How to Find a Primary Care Doctor Under Obamacare

By Amy Zimmer on January 14, 2014 7:19am 

 Roughly 240,000 New Yorkers signed up for health insurance plans before the new year through the state's online marketplace, which means a lot of new patients will be looking for primary care doctors.
Roughly 240,000 New Yorkers signed up for health insurance plans before the new year through the state's online marketplace, which means a lot of new patients will be looking for primary care doctors.
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Shuttersock/Stuart Jenner

MANHATTAN — With a quarter-million New Yorkers newly covered by health insurance under the Affordable Care Act, a rush of patients are now on the hunt for primary care doctors.

Choosing a physician isn’t always easy — but it is key to good health, experts say.

Dr. Matthew Weissman, chief medical officer for the Community Healthcare Network, which sees 75,000 patients a year at its 11 low-cost medical centers, said his organization had already seen an uptick in patients making appointments for primary doctor visits.

That's likely to continue. Roughly 240,000 people were enrolled through the state’s official health plan marketplace by Dec. 30 — and open enrollment continues through March 31.

Weissman said he's hopeful Obamacare's expanded coverage will propel more people to make preventative check-ups part of their annual routine.

“A lot of women go to their gynecologists, [but] it’s important that women are also seeing someone asking about their tetanus shots or hepatitis B,” he said.

In addition to personal references, a good starting point in a search for a doctor is looking up their profile through the State Department of Health, information that was mandated by New York's Patient Health Information and Quality Improvement Act of 2000, said Suzanne Mattei, of New Yorkers for Patient and Family Empowerment.

“You can find out about the doctor's medical education and credentials, translation services, license to practice and history of medical malpractice judgments or settlements,” she said.

But credentials aren’t necessarily enough, she said, noting that the “efficiency” of a doctor’s office is also key.

Here are some tips on what to look for:

1. Find an office that is organized and well-run

Many health insurance plans require primary care doctors be your first step before you can see a specialist, by requiring them to give you a referral first. In effect, your primary care doctor becomes your “gatekeeper,” Mattei explained.

 Dr. Ashley Roman, an OB/GYN at NYU Langone consults her patients in the office to assist with their pregnancy.
Dr. Ashley Roman, an OB/GYN at NYU Langone consults her patients in the office to assist with their pregnancy.
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DNAinfo/Steve Meyer

“You need to know how efficient your primary doctor's office is in making those necessary referrals happen,” she said.

“Once, I personally had to make nine phone calls just to get a referral to a specialist for a critical examination. No one should ever have to deal with that kind of stressful nonsense, especially when experiencing a medical concern.”

2. Make sure your doctor is accessible by phone or via the web, especially after hours

“You have to make sure someone is on call 24 hours a day,” Weissman said. That's especially important, for example, if you end up in the emergency room at 3 a.m. and you or the hospital need to reach your primary care provider.

3. Figure out what you want from a doctor

It’s not just about the doctor, but also about the practice, and in New York there are a range of options.

At the very high-end, there’s the rarefied world of “concierge medicine,” in which patients pay annual fees that can cost upwards of $25,000 for personalized attention always at the ready.

At the other end, providers such as the Community Health Network offer a sliding scale and includes a range of practitioners, including nutritionists to give diet advice and even social workers to help deal with landlord issues, for example.

“We see that all as part of the package of providing good health,” Weissman said.

3. Find a doctor who is board-certified

External credentials are important when it comes to selecting a doctor, but many patients may be surprised to find out that their doctors may not be board-certified, a voluntary credential that means a physician has met a nationally-recognized set of standards.

While doctors can, and do, practice without a board certification, most doctors and patient advocates agree that board certification is the "bare minimum," Weissman noted. To check if your doctor is board certified, click here:

4. Check for other credentials from oversight groups

Some doctors and ambulatory care facilities have recently adopted a practice common to hospitals, seeking an extra “good housekeeping” seal of approval through Patient-Centered Medical Home recognition and/or Joint Commission accreditation. This means that they pay to have inspectors come in to look at how an office is run in terms of patient safety, Weissman said.

Not all practices do this, he added, but “it’s a nice touch.”

5. Ensure that a provider has the right bedside manner for you

It’s important to find a physician you can relate to, who is responsive to your values, verbal cues and body language, Weissman said.

It’s helpful to have someone who understands how to deliver information in a way that you can digest, whether it’s in the form of handouts or having you repeat instructions if needed, he explained.

“You want someone who really spends the time with you and is approachable if you have questions and there’s a way to get in touch with them,” he added.

6. Understand a doctor’s philosophy

Some doctors, for example, may be quick to prescribe antibiotics or refer patients to specialists, while others may take a more wait-and-see approach.

“You want to know a doctor’s philosophy before you get sick,” Weissman advised, adding that it also helps to know whether a doctor often sends patients to specialists or prefers to handle matters in-office.

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