Last year, my mother’s primary care physician (PCP) referred her to a neurologist because her migraine medicine wasn’t working. Having seen my mom for over ten years, her PCP knows her and her health conditions well, and my mom trusts her opinion. It turned out my mother had an unruptured brain aneurysm and needed a procedure to prevent it from rupturing. Aneurysms are rarely ever identified until they rupture, and when they rupture they are extremely life threatening. My mom is a physician herself, and the expertise of her PCP may have very well saved her life. PCPs take care of our moms, teachers, engineers, leaders, and yes, other doctors.
Primary care is immensely difficult work, being both laborious and cognitively complex. A PCP’s training is unlike any other specialty’s, preparing them to provide longitudinal, comprehensive care for patients with ”any undiagnosed sign, symptom, or health concern” not limited to a specific “problem origin, organ system, or diagnosis” (AAFP). Not only do PCPs have an uncommon breadth of medical knowledge, but a PCP’s role extends beyond diagnosis and treatment. Health promotion, disease prevention, health maintenance, counseling, patient education, and end-of-life planning all fall under the umbrella of primary care responsibilities. Deploying these extensive duties and this complex work, PCPs, on average, see 20 patients each day and have over 2,000 patients actively under their care at any given time. But who takes care of primary care physicians?
My mother’s experience is just one example of how valuable it is to have a great relationship with a PCP. PCPs know their patients holistically, and are present throughout the best and the most difficult times in life. Given the longevity of the patient-physician relationship in primary care and the significance of the impact to your health, choosing a primary care physician is an investment one should consider carefully. But how does one choose a PCP? What should one look for? Maybe we should ask the experts: PCPs.
When it comes to selecting a primary care physician, very little is documented about how PCPs experience primary care as patients. Mechanics can use their professional expertise to fix their own cars, but primary care physicians’ expertise can’t always be applied to themselves. So what kind of PCP does a PCP turn to for their own care?
As trained professionals in the field, PCPs undoubtedly know best what to look for when choosing a PCP, so we decided to ask them. We surveyed primary care physicians from across the country to ask them one simple question: “when choosing your own primary care physician, what do you look for?”
What kinds of PCPs do PCPs have?
Much like any important relationship in life, the relationship you have with your PCP can be deeply personal. Though our survey responses reflected some individual preferences for primary care, there were several overarching themes that the majority of respondents felt were important. These can be broken down into the following categories:
- Clinical approach
- Personal characteristics
- Practice model
Perhaps unsurprisingly, the most common thread in what PCPs look for in their own PCP is clinical approach, with 69% of respondents identifying certain “best practices” as key elements they look for in their PCP interactions. The following clinical approaches were mentioned, in order from most referenced to least:
- Clinical expertise
- Active listening without spending too much time on computer during visit
- Comprehensive, collaborative care plans
- Lifestyle management approach before medication
- Timely follow up
- Asks thorough questions
- Physician credentials (specialty, board certification, etc)
Availability also stood out as an important, defining characteristic that PCPs look for in their own PCP. Just over 61% of responses included availability as a predominant factor for selecting a primary care physician, including flexibility of scheduling and access modalities. Personality and character traits were equally important, with 61% of respondents listing specific personality traits they look for in their own PCP. The main examples identified in this category include sense of humor, trustworthiness, friendliness and approachability, humility, and directness.
Finally, just over half (54%) of respondents mentioned practice models and operating efficiencies as key drivers of their PCP choice. Several mentioned they prioritize efficient, streamlined scheduling processes when seeking out a PCP, and others responded with a specific preference in type of practice. The trends indicate that PCPs steer away from both fee-for-service payment models as well as primary care physicians who are employed as part of a larger health system or healthcare organization. Specifically, they look for:
- Direct primary care practice models
- Private practice offices
- Practices with a value-based payment model (not Fee-For-Service)
What does it all mean?
Arguably the most surprising survey finding is that respondents consider not only the clinician, but where they work as well. The unexpected “practice” category of responses reflects a more significant point about primary care as a whole. Though clinical expertise and personality alignment are significant factors for finding a suitable PCP, some PCPs are limited by the practice models they are in. Independent primary care practices that have the freedom to control quality and operate outside payment models that incentivize volume are a top priority for PCPs, so maybe it should be for everyone. In fact, maybe as patients we should demand revolutionary changes to the primary care landscape to allow PCPs to practice in a way that is driven by quality.
Because information on this subject is so limited, I wasn’t sure what to expect. Perhaps I expected primary care physicians to value prestigious awards and recognitions, years of experience, or being featured in journals for cutting edge research. But the results were far from that. The truth is, primary care physicians aren’t looking for someone to be more “qualified” or “impressive” than themselves at all. They’re looking for what we all want: a clinically competent doctor who listens, is available, and navigates healthcare through a relationship built on trust and human connection.
Whether you’re experiencing primary care as a patient or as a physician, just know that sometimes… they’re one in the same.