Your primary care provider: Center of your treatment

Your primary care provider: Center of your treatmentFinding a primary health care provider who is a good match for you is the first and most important step in getting the health care that you need. This is particularly true when you have acute or chronic back pain, as this condition can test any patient’s relationship with a health care provider.  That’s because the treatment of pain can be frustrating, time consuming, and often involves working with other specialists.  A good “fit” with your provider is very important.

 

Your primary health care provider takes care of you when you are well and when you are sick. He or she may be a physician, but nurse practitioners and physician assistants in the doctor’s office often also take part in your care.    A good long-term relationship with your health care team gives them time to get to know you well and allows them to help you make good decisions — especially when those decisions are tough ones.

 

You have a right to choose who treats you, but remember that it takes time and patience to build a good health care relationship.  One visit may not be enough, and endless “doctor shopping” may actually delay successful treatment of your pain.

How do you find a primary care doctor if you don’t have one?

Talk with family and friends for suggestions, or call a hospital referral service or a local medical society. First, think about what you need in a primary health care provider. Primary care doctors include general practitioners and family practitioners, who care for people of all ages, or internists, who only care for adults.  While some women may use their gynecologist as their primary health care provider, they should consider having a primary care provider to oversee all of their health needs.

You will likely want a health care provider who:

  • Accepts your health insurance.  Your health plan may limit you to specific doctors in certain areas.  Find out if it will cost you more money to choose a doctor who is not part of your health plan.
  • Listens to you.  A good relationship needs good communication.  You should be able to talk easily with the health care provider that you choose, and be able to understand what he or she says. You should also feel that your own needs are being met, and that you’ll get answers to your questions. Quality healthcare depends on this “two-way street” of open and trusting communication.
  • Makes you feel comfortable.  You may might to have a male clinician instead of a female (or vice versa). Or you might prefer a younger (or older) clinician.
  •  Has an office within easy reach. Perhaps one who uses a specific hospital.When you call for an appointment, you may want to ask who else will be involved with your care at this office.  Many offices use a team that may include a physician, nurse, nurse practitioner, and physician assistant.  While the physician usually guides all the health care decisions, you may see other team members at some visits.

You may also want to ask where the doctor was educated and trained, and how long the wait is for return visits and emergency appointments.

When is a specialist needed?

Chronic pain is one of the most common medical problems in the U.S.  Your primary healthcare provider will probably have a lot of experience in treating pain. But there may be times when your health care provider will want you to see a specialist, someone who has more experience with your type of pain.

 

If your provider does not suggest that you see a pain specialist, you may want to ask for a referral. You always have the right to get another medical opinion.  Don’t feel that you’re questioning anyone’s judgment. You need to be comfortable with your choices.

What specialists treat pain?

Specialists who treat people with pain usually have advanced medical training.  They may show their high level of skill and knowledge by being “board certified” in their field.  Specialists include:

Doctors – neurologists and neurosurgeons, pain management doctors, anesthesiologists, physiatrists
(rehabilitation doctors) and orthopedic surgeons.

These pain specialists often work closely with other allied health and support professionals who help carry out the pain treatment plan, such as physical therapists, occupational therapists, psychologists and complementary therapy providers like acupuncturists and massage therapists.

When you are looking for a specialist, first speak with your health care provider.  Then ask people you know who may have needed similar care.  You could also call large medical centers or teaching hospitals in your area, as well as professional organizations and pain-related support groups.

What is the best path to treatment for your pain?

As you learn about your pain, you may decide to go with a combination of treatments.  Work together with your primary care provider to put together the team of people and treatments that will work best for you.

Summary

Making good health care decisions always means choosing, where, when, how — and especially who  — will treat you. Finding a primary health care provider that you can trust is an important first step when you are dealing with chronic pain.

References

Guzman, J., Esmail R., Karjalainen K., Malmivaara, A., Irvin, E., & Bombardier, C. (2001). Multidisciplinary rehabilitation for chronic low back pain: systemic review. British Medical Journal, 322, 1511-1516.

Hurd, R. (2007). Choosing a primary care provider. MedlinePlus Medical Encyclopedia. Retrieved June 19, 2008 from http://www.medlineplus.gov