A guide to understanding the different types of primary care providers.
Whether you’ve recently moved or just need a change in your health care, finding the right primary care provider is important. We talked to Robert Hutchins, MD, MPH, Dana Neutze, MD, PhD, Tracy Rentner, FNP, and Rachel Urrutia, MD, MSCR, about what to consider when choosing a provider to treat you and your family.
Determine which type of provider best suits your needs.
A primary care provider is the one you visit for most medical needs, including wellness visits, routine preventive screenings, chronic disease management and acute illnesses, such as earaches and the flu.
There are actually five types of doctors who provide primary care: pediatricians, who only see children; geriatricians, who see older adults, usually over 65; gynecologists, who focus on women’s health; internal medicine doctors, often called internists; and family medicine doctors.
Internal medicine doctors see male and female adult patients and treat a multitude of health complaints and concerns. Family medicine doctors do the same, but additionally treat children and take care of pregnant women.
“Many family doctors and internists manage the same medical conditions and many practice in the same type of environment. The biggest difference comes down to the age of patients and the type of patients that we treat and our residency training,” Dr. Hutchins says.
Both types of doctors complete three years of residency training. One of the major differences between the two specialties is how those three years are spent. Internal medicine residency training is entirely on adult patients in a mix of hospital and outpatient settings. It also includes significant clinical experience in multiple internal medicine subspecialties such critical care, cardiology, endocrinology, rheumatology and infectious diseases.
Family medicine residency training is also a mix of hospital and outpatient training in adult medicine, but include rotations in the emergency department, obstetrics, pediatrics and surgery.
Both specialties tend to perform acute, chronic and wellness care.
And both specialties have capabilities to perform similar procedures such as skin biopsies, joint injections, and skin tag removal, but it varies by provider. Family medicine doctors also often are trained in contraceptive procedures such as IUD placement or Nexplanon insertion for birth control.
In addition, many primary care offices are staffed by advanced practice providers (APPs), who can manage and treat a wide variety of common primary care complaints.
“Physician assistants (PAs) and nurse practitioners (NPs) can provide wonderful routine care,” Dr. Neutze says.
In addition to acute and chronic care, advanced practice providers often focus on diet, exercise, stressors, lifestyle and how these affect a patient’s health.
“We love teaching patients how to take the best care of themselves,” says, Tracy Rentner, a family nurse practitioner at UNC Family Medicine at Southpoint. “However, if a patient’s care reaches a level of medical complexity, we can reach out to our physician colleagues or refer to specialists.”
Some women prefer to use their gynecologist to manage their primary care needs. But not all gynecologists want to do that.
“Most of us are not going to be comfortable managing chronic diseases such as diabetes,” Dr. Urrutia says. “But for somebody who’s well and doesn’t have any chronic diseases, they could potentially use their gynecologist as their primary doctor. I think that they should have a discussion with their gynecologist about that.”
When looking for a new primary care provider, think about convenience. This requires asking yourself some questions about how visiting the provider will fit into your everyday life.
“Is it at a location that’s convenient for you to get to, either close to your work or close to your home so you can get there? Do they have hours that work for you?” Dr. Neutze says.
Some practices have evening and weekend hours, which might be a bonus for your family.
Ask yourself if gender or age matter to you.
Of course, age and gender don’t determine someone’s abilities, but it’s understandable that people want to choose a provider that makes them the most comfortable.
Some people want to see providers who are the same gender as they are, and that’s OK, Dr. Neutze says.
“That’s important to keep that in mind if that’s an issue for you,” she says. “Sometimes women who need pelvic exams feel a little bit more comfortable with a female doctor, although there are many wonderful male doctors who do those exams as well.”
Then there’s the age question. Some people prefer older providers because they are more experienced, Dr. Neutze says. Others like younger providers who are fresh from their medical school training or perhaps closer to the patient’s age.
Remember that this could be a long-term relationship.
Choosing a provider is an important decision because ideally, you’ll connect with someone who can oversee your health for years. That long-term context is helpful in giving you the best care.
No matter what, it’s important to have a good relationship with your provider, Dr. Neutze says.
“Make sure it’s someone that you feel comfortable talking to, and if you don’t, find someone else,” she says. “Get recommendations from friends about people that they have enjoyed working with. I think that is important because this is a long-term relationship. And having a good relationship with your provider is really important for your health.”
Find a provider near you.