Finding a primary care doctor

July 22, 2009 8:57 AM

I haven’t been to a doctor in nearly 10 years. 100% of this is due to what I believe is social anxiety. To get a real medical opinion I’d like/need to speak to a doctor. I cannot pickup the phone. (1) Looking for primary care physician recommendations near Columbia, MD and (2) advice on what to say to the person answering the phone.

I’ll do my best to keep it brief. From 18 years old my “shyness” has progressed into full-blown terror at most social interaction. In the last two years it’s accelerated (unanticipated touch almost “burns”, I’ll basically agree to anything, I walk into walls because I won’t look at anything on eye level, I will physically get sick if the phone rings or someone knocks on my door). I’ve been self-medicating by living the simplest, blandest life I can.

I woke up Monday with searing pain in my jaw. I spent an hour weeping because I didn’t even consider going to a dentist, it was just a new thing in my life (I’d just bitten my cheek BTW). I have to address this. I’ve had the phone in my hand probably 10 times… I feel this is the closest I’ve come to actually doing something. My understanding is that you should pursue this type of thing with your primary care first, so step 1 is getting a pcp. (1) Do you have any recommendations (Columbia, MD area)? (2) Second thing (probably the biggest for me) what do you say when scheduling? I’m unsure of the protocol here. Do I say “I’d like to see Dr. Smith because of issues with …” or just save that for the visit and say “I’m looking for a PCP, is Dr. Smith taking new patients”. Just some additional info; I do have insurance BCBS and a job. I know question 2 is really stupid… but I won’t even go into a store until I’ve driven by enough times to know the layout from looking in the windows. Thanks for reading.

posted by syntheticfaith to health & fitness (22 comments total)

Just say "Hello, I need to see a doctor", and let the receptionist lead the conversation from there.
posted by mpls2 at 9:03 AM on July 22 [1 favorite]

I've never had a primary care physician. It doesn't matter. Just do what mpls2 says. It's not a big deal at all. The receptionist is trained to lead you through the necessary steps.
posted by bricoleur at 9:09 AM on July 22

It *is* a big deal for syntheticfaith.

It'll be hard making the first phone call. The receptionist WILL lead you through the call though. Have your insurance card and your calendar with you when you call. Tell them you'd like to make an appointment with a doctor. They might ask you what you want to be seen about. You can just tell them it's a checkup. They don't need to know more than that.

It might help you to write out what you want to say. It'll keep you from getting too flustered. I do that a lot, it keeps me on track.

When the call is over you will feel a huge sense of relief and accomplishment. It'll be worth it to make the call just to feel like that.
posted by elsietheeel at 9:15 AM on July 22 [19 favorites]

bricoleur, a lot of insurance won't allow you to see a specialist without a referral from your primary care physician.

Yes, you can just call the office and say something like "I'd like to make an appointment with Dr. Smith, and I am a new patient." The receptionist will ask for your information (name/address/phone/insurance) and the reason for your visit. It would probably be helpful to let them know about the extent of your anxiety on the phone, so that when you go into the office, the staff already have a heads-up and can offer you appropriate support.

If it helps to manage your anxiety, you might write yourself a little script that you can use to answer some of the questions that might come up during the call (e.g, what's the appointment for?), or to convey the information you need to give them (e.g., particulars of your anxiety). That way, rather than feeling panicked and freezing up, you have something to fall back on and read verbatim if necessary -- even if it's just "I have some pretty severe social anxiety and will probably be feeling very anxious when I come in for my appointment," or "Can you tell me what I can expect when I arrive for my appointment?"

Maybe also make a backup plan in case this particular doctor isn't taking new patients, like having a line in your script to say, "Is there another doctor you could refer me to?"
posted by Siobhan at 9:18 AM on July 22 [1 favorite]

I agree with what elsietheeel said, with one exception: don't tell them it's for a checkup. That will put you low on the priority list, and I assume you want to address your jaw pain ASAP. Give a brief description of what's happening and do let them know you're in a significant amount of pain. Otherwise, they could schedule you anywhere from a week to a month out.
posted by yawper at 9:22 AM on July 22 [1 favorite]

Your insurance almost certainly has some list of doctors/practices available that are preferred (and whose cost will be greatly reduced compared to the alternative.) If someone here recommends a doctor, make sure he or she is on that list. Otherwise, just choose a practice at random from the list. (If you weren't in pain now, I might recommend more research.)

The thing to say is "I've had intense pain in my jaw for two days.Could I see a doctor today, please?" (Practices leave space in their schedules for same-day appointments for urgent care, but they may give preference to existing patients.) As others have noted, have your insurance info handy. If you can't get a same-day appointment, you may want to try another practice (I understand how much you don't want to make another call... but the alternative is more pain.)

Is there anyone in your life that could help you with this? Make an appointment on your behalf?

(And, y'know, crippling social anxiety is something a doctor might be able to help with. You could print out this question and point to it.)
posted by Zed at 9:23 AM on July 22 [1 favorite]

All I can offer is encouragement to get yourself set up with a doctor and maybe some anecdotal hope: I am a life-long unipolar depressive and from my late 20s on (now 39) I have battled increasingly intense and debilitating social anxiety. Last year my doc prescribed me a moderate dose of the SNRI anti-depressant Effexor (Venlafaxine). The drug worked wonders for me, both in terms of my disordered mood and—significantly and not unrelated—my intense fear of folks. I'm as cynical about Big Pharma as the next Joe, but I can honestly say that the drug gave me my life back in a way I never imagined possible.

I hope you find your way out of the fearsome space you are in, and soon. It helped me to learn that, to one degree or another, about 1/10 of people are living with a social anxiety disorder. Next time you step out and feel the unbearable tension and the creeping fear just look at someone who isn't looking at you and imagine for a moment that that person is going through exactly the same thing you are. You are not alone.
posted by sid abotu at 9:23 AM on July 22 [1 favorite]

Oh, I am you. I needed some surgery a few years ago and put it off by oh, 6 months or so because my regular OBGYN didn't do surgery, and I had to find a new doctor.

This is your script:

RECEPTIONIST: Dr XYZ's office

SYNTHETICFAITH: Hi, is Dr XYZ taking new patients?

RECEPTIONIST: Yes, she is.

SYNTHETICFAITH: I'd like to make an appointment then, for as soon as possible/for the next available time/for a checkup/for next week if possible/ (whatever fits)

RECEPTIONIST: How about XXX? Does that day/time work for you?

SYNTHETICFAITH: (has list of days/times that work) yes/no. *Offers other options if it doesn't work*

RECEPTIONIST: OK let me just confirm that - blah blah day, blah blah time.

The end.

Many insurance companies have lists of the pcps that are accepting new patients on their websites. Might be a good place to start.
posted by gaspode at 9:26 AM on July 22 [4 favorites]

Gaspode's script is almost exactly how it will go. I've made this same call several times in the past few months as I've moved and had to find all new doctors. Please don't be upset if they put you on hold; especially if the office is busy or if there is only one receptionist, you might be put on hold several times and that is normal as well.
posted by crankylex at 9:34 AM on July 22

I have this problem also. Possibly not to the same degree, but here are some things to watch out for that you might be able to avoid if you are mindful of them.

1. Be up front about your anxiety. Say to the person answering the phone, "It's taken a lot of work for me to make this call. I am anxious about seeing a doctor, and I was hoping you could help me make an appointment. I've never seen Dr. Smith before." That primes them to be the most helpful for you. It also will dissuade them from smacking their gum and giving you glib answers to your serious questions. Do not be afraid to say this: it will ALMOST ALWAYS bring out the good in someone who might otherwise keep it buried deep inside their blackened administrative heart.

2. Be prepared. Brainstorm what questions you might like to know the answers to beforehand. Are office hours important? Do you care how long Dr. Smith has been practicing? Do you need to know what specializations Dr. Smith has. I find that making a list before I make an important call is potentially the MOST IMPORTANT part of the call. It ensures that I don't yammer my way into oblivion. Which I would otherwise do with great zeal.

3. Don't let them get rid of you. More importantly, don't let yourself stand in the way. If they say, "Can I put you on hold?" and you know that your reaction will be to become hysterical and freak out while on hold, then politely say, "I'm sorry, that's not an option for me." If they say, "Let me call you back about that," and you know that you will freeze when the phone rings - politely say, "I'm sorry, I'm only available to talk now, I'm happy to wait while you find out." It isn't about being demanding, and it isn't about being assertive. You may (IANAD!) have a condition that requires serious accommodation. So the typical social interactions that the person on the other end of the phone is accustomed to simply wont work for you. If you need help thinking about this, explain it to yourself this way: I am helping them help me by explaining what my needs are.

And finally, be mentally prepared for this. Don't try to do it when you've got thirty other things going on. Don't have the TV running. Don't have a video game on. Quiet your surroundings and quiet your mind. You may even want to take some time to meditate and relax beforehand in order to be as ready as possible. In that quiet time, think of calming and relaxing things.

Best of luck.
posted by greekphilosophy at 9:35 AM on July 22 [6 favorites]

Yes, the best strategy is to be prepared. Have some scripts. You might have to call a few doctors before you find one that's taking new patients. Don't get discouraged! Focus on getting the help you need (what greekphilosophy said).

If you want to minimize the number of phone calls you might have to make, I would suggest looking for a nearby medical group, rather than a single doctor. Hopefully the receptionist will know of at least one doctor in the group that is taking new patients. You can search on BCBS' website for doctors, but I don't know if they list the medical group.
posted by sarahnade at 9:44 AM on July 22

Dr. Cheryl Leondardi at Crossroads Medical in Ellicott City is really good. She has a really nice physician's assistant as well. It's about 10 minutes from Columbia.

I had this same problem. I basically called the doctor's office and mumbled incoherently, and then the receptionist asked me a series of yes or no questions to ascertain that I wanted an appt and had never been to that office before. She was nice and professional. I think this will be the experience in most doctor's offices. You should have a pen and paper on hand to write down any information they tell you, and ask them to repeat things you don't understand. They will slow down for you.
posted by bluefly at 9:45 AM on July 22 [1 favorite]

If you have health insurance, you should go to company webpage first to get the list of area doctors that accept their insurance plan. That might save you having to make extra phone calls.
posted by Pater Aletheias at 10:04 AM on July 22

gaspode's script is good, start with the "new patients" line and the receptionist should be able to get the information from you without having to ask a lot of questions. And although personal recommendations for doctors usually works better, RateMDs is a an option if you want Yelp-like Internet recommendations.

I’ve had the phone in my hand probably 10 times… I feel this is the closest I’ve come to actually doing something.

Yeah I've been there. One trick that helps is to get to the point where you're pretty comfortable about calling but still not really ready and just start physically dialing the number even though you don't want to. The wait between the time you start and when they finally pick up will be stressful, but at some point you just have to trust that you've prepared as much as you can and do it.
posted by burnmp3s at 10:12 AM on July 22

I'd suggest calling a multi-doctor practice that's close to you, and asking the receptionist to recommend a doctor who is available and who will be good at working with your anxiety.

Often, entire practices are either in or out of an insurance company's network, so if you find a practice near you, look up one or two doctors' names to see if they're in your plan.

Do have your calendar or other schedule available so you can be sure the appointment times suggested will work.


RECEPTIONIST: [answers with name of practice, or you go through the phone menu and she just asks if she can help you]

SYNTHETICFAITH: Hi there, can you please confirm that you're in the [insurance company] network?

RECEPTIONIST: [if no, say "OK, Thank you. Bye." and hang up; if yes, continue]

SYNTHETICFAITH: Great. I hope you can help me. I woke up Monday with severe, terrible pain in my jaw. I haven't been to see a doctor in 10 years, due to social anxiety, but I think I really have to now. Since I'm in some pain, I really need someone to see me soon. I guess I need a primary care physician, but right now I need to deal with my jaw pain first. Could you please recommend someone in your practice who'd be good for someone with anxiety?

-- two things might happen; option 1 - no dice --

RECEPTIONIST: Sorry, all our physicians are booked up / not taking new patients / busy until September. Have you tried an urgent care center?

SYNTHETICFAITH: Oh, OK, do you recommend any urgent care center in particular?

[Receptionist recommends one, you save that information in case all the practices in your area are full - probably you won't need this information, but it will be good to have]

SYNTHETICFAITH: Thank you for the information. Bye. [ hang up ]

-- option 2 - success; doctor available, need to confirm appointment --

RECEPTIONIST: Well, let me think about that. I'd recommend Dr. Z, and his/her next appointment is [gives appointment time]


-- 2a: next appointment is sufficiently soon --

SYNTHETICFAITH: Let me check my schedule (glance at calendar).

[Receptionist leads you through scheduling]

[if first time is not good for you, try suggesting a different time, as in: "how about (e.g. Thursday, May 4, any time before 3:00?) - until you find a mutually available time].

[if no time is found, skip to 2b below]

SYNTHETICFAITH: [once a time is found] Thank you so much. I'll take it. What else do you need to know about me?]

[Receptionist leads you through next steps]

SYNTHETICFAITH: [What time should I arrive to fill out insurance and medical history forms?"

Receptionist answers

SYNTHETICFAITH: OK. Thank you for the information. I'll be there. Is there anything else I need to know?

Receptionist answers

SYNTHETICFAITH: Thank you for your help. Bye. [hang up phone]


-- 2a: no appointment time works, or it's too far in the future --

SYNTHETICFAITH: That time doesn't really work for me. I'm sorry. I think I need to try another practice in case I can be seen sooner, but I thank you for your help.

[Receptionist will probably reply]

SYNTHETICFAITH: OK, bye. [hang up phone]

The end.
posted by amtho at 10:45 AM on July 22

Obligatory book mention.
posted by damn dirty ape at 10:50 AM on July 22 [2 favorites]

This is an excellent practice: http://www.charterinternalmedicine.com/.
posted by holympus at 11:29 AM on July 22 [1 favorite]

Many people have social phobias. You may get some relief from anti-depressant medication. Dealing with this is difficult. Is there anyone who knows you have social phobia, and who would help you? Having someone sit with you while you call might help.
posted by theora55 at 1:10 PM on July 22

uh, well, i have doctor-anxiety. for reasons that don't need to be got into here. i HATE calling and being on hold and then having to explain to three different people why i need to come in, etc. etc.

i live in philly, and there are tons of great hospitals here. through their websites, i can "request an appointment" with any doc in that is affiliated with them. i fill out a web form, where i can go on at length if i want to about my problem (as this will help them figure out what specific doc would be best for me out of a practice of 20). within a day or so, i get an email with my appointment information.

i much prefer this to having to call and deal with that. there is no social interaction at all. it is stress-free for me.

so, i would suggest seeing if any hospitals in your area have that feature, or even if any private docs do. i understand the social phobia, and if not wanting to call is your biggest hurdle, this is one way to get around it.

as to what to say in your form or when you call, just say that you haven't been to a doctor in 10 years, that you'd like a physical, and that you'd also like to talk about [specific problem]. and, if you're female, you might consider getting a pelvic exam as well, but maybe not on your first visit.

good luck!
posted by misanthropicsarah at 2:09 PM on July 22

This was me before Xmas.

It was hard, but the imagining of it was a lot harder than the doing of it. I've improved so much I went to a Mefi meetup last weekend. Memail me if you want.
posted by b33j at 2:12 PM on July 22

I just wanted to say thanks to all who provided answers. Every post was helpful. I do realize that “just call” should be the easy (logical) choice; in most other things in my life I’m fairly rational, I promise. (Also, sorry for the confusion, the jaw thing isn’t a problem anymore, it was more the catalyst… the realization that at some point in the last few years I fallen far enough that upon serious injury, my preference was pain to social interaction).

b33j, thanks for the link, it came up in my pre-post search, but upon rereading it there is a ton of good information. elsietheeel, thanks for your post, I was frantically looking for the delete post button before it, assuming my suspicions, that it was just me were confirmed. All who suggested a multi-physician practice, that’s a really good idea. For all the scripts, I know it sounds ridiculous, but thanks they were useful.

I made my first call this morning. I wrote out some lines as well as all my insurance information and demographic data (to avoid thinking and shuffling cards while speaking). Without too much rambling, I’ll say it was mostly terrifying. And I learned what people going to doctors probably already know, they are pretty busy. Wait times were ~ 40 days. The initial terror has passed and I managed to eek out “I will try another practice, thanks for your help”. And I probably will call again (I think 1 call a day is my current limit).
posted by syntheticfaith at 8:13 AM on July 23 [2 favorites]

Congrats on making the call, syntheticfaith, and I'm really glad to hear you're pursuing this despite your pain abating.
posted by Zed at 8:58 AM on July 23