Choosing a Primary Care Physician

Choosing a primary care physician is one of the most important decisions to make as you navigate the complex and often confusing world of health care.  It is difficult to get reliable information on physicians, and referrals from friends are often met with the frustrating response that a physician is no longer taking new patients.

For gay, lesbian, bisexual and transgender people the experience can be even more intimidating because of the concern about how you will be treated and whether you will be able to communicate effectively with your physician.  This is especially true in areas that may not have a strong and visible GLBT community and therefore may not have as many physicians comfortable and knowledgeable in the unique issues facing the GLBT population.

When choosing a physician here are some things you should consider.  Communication is key to any successful physician/patient relationship, so think about the qualities that might make it easier for you to talk to your physician.  Gender, age, language and culture, though not qualities that reflect medical skill at all, may still be important in establishing a relationship and deserve to be considered.  

Obviously if you are a member of the GLBT community, choosing a physician who is gay may be very important.  For some people gay friendly physicians are fine, however for others knowing that your physician is gay makes it easier to discuss some health issues such as STDs and other sexual concerns.  Again, it is important to think about how this might affect your ability to communicate honestly and comfortably with your physician.  Often it is hard to even find physicians who are gay or gay friendly.  You should definitely utilize resources such as the Gay and Lesbian Medical Association’s (GLMA) provider list to start your search.  In addition, cities or regions might also have business directories that list gay or gay-friendly physicians in the area.

A physician’s training, experience, and areas of interest are also important to consider.  Do you want a true generalist – someone who has not chosen to specialize in any one area of medicine and enjoys the breadth and variety of adult medicine, or do you have an interest in seeking someone who may practice primary care but also has specialized in a particular area such as infectious disease?  

Some physicians have also developed interests as their career has matured such as sports medicine or women’s health without ever formally training in those areas.  Often a physician’s bio on his/her Web site might mention such interests and it is always a good idea to check the site for more information.

It is also important to know the specialists, hospitals, and ancillary support that your physician will have at his/her disposal.  Is the physician part of a large multispecialty group that has coordinated care and access to services without having to travel or make phone calls?  Do the other physicians that you might see use the same medical record so that medical information is communicated clearly when necessary?  Or does your physician work out of a stand-alone office that is more homey, private, and perhaps less intimidating?  What kind of online services does your physician provide?  In this day and age online messaging, lab results reporting, e-visits, appointment requests and prescription renewals can all be done online if the office is so equipped.  Some are, but many are not.

How efficient is the office?  Do phone calls get answered in a timely manner?  Is the physician on time?  How easy is it to get an appointment?  What is the entire patient experience like from the parking to the reception to the interaction with the nurse or medical assistant? How timely is the follow up?  Is a caring, supportive, and therapeutic environment created?  Would you have your loved ones see this physician?

I believe these are all crucial questions to ask as you evaluate what kind of experience you would like for your health care.  The best way to find out how an office works is to experience it first hand. If, as an GLBT patient, you don’t feel the environment is right for you than find another physician and office setting.

Most of these issues are important to anyone choosing a new physician.  For any patient it comes down to this:  Will I be able to comfortably and honestly communicate with this physician about my health as I lead the life I have created for myself?  If the answer is no, then you should seriously think about choosing a new doctor.  For LGBT patients, in particular, I believe it is crucial that the answer to this question be an emphatic –
Yes!

Barry Eisenberg, M.D., is an internal medicine physician at the Palo Alto Medical Foundation in Palo Alto, CA. He is board certified in internal medicine and a member of the American College of Physicians, the Gay and Lesbian Medical Association and the Bay Area Physicians for Human Rights. To learn more about Dr. Eisenberg, go online to pamf.org.

Submitted by Editor on Tue, 12/15/2009 - 11:11am.

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