Doctors are for the sick. So how does a healthy person find one?
July 10, 2015 10:11 PM   Subscribe

Tell me about finding a doctor for the first time, like I’m 18 (even though I’m in my mid-30s).

I grew up in a somewhat doctor-avoidance household, due to various health complications of one of my parents when they were younger, and having received poor care that may have further compromised that parent’s health. As such, I never learned how to really deal with medical issues or find a doctor.

As far as I know, I am thankfully in great health - I've never been to the ER. My biggest health problems are seasonal allergies, adult acne, and getting my birth control prescription renewed at Planned Parenthood (which I would like to stop doing). I’m active/athletic, donate blood occasionally, and have no reason to suspect that anything is awry - but I think it’s about time I find “real” doctors.

I do have insurance, and have only gone to a specialist (orthopedist) for an ankle sprain. I know how to find a specialist for specific things through my insurance network and go from there.

But how do I find a doctor if I’m healthy? Like to get full checkup (which I have not had in 20+ years). Will a doctor accept me as a patient if I basically have no health concerns and come in very infrequently? Do I need to have a regular doctor, if I see them hardly ever? What other options are there for someone with very few health concerns?

Do I need to have a gynecologist in addition to a GP? Can my GP prescribe birth control (have no family history of breast, cervical, ovarian, or typically "female" cancers)? I strongly support Planned Parenthood as an organization, but have had some terrible experiences at my local offices and refuse to go back again. Plus, I feel a little too old going there. Can I get my records transferred? How on earth do these things work?

Please teach me how to Doctor like a grownup.
posted by anonymous to Health & Fitness (20 answers total) 15 users marked this as a favorite
 
Yeah, you want like a family doctor or general practitioner. Your insurance company should be able to tell you who is located near you. Call and make an appointment for a physical and then talk this all out with the doc.
posted by J. Wilson at 10:27 PM on July 10, 2015


If you have insurance, look for their list of GPs and see who's accepting new patients. Generally a GP will be happy to prescribe your birth control. My GP is at a larger clinic that also has specialists; it's nice because if she sends me off for an x-ray or other test, the results go right into the same computer system.

It's useful to have a regular doctor even if you're only going in for an annual physical now. For example, they'll have a history on your blood tests, so if something is out of whack ten years from now, they'll have data to compare it to. Plus, if you have more serious medical issues down the road, you'll have a doctor you're familiar with.

One warning -- while online reviews of doctors can be helpful, they also tend to be full of patients who showed up to their first appointment with a list of a dozen painkillers they wanted prescribed and the doctor threw them out. So, try to read between the lines there!
posted by Blue Jello Elf at 10:31 PM on July 10, 2015 [1 favorite]


You should see a GYN each year. If you didn't additionally see a GP regularly, you'd have a lot of company. Your GYN can probably refer you when you have any complaints, but there are a few maintenance things that it might be good to organize with a GP. A full blood panel comes to mind first, as does a full dermatologist scan if you're at all mole-prone. I would see a GYN first and ask them to refer you to a GP. (Once upon a time, I saw a GP who also did women's health checks, but that seems less and less common.) Once you have a doctor, it's a small bit of paperwork to have your records transferred, though they may not find it particularly necessary if you don't have any ongoing issues.
posted by vunder at 10:34 PM on July 10, 2015


Additionally, a family doctor or GP is often a specialist in "internal medicine" or an "internist."
posted by vunder at 10:40 PM on July 10, 2015


You should see a GYN each year. /

What! No, this is absolutely wrong. For a generally healthy person with no major gynecological concerns, a GP is fine. They should be more than happy to handle a birth control Rx. (A Physician's Assistant or Nurse Practitioner would also be a good choice.)
posted by Violet Hour at 10:46 PM on July 10, 2015 [2 favorites]


Oh come on, it may not be what you do but it's not "absolutely wrong." The recommendations about yearly paps only changed in May of last year. I'd still start with a GYN personally.
posted by vunder at 11:33 PM on July 10, 2015 [11 favorites]


Go on your insurance's website and look for in-network general care physicians that are close to you. Find one you like, call and say you are not currently a patient there but you would like to get a complete physical/annual exam. Because you are a new patient and because it's a physical, they won't be able to see you right away and you'll have to fill out a crapload of forms. There's a chance an office may not accept new patients or will be scheduling really far out -- then just try another on the list given to you by your insurance website.

Even if you're healthy, it's good to get a baseline about where you are at. When I do my physicals, the doctor does blood work -- checks my vitamin D levels, my cholesterol, that sort of common stuff. They also weigh me so if my weigh fluctuates they will notice. It's good to have a primary care doctor for when you do need a doctor, a doctor that has seen you and has info about you.

Thanks to President Obama, gynecologists don't necessarily count as specialists. You can go for a check-up and have it covered by your insurance. I get a pap smear about every other year. Your doctor will tell you how often you need one based on your age, health and other factors, but if you have never had one and you are an adult woman, yes I would definitely go to a gynecologist and tell them you've never had a check-up or pap smear.

As for your records, call your previous doctor/clinic and say you'd like a copy of all your medical records. You can get them transferred to your new doctor, but you could also just get copies for yourself, and then give your new doctor copies of your copies. Some offices will make you sign a medical release form. They will tell you what you need to do to get the files, but you have a right to your own medical files.
posted by AppleTurnover at 11:45 PM on July 10, 2015


Don't all GP's do pap smears? I've never been to a gyn but have had 2 pap smears done as part of an annual physical exam, as a 20-something.

My GP--whose specialty is family medicine, because the internists were booked--is amazing. She does pap smears and is well-versed in different forms of birth control, trained to place both IUDs (copper/Mirena/Skylar) and rod implants. Plus, as a primary care doctor she's willing to do things like renew my maintenance prescription for a strong cortisteroid that I originally got from a dermatologist, because I hadn't gotten my act together yet to find a derm after moving.

Also, I never realized how awesome it is to have a younger doctor in a clinic system with decent online services, until I got to use it. Still need to call for new specialist appointments, but after that I can send messages to all my doctors and request appointments online.
posted by serelliya at 2:13 AM on July 11, 2015 [2 favorites]


My GP always had me go to a GYN for pap smears. I have never heard of GPs doing pap smears and all the women is my family have always gone to a GYN for that. But if some GPs do it, I think OP should start with getting a primary doctor and she can ask the primary doctor about it.
posted by AppleTurnover at 2:31 AM on July 11, 2015 [1 favorite]


Hi I just did this literally today. Well, the past couple of weeks but my first appointment was today. A couple weeks ago I had a health scare thing and finally went onto my insurance's website and looked at the list of doctors.

My insurance is a kind of neat situation that has medical centers full of different kinds of doctors in one place as well as other doctors that take many flavors of insurance, but I decided to go to one of the health centers where everything is in one place. I looked at the list of GPs there and the site let me narrow it down by different options including specialties and the doctor's gender and other things, so I decided I'd prefer a woman doctor, and asked for only doctors accepting new patients. I found one who was a GP as well as a gynecologist, who had a little blurb talking about her preferred treatment style etc. (She said she focuses on treating the whole body and mind at once and being very thorough which made me comfortable.) So then I selected her as my "primary care doctor" via the website.

If your insurance is not all techno-savvy like mine, this is something you can probably do on the phone with a customer care person. Gather some snacks/doodle pad whatever and settle in for a conversation and ask questions until everything is clear.

After I selected my doctor I was like "awesome, now I will also make an appointment online!" but that didn't happen. I'm not sure if it was the wrong time of day (well, night) or what but it wouldn't work for me. So I went to sleep and the next day called a human on the phone. I started the phone call with a real person by saying "Hi, I haven't seen a doctor in ten years so I'd like to fix that." It turns out we are NOT an uncommon thing. The guy I got asked me lots of questions about what I'd like to see a doctor about in addition to general well-being, and then checked to see if my primary doctor could see me soon. He set me up with an "office visit" (that happened today) and a "preventative care visit" (that'll be next week) and typed up a lot of notes, which today my doctor had to-hand, which was cool. He also scheduled me for a pap test the same time as my preventative care visit with my same doctor since she does both, but if she didn't do both, I still would be scheduled for one with someone else in the building, and it's all covered under a $20 copay regardless. He asked me like five times if I needed any additional information or had questions and was very thorough with telling me what might cost money and what information I should bring to the doctor and so-on.

Today I went in and filled out some paperwork. They weighed me and took my bp (high, so high, ugh) and then my doctor asked me questions and I droned on about my sundry issues. She then did some very brief examinations because I had some small complaints that she wanted to just take a look at - all clothes stayed on, I feel like I could have easily said "no, wait till next week" but I figured what the hey. She asked me if I'd be okay with it today and then sent me down to the lab with an order for a blood draw and a urine test, and told me to get some OTC meds for a phlegm issue, gave me a referral to the in-network mental healthcare people that were next on my "fix my shit" list, and sent me on my way.

In talking with older loved ones who are not doctor-averse, it evidently works like this to start, and then you'll have their contact info and some face to face experience with them, and they'll have your baseline on file. Then they'll bug you for regular checkups (like how your dentist will send you reminder post cards and emails) and you can contact your doctor with questions through a method they'll give you. (I can email my doctor through my insurance's fancy website thingy, or call her office on the phone.) They'll give you suggested frequency of checkups and other exams and vaccines and stuff, but it's up to you to actually schedule these appointments. You should also have a phone number on your insurance card that says something like "nurse hotline" that you can call if, like, you've got weird symptoms but aren't currently dying (in which case 911 of course) and you can ask them for advice, and they will tell you "doctor asap!" and then you need to contact your doctor and make an appointment. That will be a different kind of appointment where, because you are not a new patient, they don't have to do a whole physical, and can slip you in faster and get you out the door with an Rx or peace of mind or a referral to a specialist or whatever.

If you are in great health that is excellent, but something is eventually gonna happen even if it's just an accident. If you have a regular doctor they'll have it on record that you're good to go in other aspects and will give you a much more concrete diagnosis. Right now I'm in the process of telling them everything about me and they have to ask things multiple times in different ways because they don't know me and my specifics and need to be sure we're all communicating clearly. It's good to have a regular doctor or doctor's office so that communication has already been done when you're feeling poorly and they can take better care of you.

With birth control what might happen is your GP sends you to get a fairly thorough female health checkup exam thing with a gynecologist for the first go, and then you'll be able to renew birth control prescriptions through your GP or a nurse practitioner, which is what I suspect I'd be doing if mine weren't the same person, and what my friend who has the same insurance did. If you start with your GP then they can point you to all the appropriate people, you'll just be the one to actually make calls and set up appointments, but you can ask them lots of questions.

This long rambly answer is just because I feel like reading it a few weeks ago would have made me feel better today when I was very nervous. In short, you might feel comfortable having an office visit first to be sure you have time with your doctor to talk over things and make sure they've got your history down right and they can answer questions. There is a lot of shame in not having Doctored like a grownup but it turns out tons of people are also not Doing It Right so there's probably a suggested procedure to get you sorted out. Try to be upfront about it and tell them that you want to be responsible for your health and they'll love you for it. No medical professional wants people to wait until they're really sick to see them.
posted by Mizu at 2:38 AM on July 11, 2015 [6 favorites]


My primary care doc (family medicine/GP) does paps and prescribes birth control, but this is the first practice I've ever been to that doesn't draw blood for tests; they write a referral/rx and I have to go to a lab for that. Based on what others have written it seems there is at least some variation in what different doctors will do. It may depend on the insurance as well. I am very happy with having her cover the obgyn stuff because I can get it all done together which means fewer appointments.

If your insurance is through work you might ask friends from work (with the same insurance plan) if they have a doctor they like who is in your network. You can also call your insurance or look on their web page for a list of names.

(I am assuming here that you are in the US; I don't know how things may vary in other countries.)
posted by 2 cats in the yard at 4:13 AM on July 11, 2015 [1 favorite]


And yes, a family med/internal med/GP will see you even if you have no current complaints. Mine did an initial intake that was all discussion, and then a separate meeting for the first physical, as Mizu said above. Since then I have had an annual physical and I can also call at any time for questions or appointments about concerns that may arise between the annual physicals.

Also, though not quite to your question, I think someone mentioned the "I have a medical question" type phone line for the insurance. Mine has one that you can call for basic triaging/suggestions and a recommendation as to whether you should go to the doc or can take care of something yourself. I used it once when I fell off my bike and hurt my knee and wasn't sure if I needed to go the urgent care or my regular doc or could just self-treat (verdict was self-treat).
posted by 2 cats in the yard at 4:19 AM on July 11, 2015


I usually pick family medicine doctors over internists if I have a choice. Sometimes a practice will have a number of family medicine doctors, and I'd pick the one focused on womens health, again if I had a choice.
posted by Ms Vegetable at 5:40 AM on July 11, 2015


I found my doctor via recommendations on Angie's List. (The only thing I ever used it for, but it was worth the year's subscription because I love my doctor!) She's an Internist. Look for "Board Certified" doctors.

When you find a doctor you want to try, call and ask if they are taking new patients and if they take your specific insurance. This was the most tedious part for me. When you find one who will take you and your insurance, they will likely schedule you for a new patient annual exam. The first appointment is usually much harder to get than once you are an established patient. Doctors often set aside blocks of appointments for urgent current patient visits, so subsequent "I'm sick!" appointments should theoretically be scheduled faster.

In my first appointment, mine did the personal health history, ordered blood work, took vitals, a Pap smear and pelvic exam, then helped me with getting prescriptions for birth control and a couple of other things. During the year, she has an online patient portal so if I need something like a refill on a prescription I just email her. She requires that I go back once a year for a well woman's annual exam to continue to refill the birth control and other prescriptions and does the Pap every few years.
posted by cecic at 6:30 AM on July 11, 2015


My 2 cents on things you might ask about/look for if you have a choice between a few different GPs:

1. Some GPs do paps, some do not. My experience has been that most GPs do provide pap smears/pelvic exams, but I had one who didn't and it was a little inconvenient to have to make a separate appointment for that.

2. Some GPs are part of a large enough practice that they can draw blood in-house. This is also SUPER CONVENIENT rather than having to get an order for bloodwork and making a separate appointment to go to the closest LabCorp or whatever.

3. Some GPs have decent online set-ups for patient records, patient communication, etc. and this is also SUPER CONVENIENT.

4. With a GP who is part of a slightly larger practice, it can often be a little easier to schedule because they can get you an appointment with someone else in the practice.

5. Kind of location-specific, but in a moderately urbanized area I find that ease of parking is a factor co-equal with distance. IOW, I'd rather drive 20 minutes toward outer suburbia to a practice with a free surface lot than 15 minutes into inner urbia to a practice in an elevator building with underground parking that charges you $8 for the first hour, no validation.
posted by drlith at 7:11 AM on July 11, 2015 [1 favorite]


I like what Mizu said, and especially agree with finding a CENTER rather than a specific MD, particularly if you're not going to be seeing any particular specialty regularly and your healthcare needs may change over the next few years. The biggest advantage imo is that your records are centralized so if you only go in every few years or 'your' MD retires or you need to see a different specialist, your records are available without any issues in having them available to the new physician, regardless of when you were last seen. Kaiser, Geisinger and Kelsey Seybold are some examples. These are not necessarily insurance-specific as the local one accepts multiple insurances. The local KS service has a online sites for choosing your MD, scheduling your appt, and seeing test results.
posted by beaning at 7:20 AM on July 11, 2015


I go to a primary care clinic in a hospital, which I chose because they do blood work and x-rays and whatever else in house and referrals to specialists are way easy. The other benefit to larger clinics is that they tend to have better websites and doctor bios. I choice mine based on his blurb and I'm very, very pleased to the tune of about 10 years. Even if I didn't ultimately like him it was easier to rule out bad fits and line up potential next choices. And preventative care is hugely important, not least of all because someone who knows you and your medical history can much more accurately troubleshoot bigger issues.
posted by good lorneing at 10:04 AM on July 11, 2015


For the actual logistics of finding someone, I just head to ZocDoc and plug in my insurance. I can then schedule things online pretty instantly. Highly recommended.
posted by Jacen Solo at 12:28 PM on July 11, 2015


One of the best ways to find a doctor is ask your co-workers or friends who they see--your co-workers are most likely seeing someone in network. My daughter just had to find a new doctor in a new city. Asked co-worker & found someone both he & his wife like. She likes the doc, too, who is family practice, does her gyn exams, & writes her RX refills from her previous doc. Win all around, which great because she had been seeing previous doc since she was a little kid and was nervous about changing.

People you know are likely to share their honest opinions. Relying on the list on the insurance site is overwhelming--often hundreds of listings with little or no info beyond the basics.
posted by Nosey Mrs. Rat at 2:49 PM on July 11, 2015


I asked my friends for PCP recommendations and then looked up the folks they recommended to see if they were in-network for my insurance. I'm really happy with the doctor I found this way. When I tried to find a doctor on my own (mostly by blindly picking someone off the list of in-network providers), I didn't have great luck. The first doctor I saw I felt was judgemental about tattoos and my birth control choice. I didn't see her again. The next woman wasn't judgemental but she still wasn't the best fit for me. The third doctor was the one that was recommended by friends and is the one I decided to stick with. So, if you aren't comfortable with the doctor you choose, don't be afraid to try a different doctor. It can take a few tries to find the right doctor.
posted by whatideserve at 8:34 AM on July 12, 2015


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