As part of their strategy to increase quality-of-care and control costs, many managed-care plans require patients to choose a primary care physician (PCP) – usually a family practitioner, internist, or pediatrician – to provide basic medical care. Often, PCPs also play the role of medical specialists gatekeepers. That is, they are responsible for determining the treatment and the use of specialists for various health conditions. The aim of such an approach is to cut down on unnecessary and costly visits to specialists that may include needless and expensive tests and hospitalizations. Although not all insurance plans operate like this, more and more are moving to this system.
Even if your own insurance plan doesn’t require a PCP referral prior to being seen by a specialist, it’s always a good idea for you to have a PCP to provide routine care, coordinate all of your healthcare services and advise you on improving your general health and well being.