Primary care is often your first point of contact for medical care within a health care system, especially for non-emergencies. You may be seen by a primary care physician, a nurse practitioner or a physician assistant. What's the difference? Why is this important?
In this video, Russell Zane, MD, a family medicine physician at Scripps Coastal Medical Center, joins San Diego Health host Susan Taylor to discuss the vital role primary care providers play in our lives.
Dr. Zane explains the different types of primary care specialists. He focuses on the important role nurse practitioners and physician assistants play in primary care teams. He says the most effective primary care provider teams help ease access for patients to receive proper and timely care.
“When you have a team of people focusing on your best interests, that means a lot,” Dr. Zane says. “You may see your physician. But if your physician is not available, a nurse practitioner or physician assistant can see you. What’s important is that you are able to receive the care you need faster and more efficiently.”
Primary care visits account for more than half of the 1 billion doctor visits made annually in the United States. A primary care physician (PCP) has expertise in identifying and treating common medical conditions. Insurance plans often require you to have a primary care physician.
Primary care physicians provide health maintenance, disease prevention, counseling, patient education and diagnosis and treatment of acute and chronic conditions. Next to you, they know your medical history the best. They can also refer you to the right specialist for complex issues that are beyond their scope of training.
Physician assistants and nurse practitioners are not physicians, but they are considered primary care providers.
Most primary care physicians have an online presence where you can learn about their background, education and training. Scripps has hundreds of primary care physicians and accepts many health insurance plans. The Scripps website, scripps.org, offers the option to find a doctor according to specialty. “The most important thing is finding a physician you really feel comfortable with,” Dr. Zane adds.
When choosing a doctor, you may notice some are identified as DO instead of the more familiar MD for Medical Doctor. DO stands for Doctor of Osteopathic Medicine. The DO approach is treating the whole patient, rather than treating the symptoms only.
Like medical doctors, DOs are fully trained and certified to provide medical care. “Osteopathic physicians have a bit more of a holistic approach — letting the body heal itself. They are also trained in osteopathic manipulation, which is hands-on type of healing, mostly for orthopedic type of concerns,” Dr. Zane explains.
Internal medicine physicians specialize in preventing, diagnosing and treating diseases in adults, including elderly people. They receive extensive training in the body’s internal organ systems. They are often referred to as internists.
“You can see an internal medicine physician for just about anything that a primary care physician would see you for. This includes preventative care and chronic conditions, such as diabetes, high blood pressure and coronary artery disease,” Dr. Zane says.
Family medicine physicians, also known as family practitioners, are trained to treat the entire family, from newborns to grandparents. The scope of their practice may include obstetrics and minor surgery. Like internal medicine physicians, family practice specialists provide preventive care, chronic disease care and acute care.
“Some patients are very enthusiastic about having one doctor to see everyone because that is more convenient,” Dr. Zane says. “Others prefer to have their own doctor and have their family members see someone else.”
Pediatricians provide care for infants and children. This includes preventive health care, such as immunizations, and treatment for illnesses and injuries. “Pediatricians will see babies from the time they’re born until they are 18,” Dr. Zane says. “Some patients get really attached to their pediatricians and will see them into their early 20s.”
Nurse practitioners (NP) and physician assistants (PA) are medical professionals who have completed specific educational and training programs. They’re qualified to provide many of the same general care services as primary care physicians. This includes:
- Conducting physical exams
- Diagnosing and treating common routine and acute illnesses
- Ordering and interpreting laboratory tests and X-rays
- Writing prescriptions
While they are not physicians, NPs and PAs work under the supervision of a physician and help increase patient access to timely care.
“They're highly qualified to see all types of acute care and preventive care cases,” Dr. Zane says. Their ability to handle “relatively straight-forward” cases helps free up physicians to see more difficult cases, he adds. If they encounter a serious problem, they will alert their supervising physician.
Primary care provider teams made up of primary care physicians, NPs and PAs are common at Scripps. “Our primary care provider teams have been designed to maximize the quality of patient care,” Dr. Zane says.
NPs and PAs (with physician oversight) also staff more than a dozen Scripps HealthExpress walk-in clinics. These clinics offer same-day care for minor illnesses and injuries. They are located at Scripps Clinic and Scripps Coastal Medical Center sites throughout San Diego County, and are open seven days a week.
Scripps HealthExpress accepts most health plans and are convenient places to visit for minor ailments due in part to their extended office hours. But they are not meant to replace your primary care physician.
Dr. Zane says primary care physicians always remain your first line of defense when it comes to preventing you from getting an illness and treating you when you get sick.