Health NW column: Effective medical appointments, Part 1

The old saying “hope for the best, but prepare for the worst” is certainly true when it comes to health. An unfortunate fact of life is that illness and injury can strike anyone at anytime. Being healthy in the past is a good predictor of future health, but it doesn’t guarantee problems won’t arise.

One of the best things you can do for your health is to have a primary care provider. If you’re wondering what in the world this means, read on.

“Primary care” means health care given in community clinics and doctor’s offices (as opposed to care given by specialist clinics and hospitals).

“Provider” is a general term for a health care professional who takes care of patients. Doctors are providers, as are nurse practitioners (NPs) and physician’s assistants (PAs).

So, a “primary care provider” can be the quintessential family practice doctor, but might also be an internist, a pediatrician, a gynecologist, a nurse practitioner, a physician’s assistant or even a naturopathic practitioner.

Your primary care provider should have your complete medical history on record. Ideally, you should see him or her about once a year for a routine check-up. He or she should know about your living situation, your family medical history, the type of work you do, your hobbies, and your diet and exercise habits. All these factors affect your current health and future disease risks.

Why is having a primary care provider so important?

Primary care providers focus on prevention and early diagnosis of disease.

Since your primary care provider knows you, he or she may be able to give you advice by telephone on a weekend, saving you an unnecessary visit to the emergency room.

Having a primary care provider as your advocate can help you get specialty care more quickly if you ever need it.

If you have multiple health problems, your primary care provider is the one who will help coordinate your care to make sure all your needs are met.

And here’s the story of Fred. Fred has a cough.

If Fred went to a pulmonologist (a doctor specializing in diseases of the lungs), he might be told to get a chest x-ray and have pulmonary function tests done to rule out cancer and emphysema.

If Fred went to see an allergist, he might undergo sinus x-rays and skin testing for allergies which could be causing his cough.

If Fred went to an infectious disease specialist, he would probably be advised to have a PPD skin test and an x-ray to check for tuberculosis and other diseases.

Each of these specialists would view Fred’s cough through the lens of their own experience. Because they don’t know Fred as a whole person, they would be focused on his cough. And in doing so, they might subject him to expensive tests he does not need.

It turns out that Fred’s cough was caused by a small fish bone stuck in the back of his throat. His family doctor knew that Fred had never smoked cigarettes, had no history or symptoms of allergies, and had no risk factors for tuberculosis. He listened to Fred’s concerns, did a basic physical examination, and found the fish bone by simply looking in Fred’s throat.

This story illustrates the importance of having a primary care provider whom you see first for a health problem. Because this person knows you, they will be better able to focus on your symptoms and determine the most likely cause. They can order the most appropriate tests and treatment. Your primary care provider may not be able to diagnose and treat every health concern you have, but they can rule out the most common problems and then refer you to a specialist who can help you.

Health care is complicated now. Where there used to be just doctors and nurses, now there are a plethora of specialists and new categories of health care providers. Having more choices in health care does not necessarily mean you’ll get better health care. Usually, the best option is to start with your primary care provider.