Dr. Gordon-Simet sees at patient at Nurture Health.

Eight Things to Consider Before Choosing a Health Care Provider

It’s no secret that developing a long-term relationship with a primary care provider can help you stay healthier longer. In fact, 86.7 percent of adults had contact with their health care professional in the past year.

By definition, a primary care provider is considered your main doctor—the one who is responsible for the majority of your health care issues. But that’s far from all they do; a primary care physician can also help you avoid unnecessary or redundant charges. We asked Dr. Josette Gordon-Simet, medical director for Blue Cross and Blue Shield of Nebraska, how working with a health care provider can help you save money.

“Preventive care can help you avoid costly visits to the emergency room,” she said. “When you visit your doctor regularly, routine tests can help you identify major health issues before they become a problem. A single visit to the emergency room can cost thousands of dollars. This cost increases if you don’t have the right insurance coverage.”

However, your routine visits to the doctor are almost always covered by basic health insurance.

“A primary care provider can also help you avoid duplicate testing or unnecessary visits to specialists,” said Dr. Gordon-Simet. Because your doctor has your entire health profile on record, they can help you understand which tests you need, which tests you don’t, and whether your prescriptions work well together.

Here are eight tips for choosing a new primary care provider:

1. Figure out whether they are in-network with your insurance

No surprise here – some physicians or care offices only accept certain types of insurance. Choosing a primary care doctor that’s in-network means you’re working with a doctor who accepts your insurance. Working with a doctor that’s out-of-network can result in higher costs for the same level of care. How do you know if your doctor is in network? Use a free app like HATCX | cost, which will never show out-of-network providers once you connect your insurance account. It’s a good idea to call your doctor’s office as well to make sure you’re fully-covered. This can help you avoid costly surprises on your bill.

2. See if they practice a specialty

“Fragmented care is a huge challenge,” said Dr. Gordon-Simet. It’s critical that you choose a doctor who specializes or has experience in your unique health situation. Your primary care doctor will be your “home-base” for your complete health picture. They can help refer you to specialists as your health needs change over the years. If you don’t need specialized care to treat a long-term illness or chronic disease, it’s a good idea to find a doctor that specializes in internal medicine. Internal medicine is also known as general medicine or family medicine. Doctors specializing in internal medicine help you prevent, diagnose, and treat diseases and other medical problems. Their vast knowledge crosses a variety of health issues; this makes them a perfect “home base” for your health needs.

3. Check out their physical location

The physical location of the practice can make a big difference in your health. Traveling long distances to see your doctor may deter you from getting the care you need. Instead, try to find someone who practices in a location that’s convenient for you. Don’t have a vehicle? Find an office that’s close to public transit. The easier it is to access your provider, the better.

4. Look up office hours, access and availability

You’ll want to make sure the practice hours align with your day-to-day schedule. If it’s difficult for you to take work off, or if you have children to care for, flexible hours may be more appealing to you. Many medical offices offer after-work hours for you to schedule visits.

Ask your doctor what kind of access you’ll have to health advice after hours as well. Is there a telehealth option for on-demand care? What happens if your doctor is traveling and you have a health question? Timely access to your doctor can save you the hassle of finding alternate care in an urgent situation.

5. Read reviews and social proof

With social review sites gaining popularity, it’s now easier than ever to find reviews about everything – including individual doctors and medical practices. Visit peer review sites like Yelp, Facebook, Healthgrades, and Wellness to read patient reviews. But, Dr. Gordon-Simet advised to take online reviews with a grain of salt. “These sites are helpful in many ways, but they may not be painting an accurate picture,” she said. “I recommend asking family and friends first.”

6. Know their experience level

A provider’s experience and level of interest in other areas of medicine is always an important consideration. “You’ll want to consider whether they’re close to retirement,” said Dr. Gordon-Simet. “More experience is great, but if they’re retiring in the next year or two you may be back to square one.”

7. Consider their gender

Some people may feel more comfortable discussing personal health concerns with someone who is the same gender.

8. Determine whether you connect on a personal level

Dr. Gordon-Simet says that connection is the most important consideration when choosing a primary care doctor. “A patient who doesn’t have a good relationship with their doctor may find it difficult to trust their advice and follow through on their recommendations,” she said. Instead, try to find a doctor that you feel a genuine connection with. Do they seem invested in your health? Are they listening to you? Do you feel rushed through the appointment? Do they follow up after the appointment?

Don’t be afraid to seek out a different doctor or get a second opinion if you feel like you’re not connecting. “Developing a good relationship with your doctor is critical to your health,” she stated.

Not sure which doctor is right for you? Ask for a meet-and-greet.
“Depending on the office, doctors may be able to talk with you before your first visit,” Dr. Gordon-Simet suggested. While she recommends face-to-face meetings, it’s also possible the doctor can connect with you over the phone for a brief conversation. A high-level conversation about your health can help you understand whether they are a good fit for you.

Confused about health insurance? Check out this glossary of terms (for real people):