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Buyer Beware: 5 Signs You May Need New Primary Care

Updated: Apr 8, 2023

Finding a good doctor is like finding a good barber; they are hard to find, hard to find a good fit, and hard to know what kind of cut you will walk out of there with. But once you find the one, you wouldn’t dream of going somewhere else.


Unfortunately, some folks never find that relationship with their doctor and —in a broader sense—their experience with the healthcare system. There are many reasons this may occur, to include practice setup, office staff, healthcare system, state and federal laws, insurance companies, and sometimes you just don’t click with your provider.


At the end of the days, some of these things our outside of our control as patients. However, below are my 5 signs you may need new primary care (inspired by Douglas Farrago MD’s The Consumer Guide to Primary Care.) You deserve the best! Because your health and longevity are your greatest assets. Don’t settle for less.


  1. You are told how many problems you are allowed to address at each visit. The most financially successful practices in our current medical system overbook their schedule. This makes the visits short; too short to talk about multiple problems because someone is waiting in the next room. Also, based on how insurance works there is not much of a financial incentive to talk about more problems. However, we all know most things are related and it is vital to treat the whole person. This is often accomplished with long-form, open-ended conversation.

  2. You are told you need to come to the office for an appointment when you call the office. All patients should be seen yearly, controlled medication legally require a visit every six months, and some medical needs may need a visit weekly or daily until things improve. I have all of my conversations about cholesterol in person if possible. Just be wary though if you are repeatedly asked to come into the office to review results, refill medications, or just answer your simple questions. This may just add a big bill to your account with little added value to your overall care.

  3. You get a huge bill for something you thought was covered under insurance. Most insurance plans cover an annual physical. We all know you likely need more than that. However, a basic office visit could cost a hundreds of dollars and labs even more. The worst part is you don’t know this ahead of time and end up with sticker shock. Your doctor doesn’t know the price of these things either. This works for insurance companies, but not for you. It can and should be easier than this.

  4. It takes a very long time to get an appointment. The rise of urgent care is in part a result of peoples inability to get in with their regular doctor. Emergency rooms across America are filled with primary care problems. We understand life happens and in a perfect world, you would be able to get in with your doctor to be evaluated. In modern practice, urgent care and the emergency room are the most advertised options when in reality a quick phone call, televisit, after-hours appointments and house-calls could help tremendously in many situations.

  5. You get sent to lots of specialists for lots of problems. It could be argued that most medical problems are primary care problems. Obviously specialty care is important; sometimes surgeons need to cut things out and sometimes the heart doctor needs to look at your heart. Unfortunately due to multiple factors, your family doctor may feel as if they don’t have enough time to fully address some of your medical problems. This prompts referral to a specialist for common conditions such as hypothyroidism, migraines, routine well women care. Furthermore, approximately 70% of physicians are now employed by a hospital or corporation. These groups are highly incentivized to funnel primary care to specialists for more labs, imaging, tests and procedures.


There are lots of good doctors out there. You may see one of them. However, if you have experienced some of the issues above, it could be time for a change. Please feel welcome to come by our office to discuss if SWVA Direct Primary Care would be a good fit for you and your family.


Jarrod Couch, DO


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