Navigating healthcare may be confusing when you don’t know where to start. You might be wondering if you should reach out to a specialist, urgent care, the ER or your primary care provider. Simply thinking about going to a primary care provider is often the right initial step, since it is your “home base” in healthcare.
Primary health care is intended to provide first-contact, ongoing, and whole-person care. According to the American Academy of Family Physicians, Primary care is healthcare provided for individuals with undiagnosed symptoms, health concerns, ongoing medications, or continuing medical needs, regardless of the affected organ system or diagnosis. Another way to put it is that your primary care provider acts as a go-between for the other pieces you are putting together—your health past, symptoms, medications, lab results and future needs.
What Does Primary Care Do?
Annual check-ups, blood pressure, diabetes, cholesterol, thyroid and fatigue issues, headache, infections, medication refills, prevention screenings, vaccines and follow-up care are just some of the daily problems that can be addressed by a primary care provider.
It is also at the primary care setting that long-term health planning takes place. Your provider will address multiple symptoms at once rather than treating them one-by-one. Fatigue may be due to anemia, thyroid disorders, insomnia, diabetes, stress, side effects of medicines or another cause. A primary health care visit will facilitate narrowing down to understand the cause and what to do next.
This is important since primary care is one of the most utilized components of the healthcare system. The CDC estimates approximately 1.0 billion doctor visits were made in the U.S., of which 50.3% were to primary care physicians.
Do You Always Need a Referral?
Not always. Depending on your insurance policy, the type of specialty doctor you seek and the reason for your appointment, you may or may not need a referral. With some insurance plans you need to get a referral prior to the insurer covering specialist care. Under other plans, insurance holders can schedule straight with professionals.
Although referral may not be necessary, it is advisable to initially consult with primary care providers. Your provider will assess your symptoms, order preliminary lab tests or imaging, check your medications, and recommend who would be best suited for evaluating your specific case. This can save you time, help you avoid seeing an inappropriate first-line provider and help to avoid unnecessary visits.
Depending on the symptoms, for instance, the abdomen may need a gastroenterologist or gynecologist, a urologist or surgical intervention, or urgent treatment. Chest pain can be caused by the heart, the stomach, the muscles, or anxiety disorders and could indicate a serious problem. Primary care can guide us safely in that decision.
Why Referrals Are Important
A referral is more than a formality. It assists in the development of agreed assistance. Your main health care provider can share your past medical history, lab results, imaging reports, medications and the reason you were referred. This is then providing the specialist with more context and could help to cut down on duplicate testing.
Primary care is important AFTER seeing the specialist. If a specialist – such as a cardiologist, endocrinologist, dermatologist or orthopedic specialist – prescribes treatment, your primary care provider can ensure that you get the care you need, while monitoring all of your health needs and making sure the treatment plan works with your other conditions and medications.
According to the Office of Disease Prevention and Health Promotion, patients who have a usual source of care are more likely to receive preventive services that they are advised to get, such as influenza vaccination, blood pressure monitoring or screening, and cancer screening. Consistent primary care is so beneficial for this one reason.
When Should You Not Wait for Primary Care?
Medical and public health decisions about primary care should not override emergency care decisions. Proceed to ER or call the emergency services for chest pain, stroke symptoms, trouble breathing, fainting, bleeding, serious injuries, severe allergic reactions or sudden severe pain.
Urgent care could be the right choice for a minor injury, moderate infection or for symptoms that need treatment or evaluation but are not life-threatening and require same day attention.
Final Thoughts
A primary care physician makes health care a little less confusing. Provides you with a single point of care for prevention, diagnosis, long term management of your chronic illnesses, medication review, referral services and follow-up care. Your primary health care provider can support you in either obtaining a referral or, at the least, helping you to appreciate just what you should do next.
For primary care visits, referrals, checkups, or help deciding where to start, email appointment@familydiagnosticclinic.com and our team will get you scheduled.
