Thursday, December 16, 2010

The Primary Care Physician

I am told that a primary care physician is supposed to manage your care. I'm still waiting to see this part of my medical care. I assume this is a similar role to that of my pediatrician who was interested in all parts of my care and sent me for throat cultures and things like that but basically took care of all of me.

I think I am a bit different then most. When I was young I went to my pediatrician and then in college with my first cancer diagnosis, I had an endocrinologist for my main doctor... I went to a gynecologist too. But medical standards changed somewhere in there and everyone got a primary care physician. My endocrinologist retired and I needed a primary care. I found one by taking the advice of someone.

My primary care has been my doctor for probably close to ten years. I don't feel very attached to her. Actually I kind of feel remote from her. Her schedule is very busy and its difficult to get an appointment with her and not her nurse practitioner.

When I was diagnosed with breast cancer, it was actually following a mammogram she had sent me for. I was instantly enfolded into the oncology unit's team of doctors with a social worker, medical oncologist, surgeon, radiation oncologist, and a bevy of nurses. I never heard from my primary care. I even stopped by her office one day while at the hospital for one of my innumerable appointments and left her a note. I never heard from her.

Now that my life has somewhat calmed down, I still don't feel she has a handle on or manages my health care in any way. I haven't seen her in person for a few years - just her nurse practitioner or other doctors in her office (mostly due to scheduling reasons) when I needed something. It is time to move on and find a new primary care.

I have made a more focused effort this time. I have asked around for references. I have set a few goals that I want - younger than me (so she won't be retiring while I still need her), female, willing to manage my care, and calm in the face of medical disaster after medical disaster... I called and asked to switch my primary care and have an appointment to see her for a physical in May.

But the problem is, every time I go to the doctor for anything, they always ask who is my primary care. So now do I say my old one... or do I say my new one - who I won't see for months? Or do I try to explain the situation to whoever asks each time? So complicated.

All I know is I want a primary care physician who when I see her actually reviews what is going on with me and has some grasp of the continued issues I face.


Debby said...

I've really had very good luck with the physician's assistants and the nurse practitioners at my doctor's office. They are responsive, and if they have any questions, they go straight to the doctor to make sure they are all in agreement. It was a PA who I saw when I first saw my lump, and she got things moving more quickly than I could have ever expected.

Leah said...

As someone who has been through this as recently as last month!! I kept giving my old PCP, and then when I called for the records, the last things I had were actually there for the new dr. I dropped off the records to her office a week ahead of when I saw her, with some salient pages marked, and we had a great first meeting! I am pretty satisfied- had a 16 year relationship which ended when he left the I had no choice.

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