Written by Joana Pichs Bringas, MSN, ARNP, FNP-BC
Marina is a 67-year-old Hispanic female who presents my office today as a new patient so that I may provide here primary care. She has multiple conditions, cannot remember the name of her medications, and did not bring a list of her medications or her medication bottles.
As I continue to ask her questions and examine her she appears frustrated, confrontational, and distrustful. In addition, she asks angrily, “And who are you, the doctor’s assistant?!” I then reply, “No, I am not the doctor’s assistant, I am the Nurse Practitioner, however, the doctor and I do collaborate on every patient’s care in this office to provide exceptional care and create increased access with improved healthcare outcomes.”
Toward the end of the office visit, Marina begins to vent on how unhappy she was with her previous primary care provider (PCP). She states every time she tried to get a hold of her provider she had to go through a medical assistant, which took hours before she would get a call back. Same day walk-ins were nearly impossible to attain. In addition, during most of the visit time the PCP kept looking at the computer screen and typing instead of looking directly at her. Marina states this previous office appeared to her as if she was in a “factory,” being herded like cattle. Marina later apologized and confessed that she felt that her previous PCP did not care about her, treated her like another “number,” and did not really listen to her needs. In my mind, I knew it would take some time to gain her full trust and build a good rapport, as she has been very disappointed by our healthcare system.
It is unfortunate to say that Marina’s experience seems to be a very common one. Medicine has become more of a business, where the quantity of patients that come in the office is more important than the quality of care that is provided. Therefore, beware healthcare consumer!
When choosing your PCP, here are a few factors to keep in mind:
- Your sex preference: Who are you more comfortable with having, a female or male healthcare provider treating you? This will allow you to really express your concerns therefore enhancing communication and feeling more comfortable with your provider.
- Does the provider speak your language? Again, this allows for adequate communication.
- Family/friends’ and other healthcare provider recommendations/referrals: Satisfied patients and healthcare providers are more likely to recommend other health care providers.
- Close proximity to your home or work: You want to have quick access to your PCP office.
- Does your PCP have any board certifications? Any Physician or Nurse Practitioner practicing must have a license, which by definition means they have the minimum competency requirements to provide care, however, this does not mean they are specialized in any specific area. Board Certification validates that a Physician or Nurse Practitioner has intensive expertise in a certain specialty and/or subspecialty of medical practice such as Internal Medicine, Family Medicine, etc.
- Accessibility to practice: What are their office hours, and are the office hours convenient for you? Do they open early enough for you to go before work hours or late enough for you to go after work? Are same day appointments given or “walk-ins” accepted for emergencies or acute illnesses?
- Access to your provider: Does he/she call you directly for lab/diagnostic results in order to provide answers to any questions or concerns? Does the provider provide his/her cellphone? In my case, all my patients have my cellphone number as well as my collaborative physician’s cell phone number and they are able to call us 24/7. It saves us a lot of miscommunication and saves a lot of trips to the Emergency Room.
- Does your provider have adequate communication with other specialty consultants around the area? My collaborative physician and I do communicate closely with other specialty consultants in order to provide a well—rounded interdisciplinary team approach by collaborating in the patient’s treatment plan.
- Does the practice have an Electronic Medical Record (EMR)? This provides for more efficient care by having proper communication with other health care providers, hospitals, lab facilities, and other facilities’ in a timely manner.
On your initial visit with your PCP, here are a few recommended tips:
- Refer to the practice’s website where you can download new patient registration forms, or ask if these forms can be emailed or faxed to you. Having these forms filled out prior to your initial visit and bringing them with you to your visit will save you plenty of time in the waiting room before being seen.
- If you do not have a list of your medications, bring your medication bottles to the initial visit and every subsequent visit. Keep a record of medication names, dosages, and frequency. This saves a lot of time, miscommunication, and improves the safety of your care with your PCP.
- Any questions you may have for your provider, write them down or save them on your phone, therefore, leaving the office without any confusion of doubts.
Finally, keep in mind that many PCP offices have primary care Nurse Practitioners involved in the patients’ care which are advanced level nurses who hold a Masters of Nursing in Science and/or a Doctor of Nursing Practice (DNP) degrees. They are able to diagnose and treat acute and chronic health conditions. Multiple studies have shown that Nurse Practitioners provide high quality, cost-effective, safe care and increase access to health care producing improved healthcare outcomes.
According to Health Resources and Services Administration (HRSA) (2013), if the health care system for providing primary care in 2020 were to stay equally the same as is today, it is anticipated that there will be a shortage of 20,400 primary care physicians. If the primary care of Nurse Practitioners (NPs) and Physicians Assistants (PAs) are fully incorporated into the delivery of health care that highlight team-based care, this projected shortage of primary care practitioners in 2020 could be improved (HRSA, 2013). The affordable care act focuses on preventive medicine, which directly impacts primary care, increasing the demand for competent and well-versed health care providers (Lathrop & Hodnicki, 2014). Advanced Registered Nurse Practitioners (ARNPs) are ready to meet this increased need of primary care providers and access to care by delivering leadership in community health centers (Lathrop & Hodnicki, 2014).
Healthcare consumer, compassionate care is not a lot to ask for such as having a PCP who truly listens to you, and performs a proper head to toe physical exam. A healthcare provider should review the latest guidelines for health care screenings. They should educate you regarding your diagnosis, treatment plan, medication side effects, benefits and risks to treatment. Your healthcare provider should always answer your questions regarding your plan of care. Exceptional, safe, high-quality health care, which is easily accessible is not a privilege, it’s a right!