Funny story. For a long time, I didn’t have a primary care doctor. I just went to my endocrinologist. Eventually, he got tired of treating every cut or sniffle and gave me the name of his. If the guy was good enough for him, the doctor I trusted most, he was good enough for me, right?
I agreed to see him, but I never said when. Turns out I waited so long, he had retired. By the time I actually needed a primary care doctor, I was stuck. When I called the practice, they had already hired someone to replace him. I went ahead and saw that doctor because I had to. It was a good decision. I am still with the guy over 15 years later, and he is so good, I will travel a couple of states over to see him.
But why does it matter, especially for chronic patients? Don’t we get everything we need from our specialists?
Well, no, not really. My GP is the only one with a bird’s eye view into ALL my conditions. My specialists are all experts in the disease I see them for, but I’m not sure my endocrinologist knows that much about plantar fasciitis or cataracts. And I am pretty sure my podiatrist couldn’t tell me much about neuropathy, even when it’s in my feet. (Neuropathy is a nerve issue, not a bone/ligament/muscle issue.)
To illustrate this point, I once had a “cardiac incident” while I was at work. My breathing became labored, and my lips were tinged blue*. My two main specialists were out of town, and the emergency room docs failed to catch what was obvious to my GP. I had forgotten to mention to my kidney doctor that I had asthma, so she put me on beta-blockers for hypertension. As the dose increased, my lungs became more and more obstructed, and my inhaler got less and less effective. By the time I maxed out the dose. I was really struggling.
When I called my GP, frustrated that the emergency room hadn’t done anything for me except give me a little oxygen, it took him all of 30 seconds to zero in on the issue.
My GP is also the person I go to for emergency prescriptions when something goes wrong with my insurance or I’m out of town and stuck on a weekend. (You wouldn’t think it happens that often, but it does, and always on a Sunday.) I call him for treatment for normal-person illnesses, which also happen often because of my compromised immune system. It’s a lot easier to get an appointment with him than it is to wait for my specialists, whose appointments are usually booked three months in advance. And his office is where I can get an EKG during my physical just to make sure one of the few systems that isn’t damaged hasn’t moved from its baseline. I once went in for an infection on my cuticle. I felt so stupid. With everything that I juggled medically, I was seeing a doctor for a boo-boo on my finger. When I told him that, he asked, “It hurts, right? Then this is where you should be.”
I may not see him often, but he knows me, and I know him. It’s a comfort that I can go to my ringleader whenever something falls outside one of my specialist rings.
*I made my colleagues drive me a half hour to the hospital where my doctors had privileges. If you are ever in that situation, don’t do that.