Studies have shown that GLBT individuals are less likely to seek preventive care services than our straight counterparts. Part of this could be due to a lack of openly gay or lesbian primary care providers or GLBT affirming straight providers. In this article I'm going to address some basic issues to consider when selecting a primary care provider. In part II I will discuss a few preventive care services especially important to the GLBT population.
First let's discuss the importance of having a primary care provider. It's very convenient to wait until we're sick and then go to the urgent care clinic down the road to get treatment. But, these clinics really are only meant to augment the primary care offices by providing after hours care or minor urgent procedures such as suturing. They are not meant to be your primary care provider. When you have a home for all of your medical records, then you are much more likely to receive recommendations for preventive care services and your chart will stay up to date. Also, should you ever be in an accident or faced with a serious illness your medical records can be easily accessed by a specialist or a surgeon.
How do we find a primary care provider? The Gay and Lesbian Medical Association (www.GLMA.org) is a great resource. Another terrific way is to just ask around. Your friends may know of an openly gay or lesbian provider or one that was accepting of your friend's disclosure of sexuality. Remember, you don't necessarily have to disclose your sexual orientation to your primary care provider (PCP). But, you should feel comfortable enough to do so if you wish. Good sexual health is important to good health in general, so it's in your best interest to disclose as much about yourself as you can.
I do not personally have a bias toward a physician PCP vs. a nurse practitioner PCP. Either should be nationally board certified in their specialty area and have a good reputation in the community. There are numerous studies showing that both do a great job at providing primary healthcare services. If you hear of a potential provider then you can easily verify the credentials by going to www.tn.gov/health and clicking on "license verification" and enter the first and last name of the person you are inquiring about and then click on "practitioner profile". If the profile is up to date you should get information on any schooling and certifications as well as disciplinary actions against this person.
When considering a physician for your PCP it’s important to remember that internal medicine is the specialty that deals with adult primary care and for most adults this is what you are looking for. A family practice specialist is a physician who provides primary care services to any age individual from new born babies all the way to elderly adults. Family practice physicians in some areas also provide obstetrical care to pregnant women, but this seems to be declining as more and more women have access to an obstetrician. Locale is not as big of a factor as it used to be as many primary care physicians have stopped providing hospital services and rely on a new type of specialist called a hospitalist. So, if you are sick or injured and go to a hospital chances are you would not see your primary care physician (the exception is small towns with limited physicians) but would instead see the hospitalist or an assigned physician.
When looking at a nurse practitioner you have several choices. Nurse practitioners are registered nurses with masters or doctorates in nursing who have an advanced practice license to provide expanded care which includes diagnosing and treating many healthcare problems. An adult nurse practitioner (ANP) is an advanced practice nurse who specializes in providing care to adolescents and adults of all ages. A family nurse practitioner (FNP) specializes in the care of babies, children, and adults, as well as the care of the pregnant woman before and after delivery. If you're over the age of 55 then a geriatric nurse practitioner (GNP) may serve as your PCP. Or, if female or trans-sexual (male to female) a women's health nurse practitioner (WHNP) may serve as your PCP.
Both physicians and nurse practitioners can prescribe medications, order and interpret laboratory results, and refer you to a specialist when needed. If you can find a physician who has a nurse practitioner who works closely with him or her then you really have the best of both worlds and can choose either provider for follow-up appointments or see the first one available for urgent needs.
Next month in part two I will discuss some basic preventive care services you should consider discussing with your PCP.
