Help! I need a doctor!

With the New Year, you are motivated to take charge of your health once and for all; you have promised your partner/spouse/ kids/abuelita that you are going to do what you know you are supposed to do.

I tell patients that they need to start going to the doctor for a yearly physical beginning at the age of 40. So where do you start? What if you don't have a primary care doctor?

There are lots of options, and hopefully you will find one to fit your budget. Another option that I have seen on several billboards around town is Oscar Health Insurance. Patients tell me it is easy to sign up for, and cost effective.

Now what? Get recommendations from friends for a family practice or internal medicine doctor that they like, or use Google to find doctors in your area. Many family practice doctors see children and teenagers as well, so consider that if you need a doctor for the whole family. Internal medicine doctors stick to grownups and manage chronic diseases, like high blood pressure, diabetes and heart disease.

The other question that often comes up is: who do I need to see? For a basic physical exam and labs, see your family practice or internal medicine primary care provider. You might also see a PA, a physician's assistant, or a nurse practitioner. They often have several years of experience and can take care of you as well as your doctor.

What if you need to get your annual mammogram done? You can usually schedule that on your own, but the location will need a doctor to send the report to. They will not just send it to you because a physician, or other primary care provider, needs to interpret the results and tell you what they mean.

A colonoscopy is done by a gastroenterologist, also affectionately known as the GI guy or gal; some insurances will let you schedule this on your own as well, since it is part of preventative care. The GI doctor will give you the results directly and will refer you to a surgeon if something serious is found, like a colon cancer.

The third question that often comes up is: do I need a referral? That generally depends on your insurance. Most insurances are PPOs, so your primary care doctor does not need to get authorization for referral from your insurance to send you to another doctor.

If your insurance is an HMO, however, you must go through your PCP to get a referral to another doctor. In HMOs, the primary care providers are gatekeepers, and you basically begin with them to get to anyone else for healthcare. Most Medicaid and some Medicare replacement plans are HMO-type, so you have to start with your PCP. That is controlled by insurance, not by your doctor.

I hope this is helpful; now you have no excuses not to go to the doctor!

By Maria A Palafox, MD