what should I know or know to ask once I find one. According to Dr. Steven Goldstein, respected neurologist, and founder of the Houston Healthcare Initiative the answer is a resounding yes, everyone needs a primary care doctor. He also has advice on how to find one and what to ask once you get into the office.

1. Is choosing a regular or primary care doctor always needed? According to Dr. Goldstein those without a primary care doctor miss out on an important relationship, one with someone who is able to help keep them healthy. “Over time, a regular or primary care doctor learns all about you and your history. So, choosing one is very important and the right time to find one is when you do not need one for any type of immediate care.”
2. Our primary care doctor will know us, but what is another reason? People with primary care doctors are more likely to get preventive services, including cancer screenings, and report significantly better health care access. According to the Journal of American Medicine, Americans with primary care doctors received significantly more high-value care and reported significantly better health care access and experience. Patients in states that spend more on primary care have fewer hospitalizations and emergency room visits. So, there is no doubt that a regular or primary care physician is an important part of anyone’s health and well-being.
3. How can a primary care doctor be found? According to Dr. Goldstein, “you want to obviously find a primary doctor that is right for you.”  He went on, “depending on your situation it could be a family doctor, OB-GYN, Internist or pediatrician. Make sure that the doctor you choose or consider, offers easy access - either by phone, email, telemedicine visit, or office visit. You should shop the price and accessibility in advance so that you are not desperate when a health issue arises. An alternative is to identify a doctor hotline to call in an emergency.”
4. Once a primary care doctor is found, how do we pay for it? Dr. Goldstein advised, “when you make an appointment with a new doctor, ask what the cash price for your initial visit will be and ask to compare it to the discounted price your insurance company has negotiated. You may need to speak to the billing office or the office manager to find this out.” A common answer is that it depends on the complexity of the problem. When you hear this ask, can you give me a range from a routine to a complex visit? Can you also tell me what my insurance allows? “If you have the temperament, you can also try to negotiate a cash price,” Dr. Goldstein said. “If you are treated poorly or they refuse to give you this information, find another doctor.”
5. So a new doctor is found and a way to pay identified. What happens on the first appointment? When you first arrive, you will be greeted by a receptionist and given multiple forms to complete in the waiting room. “Make sure when you come to the ‘consent for treatment’ form you are not agreeing to any test the doctor orders, but you reserve the right to accept or refuse any test in advance,” Dr. Goldstein counseled. “Then you will be escorted to a room where a medical assistant will record your symptoms, take your vital signs and depending on the doctor’s specialty might wish to perform “routine” tests. You can feel free to question the reason for these tests and have a perfect right to refuse them if you do not understand.”
6. All the paperwork is done. Now what? When the doctor comes to see you, record the time by sending yourself a text saying the doctor has arrived. “He or she will take your history and examine you,” Dr. Goldstein said. “Afterward, they should then arrive at and present an initial diagnosis or least several possible diagnoses. The doctor may then suggest testing to arrive at a definitive diagnosis.”
7. Can I ask questions and what should I ask? According to Dr. Goldstein, the best first question is how the doctor arrived at his or her diagnosis. “You can ask if doing any of the tests ordered will affect his treatment plan and are there alternative ways of arriving at the diagnosis,” he said. “You can ask about the prognosis and what to expect from treatment including possible side effects and what to expect if the condition is untreated. At the end, send yourself another text when the doctor leaves the room. This will document the time the doctor spent with you and this information can be useful to be sure you are not overcharged, your time with the doctor was adequate and a good value.”
8. Should the doctor prescribe medication, is there anything I should know or ask about? When it comes to prescriptions-always ask for a written prescription. “This will allow you to shop the price at various pharmacies,” Dr. Goldstein said. “Websites such as GoodRx can be a help and simplify shopping for the best price.”  

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, or the website at www.houstonhealthcareinitiative.org. Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.