There are many reasons that older adults may be looking for a new primary care practitioner. Perhaps they are unhappy with their current doctor. Maybe they recently moved or switched to a new insurance plan, or there’s the possibility that their PCP is retiring.
Whatever the reason, choosing a new PCP is an important decision, especially for adults aged 65 or more year — and, in the case of older adults, for the administrators, case workers and other key staff at senior living communities and adult living facilities, it’s imperative that they can help residents keep a sense of independence while improving the quality of their everyday lives.
As a primary care physician and someone with many family members who are older, I’m often asked what people should think about when it comes to primary care. Here are three important questions older adults and their loved ones should consider when beginning the search:
1. What matters most?
The first step in choosing a new PCP is to think about what matters to the resident or patient, because it can vary from person to person. Primary care is personal, and everyone deserves a PCP who is guided by the person’s own values and preferences. What are their health goals? What barriers do they face? Is their current care and treatment helpful? Are any parts burdensome to them?
It may sound simple, but reminding residents and their loved ones that they should make decisions based on what matters most to them is a critical place to start when looking for a new PCP.
2. How do they prefer to use primary care or specialists?
Many older adults are managing multiple chronic conditions, such as hypertension, diabetes or arthritis, so it’s important to think about what role they would like their PCP to play in taking care of all their conditions. Do they prefer a PCP who wants to care for all of their needs directly, or do they prefer a PCP who likes to refer them to specialists?
Different primary care providers offer different levels of care. Some PCPs take a more hands-on approach and see their role as bringing care together and, as such, they are heavily involved in important decisions such as managing daily medications or chronic conditions, even when those treatments were originally prescribed by specialists. They also may think about a patient’s social and emotional health, providing suggestions to improve their overall well-being.
Other PCPs take a different approach, limiting interactions to annual check-ups or sick visits, seeing patients less frequently throughout the year, and letting specialists take the lead in care with less involvement. Each patient should think about their preference and find a PCP that matches their choice.
3. How and where do they want to receive care?
Most older adults have preferences in how and where they want to access their PCP. For example, they might prefer office visits, telemedicine or maybe even home visits. Or there’s the possibility that they like a mix of one or two ways in which they receive care.
Each option comes with its own set of benefits. For example, at a recent home visit, we noticed that our patient’s walker was causing shoulder pain, which made it difficult for her to get around. We were able to make a simple adjustment that solved the issue, but this couldn’t have been made without seeing the patient in her home environment. For patients who prefer virtual visits, there are many easy tools and technologies that make it possible for examinations to happen through a computer screen and to communicate with a PCP.
When thinking about how and where patients want to receive their care, choose one or a mix of options based on their preference. If they prefer to avoid a crowded office, then perhaps a mix of at-home visits and virtual care is right for them.
For care providers with patients at senior living communities, collaborating with loved ones is especially important. So understanding how their PCP will help with care coordination and communication is critical. Good primary care should make it easy for others to join in visits and medical decisions, allowing them to take an active role and actually be a member of the patient’s care team.
Moving forward: Choosing a PCP
What guidance can you share with the older adults in your community or facility?
Start off by reminding seniors to ask the people they trust — senior living community staff members, friends, family, trusted specialists and their insurance provider — if they know a PCP who matches what they’re looking for. For example, “I am looking for a PCP who is willing to respect my preferences and is ready to help me take charge of all of my specialty care.”
Once they have a referral, make sure that they’re asking the PCP (or their care team) questions to help determine whether they align with the aforementioned questions. For example, “Does Dr. X usually make referrals for diabetes, or does she manage most diabetics herself?”
By helping older adults understand how to evaluate their needs and how to find providers that align with them, you can help improve their quality of care — and their quality of life as they age.
Neil Patel, MD, is chief health officer of Patina Health, a relationship-centered primary care provider dedicated to improving the healthcare and aging experience for people 65 and older.
The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.
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