What is a Primary Care Provider?

A primary care provider (PCP) is a doctor, nurse practitioner or physician assistant who you select from your health plan’s approved group of providers (network) to handle health care needs like annual checkups and sick visits. Your PCP will also help coordinate additional care you may need such as a visit with a specialist, X-rays or lab work.

If you have an HMO health plan, you will usually be required to choose a PCP and to get a referral (written notice) from your PCP to see any medical specialists other than an OB/GYN.

How to Choose a Primary Care Provider in Washington D.C., Maryland, and Virginia

If you don't yet have a primary care doctor, you can start your search by talking to friends and family about their doctors. Personal recommendations can give you a sense of whether you would be comfortable with a particular doctor, and what his or her values and personality are like.

If you're new to the area or don't know where to start, you can use the Find a Doctor tool to help you find a primary care doctor in your area.

For the best health care experience, you’ll want to choose a PCP who is:

  • Part of your health plan's network.
  • Currently accepting new patients.
  • Conveniently located.
  • Fluent in your preferred language.
  • Able to offer appointment times, like evenings or weekends, that work with your schedule.

You may also want to consider choosing a PCP who specializes in a certain area. Common specializations for primary care providers include:

  • Family Practice – Family practitioners treat patients of all ages, including newborn babies and elderly individuals. They can treat a wide variety of conditions including some you may otherwise see a specialist for, such as sports injuries or women’s health. A family practice physician might be a good choice if you are looking for a primary care provider for yourself, your spouse and your children.
  • Internal Medicine – These physicians usually treat adult patients, and are experienced in preventing, diagnosing, and managing diseases and chronic conditions. An internal medicine physician may be a good choice if you have a chronic illness or if you have a family history of health conditions you'd like your PCP to be knowledgeable about.
  • Geriatrics - Geriatricians specialize in treating the elderly and have experience with conditions such as osteoporosis that are more common as we age. If you qualify for Medicare, a geriatrician may be a good choice for your primary care provider.
  • General Practice – General Practice physicians, like family practice physicians, are familiar with treating patients of all genders and ages.

Using the Find a Doctor Tool

To use the Find a Doctor tool to help you choose a PCP, log in or select the Guest option. Then from the list of types of care, select Medical Care. You will then see an option to search Primary Care Providers. This tool will show you primary care doctors who are in-network for CareFirst's Blue Cross Blue Shield coverage, with their specialty, whether they are accepting new patients, what languages they speak, where they went to medical school, and their practice address and phone number.

If you’re already a member, you’ll only get results for doctors that accept your particular CareFirst plan.

Why is it Important to Choose a Primary Care Doctor?

Establishing a relationship with a PCP is as important as saving for retirement. The job of the PCP isn’t simply to keep you healthy today, but to also help you make the right “investments” or positive lifestyle choices to maintain your health well into the future.

Establishing a relationship with one doctor is the best way for you to receive consistent, quality health care. A doctor who knows your personality, habits and complete medical history can potentially catch health issues before they become serious. Recognizing and detecting problems in the early stages can help you avoid medication or worsening health.

A PCP is also concerned with your overall health. If you have an urgent health issue, having a PCP who knows your health history often makes it easier and faster to get the care you need. Your PCP can sometimes provide advice over the phone or fit you in for a visit the same day. That helps you avoid long lines and expensive charges at the emergency room.

Choosing a primary care doctor can help you get the most out of your health coverage and stay in good health to feel your best.