PCP Change - what would you do?

I'm not medicare eligible yet, so I can't speak to that part of it. I do think it's important to have a PCP, who has my whole history in their hands. When we moved 2 1/2 years ago, we had to leave our long time family practice docs---who were our kid's pediatricians AND our docs as well. Now, we are at a family practice and our primary is a NP--which is fine for our needs.

I think the role of PCP is to know our big picture, and tell us--hey, maybe you should go visit the ____ doctor because I'm seeing X and it's different from when I saw you last.....Is your cardiologist going to care a lot about your PC? Or your GI issues?

From your description prat, your internist and the pros and cons of seeing him are very much in line with mine. So, I hope I can understand where you are with this.

My solution is in having him, plus a general practitioner. The GP is two miles away. It takes 5 mins. to get there and getting in is a given. A call to his office at 7:45 am many times results in a “How fast can you get here?” response. It’s same day service 80% of the time.

He’s also the guy who refused to refer me to a urologist for 4 years with a psa of 4. Once I began having symptoms, he continued to resist. It wasn’t until I told him, “That’s fine. But if I have prostate cancer it’s on you.” He then relented and on his way out the door said, “No problem. And don’t be surprised if it comes back positive.”

Two years ago, my blood pressure was solid at 150/100. Taking it 5 times a day. Everyday for 3 months. I kept a log. It was rarely below that. He refused bp meds. That’s when a friend recommended I see their Internist. So I did. He took one look at those numbers and said, “That’s enough that could cause you problems. Let’s start you on what I take.” It’s been solid at 120/80 ever since. He also has ultrasound in his office (good for checking for DVT). He has a CT. He’s set up. My GP has to send me to the hospital for a simple x-ray.

So there’s pros and cons for each one. My need at the time determines who I see. Need antibiotics for an infection or nausea medicine for a tummy bug? I go to the GP. Anything much more than that, I use the Internist.

So I wonder if you might be able to use convenience as your basis for picking a gp instead of competence? During your search, put accessibility at the forefront? It might take some doing but...it would make competence less of an issue if you don’t see it as “quitting” your current internist?

That’s just one thought. One person’s way of doing this. I look forward to hearing what others do, and what their suggests are.

Medicare has never blinked. And neither doc seems to care. Though I don’t make a big thing of it with either one. I’ll only mention it to either one from time to time when it’s obvious one needs to know what the other has already done or not done.

.excuse my wordiness

I've always found the value of my PCP is to do first level diagnosis and referrals to the correct specialities. Most times this has been an internist because of my high blood pressure. I find that having one I can get to quickly is of more importance that most other considerations. The one I currently have is part of an HMO and I have email access to her and she is very good about replying (in fact she prefers it, unless she needs to do an exam to figure out a problem).

Our PCP left his small private practice to join a large medical group right around the time I was seeing my psa increase. We were reluctant to follow him, but it turned out to be a blessing. He got me started with my uro,and then my RO. The care and expertise I have received has been nothing short of great. Interestingly, our wait times for our PCP has actually gotten better, and the folks in his office are superb.

Obviously I am kinda of partial to this doctor, so I am not sure how it affects your decision!

Thanks for the responses, all.

IT, to me, a GP and an Internist/PCP, are the same thing.
What am I missing?

Rob, I know there is more than just the heart issue. Sometimes though I feel like I can figure out on my own, which specialist to see. But your story is a good reason to have both. ThanksThe question remains whether I should replace this dr with a New cardiologist

^^^^^^

When you think “internist”, think House.

When you think “family practitioner”, think Marcus Welby.

And, when you're with Welby, and he's stumped, he's not afraid to call House in.

Got it on internist vs PCP. I think I’d want an internist.

Tud, I hear you. It’s maddening. I’ve been hesitant to leave him because he’s good, and he cares. But the wait drives me nuts. Recently, it hasn’t been an issue, because I haven’t had any last minute appointments I’ve been able to make them all well in advance so 8am. But I don’t want to have to go through that again..

Maybe I should see one of these other doctors before I make a decision. I’ve got nothing to lose.

I also have to wait maybe 30-45 minutes beyond my appointment time to see my physician. I don't mind because he always spends as much time as needed with me. Also, I anticipate the wait and bring reading material. In fact, when I was teaching I brought test papers and graded a class or two!

Mel