It's Time to Respect the Role of the Primary-Care Physician

August 19, 2013

A lot of my patients don't have, or don't understand the value of, a primary-care physician. It's time for both to start happening.

It flabbergasts me every time. At the end of each visit, I ask my patients who their primary-care physician (PCP) is so that I can send a copy of my note. Countless times, I hear, "I don’t really have one." Often, during a visit, when a patient brings up new symptoms, I’ll ask them if they’ve spoken to their primary about it, and again, "Well, I knew I was coming here."

I had one patient ask me about this symptom and that symptom and this illness, and ask if they can do this test for that and add this test to that, and I said, "No, these are issues that you need to bring up with your primary." And she replied that her prior endocrinologist did "all" her tests and that she hasn’t seen her PCP in years. I told her that maybe her endocrinologist did primary care, but I don’t. Others say, "Well, I see you and my cardiologist and my OB, so what do I need a primary for?"

What?!? I tell them that aside from themselves, the PCP should be the most important member of their healthcare team. The PCP should be coordinating all their care. Patients will often go to specialist to specialist trying to find an answer to their problems instead of having the PCP do the initial work up and direct them to the correct specialist, if necessary, or manage the problem themselves.

I also tell patients that PCPs will give them their vaccines, perform routine screening tests and, God forbid they get sick, will treat their acute illness. I’ve had patients say, "Well, I just go to the walk-in if I’m sick." And while I understand that is convenient, a walk-in doesn’t know that patient’s background. Nor will they do the routine health maintenance tests.

I take pride in what I do, but what I do isn’t primary care. I have a lot of respect for the people who do it and do it well. It’s a tough job. And patients don’t give them enough credit.