Who is my primary care physician

Who is my primary care physician

A Primary Care Provider (PCP) can be a doctor, physician's assistant, or nurse practitioner, and may include other providers within a health care practice, clinic, or center. A PCP is the main health care provider responsible for managing your care.

How can my Primary Care Provider (PCP) help me?

Your PCP will:

  • Manage all your healthcare needs as they know your medical history and health conditions best.
  • Provide preventive care, such as tests and immunizations, to help keep you well.
  • Refer you, or give approval, to see another doctor or specialist for services your PCP doesn’t provide.

Many PCPS are available 7 days a week, 24 hours a day to ask urgent questions about your health needs.

  • If the PCP can’t see you right away, you can go to an urgent care center.
  • If you have an emergency, you can go to the emergency department.

How do I choose a PCP?

To see who is accepting new MaineCare members, call MaineCare Member Services at 1-800-977-6740. TTY users dial 711. Office hours are Monday through Friday, 7:00 a.m. to 6:00 p.m.

What do I need for an appointment with my PCP?

Make an appointment with your PCP right away.

Once you have a PCP, you should call them to make an appointment. Do not wait until you are sick. To get the best care, you should know your PCP and your PCP should know you.

Call ahead for an appointment.

If you need a ride to a MaineCare-covered service, you can use Non-Emergency Transportation (NET) to get there. Once you have your appointment scheduled, call the transportation agency that is closest to you as soon as possible. See our Transportation webpage for the brokers’ contact information.

Keep your appointments and be on time.

Call your provider if you are going to be late or if you cannot keep an appointment. MaineCare does not pay providers for missed appointments. Your provider may not see you again if you miss an appointment.

Take your MaineCare card to all your appointments.

If you do not have your MaineCare card with you, your provider may not see you.

What if I am sick or have an injury?

Call your primary care provider if it isn’t an emergency.

What is Primary Care Plus (PCPlus)?

Through PCPlus, your primary care practice will work with your other healthcare providers to give you better care. The program makes the relationship between MaineCare and primary care practices stronger. It allows MaineCare Services to look at how well primary care practices are managing care for their members and work with them on what is best for our members’ health.

  • List of PCPlus Practices by County (PDF)

What is an Accountable Community (AC)?

An AC is a group of doctors and other healthcare providers that work together to give better care to their patients and lower the costs of healthcare services. For details about this program, see the example of an AC Member Letter (PDF).

What if I have chronic health conditions?

If you have chronic health conditions, you may be eligible to receive Community Care Team, Behavioral Health Home, or Opioid Health Home services.

Community Care Teams - Community Care Teams are organizations who partner with primary care practices and community providers to support members with certain chronic conditions and who are risk of poor health outcomes and/or high utilization of health care services

Behavioral Health Homes - Behavioral Health Homes are health care teams within a licensed community mental health agency to manage the physical and behavioral health needs of eligible adults and children.

Opioid Health Homes - Opioid Health Homes deliver team-base care for opioid use disorder including medications, opioid dependency counseling, and comprehensive care management for eligible MaineCare members and uninsured individuals.

Questions?

MaineCare Member Services:

  • Call 1-800-977-6740. TTY users dial 711.
  • You can also email.

Office hours are Monday through Friday, 7:00 a.m. to 6:00 p.m.

Medically Reviewed by Melinda Ratini, DO, MS on July 01, 2021

Staying healthy is more than just going to the doctor when you’re sick. It’s about having a healthcare team that not only addresses your health concerns and illnesses but also takes a proactive approach to help you stay healthy. 

A primary care physician plays an important part in helping you stay healthy. They are often the first contact you or your family members have with the healthcare system and are instrumental in helping you live a healthier life. They provide care for preventing, treating, and curing common illnesses as well as promoting better health.

Research shows that having access to primary care directly favorably impacts health and wellness outcomes.

A primary care physician practices general healthcare, addressing a wide variety of health concerns for patients. They are typically the first person you talk to if you have a health concern. You might turn to them for:

  • Preventive care (stopping illness before it happens)
  • Treatment of common illnesses
  • Early detection of illnesses or conditions (such as cancer)
  • Management of chronic (long-lasting) conditions
  • A referral to a medical specialist

Many people stay with their primary care doctors for years. Over time, a bond of trust develops and a relationship forms. It is not uncommon for an entire family to go to the same doctor for generations. This allows the doctor to know them not just as a patient file, but as individuals.

It’s this familiarity that provides added insight, allowing the doctor to deliver more personal care.

The educational path for a primary care physician begins with earning an undergraduate degree in pre-med or the sciences from an accredited (approved) school. From there, they begin specific medical training, which involves:

  • Graduating from an accredited medical school with a degree in medicine or osteopathic medicine
  • Passing board exams for either:
    • Steps 1 and 2 of the United States Medical Licensing Examination (USMLE), or
    • Levels 1 and 2 of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMPLEX-USA)
  • Completing clinical instruction or core clerkships
  • Finishing a residency program with required rotations in pediatrics, emergency medicine, obstetrics, general surgery, and inpatient hospital care.

The physician’s training is complete when they have met all requirements, and are residents of the state in which they will practice. At that time, they may take the exam by either the American Board of Family Medicine or American Osteopathic Board of Family Physicians to get their certification.

As they near the end of their residency, they will apply for a license in their state which will allow them to practice as a board-certified family doctor. This involves passing level 3 of the COMLEX-USA or step 3 of the USMLE.

A primary care physician is a health manager. They are in clinics, long - term care facilities, private practices, outpatient hospital settings, inpatient hospital settings, and group practices.

Your primary care doctor is who you can turn to if you have the flu, need vaccinations, want to quit smoking, need to manage your diabetes, or want to lose weight. They are trained to handle all aspects of healthcare but may send you to a specialist if your condition calls for more focused care.

They help you manage your health by providing routine physicals, immunizations, preventive care, and wellness screenings. They also diagnose common illnesses and chronic conditions like diabetes, obesity, and hypertension (high blood pressure), which they help you manage.

Your primary care physician can treat many conditions including depression and anxiety.

Unlike most other doctors, you don’t see your primary care physician only when you are sick. You may also see them:

  • If you have questions about your health, want to take steps to get healthier, get your annual exam, get a health screening, or get immunizations.
  • If you are feeling under the weather. Your primary care doctor can examine you, order blood tests and other tests, make a diagnosis, and prescribe medications.
  • If you have a chronic condition like diabetes, hypertension, asthma, or chronic obstructive pulmonary disorder (COPD). Your primary care doctor can help you find specialists, and they will continue being an important member of your health team throughout treatment.
  • If you are in an accident or sustain an injury. Your primary care doctor is often your first stop, even if it is just a phone call to get advice on what to do.

Your primary care physician can help you reach your best health potential.

The first time you meet with your primary care physician the focus will be on providing information that will give them a better understanding of you, your medical history, and your healthcare needs. They will review your medical records and medications, discuss your personal medical history as well as your family members’, and give you a general exam.

Follow-up visits will be centered on specific healthcare goals such as strategies to improve or manage wellness or to treat an illness. 

Before going to any of your appointments, make a list of questions, concerns, and any symptoms you are experiencing. This way you won’t forget to tell your doctor something important or forget to ask a question. Preparation is key to a productive doctor visit.

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