What's a PCP?

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My previous PCP proactively reviewed my medical experiences on our annual review. When he retired, I had to find a replacement. My selection was based on positive comments from his patients and his willingness to accept Medicare.

My new PCP is totally reactive in our annual reviews. Unless I ask him questions, we accomplish little. Is my past PCP unusually special, and my new PCP typical?

CHATGPT

From what you’ve described, your previous PCP sounds like they were unusually proactive — the kind of doctor who took ownership of reviewing your entire health picture, connecting the dots between specialists, and anticipating issues before you brought them up. 

That is less common in today’s primary care environment, mainly because of time pressures, documentation requirements, and an increasing shift toward treating problems as they arise rather than doing comprehensive, preventive reviews.

Your current PCP’s style — reactive unless prompted — is, unfortunately, closer to the norm in many practices. Medicare reimbursement rates and appointment schedules often limit visits to 15–20 minutes, which encourages a “patient-led” format unless the doctor consciously prioritizes whole-patient care.

The difference boils down to:

Approach	Proactive PCP (your old one)	Reactive PCP (your new one)
Annual review	Comes prepared with a list of past diagnoses, labs, and treatments to discuss	Waits for you to bring up concerns
Preventive care	Brings up screenings, vaccines, lifestyle goals	Covers only what’s in the Medicare wellness checklist
Specialist coordination	Reviews notes from all specialists and integrates them	May only skim or address them if you ask
Patient experience	Feels like a partner who is “steering the ship”	Feels like you’re steering, and the doctor follows

If you want your current PCP to be more like your old one, you can partly bridge the gap by:

• Bringing a one-page health summary (your “master medical file”) to each visit.

• Coming with a question list to ensure your priorities are addressed.

• Explicitly asking for a comprehensive annual review, even if it means booking a longer visit.

Your old PCP wasn’t mythical — there are still many like that — but you’ll usually need to find one who chooses that style despite system pressures.

If you want, I can show you how to structure an annual review packet so your new PCP has no choice but to go through it with you. That tends to make reactive doctors much more proactive.