How many doctors do I need to see, and with what frequency?

December 29, 2008 1:15 PM

Trying to make sure I've got all my bases covered and can spend all my 2009 flex spending--how many doctors do I "need"?

I am a 27 year old woman, generally in good health. I don’t smoke, drink moderately, am fairly active, eat well, and weigh in the low end of average for my height. I go to the dentist regularly and have been going to an ob/gyn for birth control and annual physicals for years.

I’m getting Lasik surgery next month so I won’t need an eye doctor aside from them for a while. I’ve had braces and had my wisdom teeth out, so no orthodontia needs. I have been in counseling and so have already found someone in that department when needed.

However, I wonder if I need to add other doctors to my list. Should I have a “regular” doctor I go see for any other kind of annual physical or when I’ve got the sniffles or food poisoning? (Usually, I just go to an urgent care clinic or wait it out). Is there any kind of doctor that can help in the above cases as well as provide ob/gyn checkups and birth control prescriptions? Should I start seeing a dermatologist with any regularity at some point? (I’ve been once, about a strange mole; my mother has a history of skin cancer although I’ve not had as much exposure as she did). Any other doctors that I’m leaving out?

I realize a lot of this depends on an individual and his/her health needs. I don’t have any health concerns right now, but my previous ob/gyn is leaving my insurance network so I need to find a new doctor, and I will have a surplus of 2009 flex spending money so I figured it might be a good idea to find out if I’m covering all my bases here. Which doctors do healthy adult females need to visit and how often?

posted by peanut_mcgillicuty to health & fitness (9 comments total)

I am still a grad student, so my general practitioner at the student health center also performs my annual pelvic exams, and they also keep an eye out on weird moles and lecture me about my weight and general health all in one office visit! I think in the Real World (and this is how it is for my mom and sister) most women have an OBGYN for annual exams and a general practitioner for everything else. I think in the Real World (except for maybe very small towns) you will not find doctors like at my student health clinic who do both GP sniffles appointments and OBGYN pelvic exams, especially since it is difficult to get in to see most OB's on short notice.

I think if you had a question about a weird mole, skin condition, or otherwise, you could go to a GP and be referred to a dermatologist, although I am not sure how it would work with your flex spending. However, I don't think you should worry about adding an orthopedist to your list just in case you should your injure your knee in the upcoming year, it is likely you would be referred by a GP. So I think adding specialists other than an OBGYN seems unnecessary, although you should thoroughly check your health insurance plan and talk with your HR person if need be.
posted by sararah at 1:56 PM on December 29, 2008

A lot of "Family Medicine" type doctors will do annual pelvic exams, so then an OBGYN is only really necessary when pregnant--and not necessarily even then, since I think some of them will do routine pre-natal care as well. It might depend on where you are how common this type of practice is and how easy it is to get in to see them. I grew up in a small town where most doctors were like that, but now live in a city with a big fancy hospital and no all-purpose doctors in sight.

It is good to have a designated primary care doctor. Nobody likes to think about it, but sudden severe acute or chronic conditions can develop at any time (especially among women in their 20s and 30s, it seems like) and having somebody you trust before all that happens will make it a lot less unpleasant.
posted by hydropsyche at 2:05 PM on December 29, 2008

A PCP (primary care physician)/GP (general practitioner) would be a good thing to have in order to get an annual physical, including blood work. (When's the last time you had that done?) It's good to have baseline levels should you be sick later in the year. And when I say annual physical, I mean a full one; EKG and everything - not just BP and weight check.

I would absolutely go see a dermatologist if your mom has a history of skin cancer and you already had a suspicious mole.

Is your entire LASIK surgery going to be covered? You should check your FSA and see if you can apply your annual insurance deductible toward it (I know I can with ours). Also, you can get reimbursed for all your co-pays, rx prescriptions, etc. They may also cover your birth control (again, depends on your plan and how it's prescribed). Get a list of all the OTC stuff that's covered and stock up.

I just sent in my 2008 stuff today, and squeaked by. I feel your pain.

Good luck with your eye surgery!
posted by dancinglamb at 2:19 PM on December 29, 2008

Thanks for the quick responses so far! I think I'm going to find a primary care doctor and ask for a referral from him/her to a new gynecologist and a dermatologist.

@dancinglamb--yes, my entire Lasik surgery will be covered by the flex spending, which is why I have extra. I maxed out the account before I knew how much it would cost, and I will have around $1,500 to use up. Given my standard usage--one gyn visit, four birth control prescriptions, two dental visits, a few OTC purchases--I will not be able to use that up without doing some of this extra stuff. Might as well get the bloodwork done (I don't think I've *ever* had that before) and maybe an allergy test and skin cancer screening as well.
posted by peanut_mcgillicuty at 2:26 PM on December 29, 2008

A good primary care doctor/internist/etc. is a good thing to have, as a sort of one stop shop for any health problems you might have. As a healthy young person, you probably don't *need* a yearly physical, but go for it if your insurance covers it. You would go to a GP or an internal medicine doctor for that, most likely. They can get you a referral to any other specialist you might need. They may also be able to take care of your yearly pelvic exam and pap smear as well as your birth control, or you might want to see a separate OB/GYN for that. Your GP is kinda like a base camp- they take care of the basics and are your go-to person for any other health expeditions you care to take.
posted by MadamM at 2:28 PM on December 29, 2008

Only $1500? It shouldn't be hard to get there. I thought you were talking way more than that. ;)

If you've never had bloodwork done, then absolutely do it. It will gives you such a good insight into your general health and if you're healthy now, it will provide that ever important baseline for down the road. If nothing else, you should know your cholesterol levels, iron, calcium, etc.

And the skin screening, too. Can't emphasize that one enough, either. Especially since it has already directly affected an immediate family member.

We max'd out the FSA for '09 and have no doubt that we'll hit it with two adults and two kiddos in the family.
posted by dancinglamb at 2:38 PM on December 29, 2008

If you are worried about the money, flex spending accounts can also be used to pay for many things that are only tangentially medically related. Air filters, vitamins, massages. You might need a prescription, but it is not hard to empty the account every year.
posted by bh at 3:20 PM on December 29, 2008

I'm a big fan of continuity of care, so I'd find yourself a primary care physician - either a family physician or a general internist. You want to find a doctor who knows you, at least from a patient perspective - something you don't generally get when seeking care at an urgent care center. It's nice to be a little bit more than a name off the clipboard. Also, while a family physician can provide pelvic exams and general female "well" care, a dedicated OBGYN is a nice resource, as they only have that to focus on, and will likely know more about new birth control options.

Save the rest of your FSA money for incidental visits. You never know when you're going to need a specialist for something.
posted by honeybee413 at 5:26 PM on December 29, 2008

I have an amazing primary care physician here in the city, if you're interested. I think she does basic GYN checkups (I don't see her for that though), and the other doctor in her office is an OB/GYN anyway, so if the insurance "in-network" stars align it can be a one-stop shop.

Drop me an email if you want to know more.
posted by ocherdraco at 6:22 AM on January 10