When you hear the term “primary care,” you probably focus on the second word—but also don’t forget the first.
Your primary care physician—or family practice doctor—is the first doctor you need to see.
She answers six questions pertinent to primary care:
Q: What are the perks of seeing a primary care physician?
A: There are many.
“Your primary care physician knows your entire medical history,” Dr. Virani says. “You can see them for acute conditions and work with them to lead a healthier life.”
By regularly monitoring your symptoms and blood and urine test results, they help you detect and control chronic illness. “You don’t necessarily need to be treated by a cardiologist for high blood pressure or an endocrinologist for diabetes,” she says.
But your primary care physician can connect you with the right specialists and share your background. Your new doctors will have a foundation and won’t have to start from scratch. That spares you redundant medical tests.
Q: Will insurance for my doctor’s visit cover the labs that are being ordered?
A: Whether insurance covers yearly preventive blood or urine tests depends on whether you’ve had concerning levels previously, Dr. Virani says.
Certain blood tests are likely to be covered if you have hypertension, diabetes, high cholesterol, a thyroid disorder or liver or kidney disease. For example, those tests could be a lipid panel for high cholesterol (hyperlipidemia) or Hgb A1c that measures blood sugars for diabetes. The insurer may set the frequency that your tests will be covered.
Q: What vitamins or over-the-counter supplements will I be advised to take—or avoid?
A: This may be a shocker, but most likely you don’t need a multivitamin. “You may not need a general vitamin supplement,” Dr. Virani says.
But it’s vital that your physician knows about any over-the-counter supplement you take. That includes herbs, sleep aids or any vitamin, mineral or protein supplements. “Some can be helpful—or harmful, depending on your medical condition,” she says.
If you have the bone-weakening disease osteoporosis, or its precursor, osteopenia, you likely will be asked to take calcium and perhaps vitamin D.
Pregnant women should take prenatal vitamins, which are higher in folic acid than other multivitamins.
And some drugs, herbs or supplements alter your body’s level of essential vitamins or medicines vital to treat a condition. For example, Metformin, a common diabetes drug, may deplete your body’s B-12 supply.
If you take methotrexate, a drug prescribed for some cancers or inflammatory conditions, you most likely will need to take folic acid with methotrexate, since the immunosuppressant drug inhibits that B vitamin.
And grapefruit juice can make some heart, liver and other drugs linger in your body, which can cause bleeding or other side effects.
Q: Can I improve my diabetes or high blood pressure with just exercise and diet before starting any medications?
A: Yes. Fitness and diet can lower—even eliminate—your need to take drugs for borderline diabetes or slightly elevated blood pressure.
A low-carb diet helps with diabetes, and a low-salt diet (such as the American Heart Association’s DASH diet) can help lower your high blood pressure.
Working out and eating a diet rich in vegetables, fruits and whole grains and low in saturated fat and sugar is healthy overall. “Be mindful that there are surprising sources of sugar and salt. These include prepackaged foods, sauces and juices,” Dr. Virani says.
Study nutritional labels on packaged foods and limit pre-packaged, fried and fast foods in your diet.
Q: When seeing a primary care physician for an acute ailment, what symptoms may indicate I need more advanced care?
A: Contact your doctor if you develop fever, or symptoms fail to improve, or you have new ones a week after seeing your health care provider. You also should alert the physician’s staff if your illness worsens despite having finished prescriptions and following your doctor’s advice.
“Always ask your physician at what point you need to go to the emergency room. If you develop chest pain, shortness of breath or severe abdominal pain, head to the ER and alert your doctor’s office,” Dr. Virani says. “In some cases, if abdomen pain is unbearable, you may need imaging for an obstruction that needs to be evaluated immediately.”
Q: How often do I need to see a primary care physician for follow-ups?
A: Your doctor may ask to see you just once yearly for a physical exam if you have no comorbidities—risk or presence of serious diseases that might shorten your life, such as obesity, high blood pressure or diabetes.
But if you are diagnosed with diabetes or hypertension, the physician may ask to see you every three to six months until the disease is controlled, Dr. Virani says. Afterward, the doctor likely will want to check your symptoms and blood levels twice yearly.
Q: How frequently should I be screened for cancer or other diseases?
A: Preventive care can save lives—and help you and your family avoid the pain and cost of chronic diseases. That’s why everyone ages 18 and up should have an annual physical and be screened for depression, Dr. Virani says.
Overweight adults from ages 40 to 70 and those with a BMI of 25 and over should be checked for diabetes every three years.
Blood tests for cholesterol and other lipids that could lead to coronary disease should start at age 20 and repeat every five years, according to Memorial Hermann guidelines.
Those at increased risk for cardiovascular disease may need more frequent screening, starting at age 35 in men and 45 in women, she says. Why the later date for women? The female hormones estrogen and progesterone slow the progress of heart disease before menopause.
Breast cancer screening should start at age 40 and continue every one or two years till age 75. Women should be checked for cervical cancer every three to five years till age 65.
Your doctor may urge postmenopausal women to have their bone density checked.
Men should get checked for prostate cancer regularly. Talk with your doctor about when and how often you’ll need a blood test or physical exam.
Colorectal screenings should start at age 45—or earlier if you have a family history of colon cancer.
If you smoke or have quit within the past 15 years, your health care provider may suggest lung cancer screenings from age 50 to 80.
Adults over 50 should get vaccinated against the painful disease shingles. The two-shot series protects for life. Your doctor also may advise you to have other vaccines, including an annual flu shot.
With all tests, your primary care physician may urge more frequent screening if you’re at greater risk than most people, due to family or personal health history.
“We want to prevent serious illnesses from developing,” Dr. Virani says. “Testing often helps catch disease sooner—and that can lower your risk of poor disease prognosis.”