How to prepare for a PCP / Primary Care Physician Office Visit and what to expect?

Preface: Most of us do not have a concierge doctor or are enrolled in a membership program where we get to see our PCP often, on short notice, or at a convenient time. Nonetheless, at your appointment, do consider that most PCPs are overworked and many of your fellow patients are there because of medical issues, thus "having a bad day".

Before the visit

Ask your previous physician / clinic to send your health records over to your new doctor. Alternatively, now that the US has required electronic medical record (EMR) for some time, you may be able to determine by checking with the office staff to see if your old EMR will communicate the EMR that your new doctor uses. For example, MyChart through the EPIC EMR system can be shared if you provide a consent.

During the visit

1. Checking in... Always arrive early for your first ever appointment as you likely have quite a few paperwork to fill out (if not done so ahead of time, online or otherwise)

   1. Typical forms: basic demographic information, current health status, medical history, health insurance information, etc.

   2. Policies: HIPAA (Health Insurance Portability and Accountability Act) policy, other clinic/system specific forms, etc.

2. The Office Staff: Usually an Medical Assistant (MA) or sometimes a Nurse (RN, LPN), would be getting some additional information about you (e.g. current medications, allergies) to update the EMR (electronic medical record) as well as vitals. Perhaps, they may ask you if you have any specific concerns

3. The Doctor: Perhaps some friendly chit-chat to get to know you, but here are some things/histories that they would need to know

   1. Past medical history

   2. Past surgical history

   3. Family history (biggies include heart disease, stroke, diabetes, cancer)

   4. Social history (alcohol, smoking/vaping, recreational substance, exercise, family/job status if applicable)

   5. Allergies (sometimes skipped if done by office staff)

   6. Medications (sometimes skipped if done by office staff; also include any supplements that you may be taking)

4. Review of System, which is often quick yes/no questions to identify any signs/symptoms of concern. During an initial/annual visit, this might be more open-ended as presumably you are not present for a "sick" or "follow up" visit where there are specific things to discuss.

5. Physical Exam: The amount of physical exam done can be dependent on whether you have any specific concern, whether your doctor has any concern based on your history, and whether any specific screening is due.

6. Labs/Imaging: This is also dependent on your background/history and exam

7. Plan: Your doctor should let you know what their plan is with regard to your health. You may be healthy with no concerns and just need to come back for another visit in one year. You may have chronic diseases that would require further discussion in a follow up visit over the next few weeks to months. You may have labs drawn that if abnormal, will need to sooner visit afterward.

Things to keep in mind: Be honest with your doctor. They only know what you tell them and what is available to them from your record (assuming it's organized and legible and NOT thousands of pages, or searchable electronically). This is necessary to provide the best recommended screenings, any suggestion for lifestyle changes, and prevent adverse medication interactions, etc.

After the visit

1. Unfortunately, with many PCPs booking out MONTHS in advance, if you feel that the two of you are not a good match, it would be time to start looking for a new doctor for your next routine/annual visit.
   

2. If you have labs/imaging done, you might be able to look up the results on EMR as soon as they are available

   1. HOWEVER, you are much more likely to find out the results BEFORE your doctor has a chance to review. Do remember that they have Hundreds, if not Thousands of patients on their panel and can only follow up once they are done with visits or when there is downtime.

   2. If the results are normal, you may or may not receive a call from the clinic, likely from a nurse, or receive an okay message through EMR.

   3. If abnormal, you may receive a call directly from your doctor to discuss the result and next step, or if less concerning, you are more than likely to receive a call from a nurse or a message through EMR if you had consented to it. Sometimes if the lab is minimally abnormal (meaning the lab marked it as abnormal, but really there's nothing to do), you may not receive any contact.

   4. In terms of imaging, you are likely to get a call for any acute/urgent findings, otherwise, you may have findings that are abnormal though known/chronic

3. Finally, remember that you are your own advocate and that it is important for you to reach out if you have any concern/question.

Congratulations on prioritizing your health & wellbeing, and taking care of yourself !