Primary Care Provider (PCP)

Find out what kind of doctor can be your PCP and why you need one

A primary care provider (PCP) is considered your main medical provider. Your PCP is responsible for dealing with the majority of your routine healthcare issues, and for coordinating care with specialists you may need to see.

Depending on the type of health insurance you have, your insurer may require you to have a PCP. But even if you're not required to have a PCP, it's still in your best interest to have one—they can help you navigate complex health situations if they arise, and will already know you and understand your medical history if and when you need more extensive care.

As we'll discuss below, there are several types of medical providers who can serve as your PCP, depending on your needs.

This article will explain what PCPs do, what type of doctor can serve as a PCP, why your health plan might assign you a PCP if you don't select on yourself, and why it's important to have a PCP even if your health plan doesn't require it.

A doctor and nurse talking with their patient
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What PCPs Do

In most cases, your PCP is a generalist and can address most of your healthcare needs. In the event that you have a problem that's more complex than she can manage, your PCP will refer you to an appropriate specialist. This may include a surgeon, a psychiatrist, or a cardiologist, for example.

You’ll go to your PCP for your yearly physical exam and preventive health care. She will help you determine any medical concerns you’re at risk of developing in the future. She will also give you advice on ways you might be able to prevent those problems or decrease your risk.

You’ll also go to your PCP for non-emergency problems that arise unexpectedly. For example, your PCP will fix you up when you have a miserable cold that settles in your chest and just won't go away after a week. Did you tweak your back while giving your dog a bath? Your PCP’s office should be your first stop.

Managing Chronic Conditions

Your primary care provider is also good at managing most chronic medical problems. If you have high blood pressure, diabetes, acid reflux disease, or osteoporosis, your PCP will help you keep these under control.

In some cases, your PCP may work together with a specialist to manage chronic medical problems.

Take rheumatoid arthritis as an example. A rheumatologist may be involved in the initial diagnosis and treatment of the disease. He may turn routine care over to your PCP once the disease is well controlled by medications. Or if you've had a kidney transplant, your PCP will coordinate with your nephrologist to make sure that you're receiving the care you need to remain healthy.

Your PCP will then follow up on routine blood tests and prescription refills. She may send you back to the rheumatologist if you have a flare-up, your symptoms get worse, or you develop complications.

In these situations, your PCP is the key member of your healthcare team. Quite often, she is your primary contact who can help guide you along the way. She will also communicate with your health insurance company to make sure everyone is on the same page—particularly if you have an HMO plan.

And if you have an established long-term relationship with your PCP, they might notice health changes or medical issues that a doctor who sees you less frequently might miss.

PCPs Can Coordinate Care

Perhaps the most valuable role primary care providers fill is also the least understood by the general public. PCPs are experts at coordinating care.

If you’re healthy, this won’t mean much to you. But if you develop complicated medical problems, need multiple specialist physicians, or are in and out of the hospital, you’ll appreciate good care coordination.

In the role of care coordinator, your PCP is the team captain. She knows what each of the specialists is doing and makes sure they’re not duplicating tests or procedures that have already been done by another specialist. Your insurance company will also do this as part of their utilization review, but having your PCP coordinating it will help to avoid denied insurance claims and needless medical services.

Do you have 20 active prescriptions from different specialists? Your PCP makes sure they’re all absolutely necessary and compatible with each other (your pharmacists can also help with this, if you use the same pharmacy for all your medications).

Recently hospitalized for heart problems and now ready to start cardiac rehab? Your PCP will help keep your arthritis and asthma under control so they don’t prevent you from participating in the cardiac rehab program you need.

The Types of Providers That Can Be PCPs

In the United States, primary care providers can be a physician, physician assistant (PA), or nurse practitioner (NP). PAs and NPs usually practice under a physician and are known as mid-level providers or physician extenders.

Primary care physicians are usually family practitioners, internal medicine doctors, pediatricians, geriatricians, or obstetrician/gynecologists.

  • Family Practitioner: A family practitioner (FP) is a doctor who has gone through medical school and completed a three-year residency in family medicine. This residency provides training in the care of adults, kids, the elderly, and pregnant women. However, most FPs choose not to offer pregnancy care as part of their practice.
  • Internal Medicine Doctors: Internal medicine doctors (or internists) are physicians who have gone through medical school and completed a three-year residency in internal medicine. This provides training in the care of adult and elderly adult patients but doesn’t usually include children. Internists receive extensive training in the body’s internal organ systems, hence, the name internist.
  • Pediatricians: Pediatricians are doctors that specialize in the care of children. They’ve completed medical school and a three-year residency in pediatrics. A pediatrician can be your child’s PCP, but not for an adult.
  • Geriatrician: A geriatrician is a doctor that specializes in caring for the elderly. After medical school, they will complete a three-year residency in either family practice or internal medicine. They then do a one- to three-year fellowship in geriatric medicine.
  • Obstetrician/Gynecologists: Obstetrician/gynecologists (OB/GYN or OBGs) are physicians who specialize in treating diseases of the female reproductive system. They’ve completed medical school and a residency in obstetrics and gynecology.

While they're technically specialists, many healthy women of child-bearing age see their gynecologist more often than any other doctor. They consider their gynecologist to be their PCP, and the Affordable Care Act (ACA) protects this choice.

As a result of the Affordable Care Act (ACA), women are not required to receive a referral from another doctor to see an OB/GYN. Referrals from an OB/GYN must be treated as acceptable in terms of specialist referrals required by managed care plans). Essentially, the ACA allows a woman the option to select an OB/GYN as her PCP.

Why Having a PCP Matters

If your health insurance is an HMO or a POS plan, your insurer will likely require you to have a PCP. If you don’t choose a PCP from the plan’s list of in-network PCPs, the plan will assign you one.

In most HMOs and POS plans, your PCP acts as a gatekeeper to the other services included in the health plan. For example, in an HMO, you may not be able to see a cardiologist or get physical therapy unless your PCP refers you.

Traditionally, HMOs always required a PCP referral in order to see a specialist, but some modern HMOs allow patients to self-refer to specialists within the plan's network. As a general rule, you'll always want to carefully read your own plan's details and rules—never assume that your coverage will work the same as your friend's or neighbor's coverage, even if you both have the same insurer or the same type of managed care program (ie, PPO, HMO, etc.)

Even if your health insurer doesn’t require you to have a PCP, it's a good idea to choose one. Having a primary care provider is an important part of keeping yourself healthy in the long run.

When you do get sick, your doctor already knows you and your medical history as well as how you look and behave when you’re healthy. They also understand you’re not a hypochondriac or just looking for narcotics, which can be very helpful.


A primary care provider can offer a range of general/routine medical care. They can also refer a patient to a specialist or other provider when necessary, and will coordinate care that a patient receives from multiple providers. Some health plans require members to have a PCP, and will assign one if the member doesn't pick one. These same health plans often require a referral from a PCP in order to see a specialist.

A primary care provider can be a doctor (family practitioner, pediatrician, OB/GYN, geriatrician, or internists), nurse practitioner, or physician's assistant.

A Word From Verywell

Establishing a relationship with a PCP can go a long way toward keeping you healthy. They can provide a variety of routine medical needs, and will come to know you over time. This can be helpful if you develop a new medical condition, as your PCP will be familiar with your usual health status, and better able to identify what might have changed. And if you do end up needing more extensive care, your PCP will be able to help you coordinate care across multiple specialists.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Medline Plus. Choosing a primary care provider.

  2. Department of Health and Human Services, Text of the Affordable Care Act. ‘‘SEC. 2719A [42 U.S.C. 300gg–19a]. PATIENT PROTECTIONS. (d) PATIENT ACCESS TO OBSTETRICAL AND GYNECOLOGICAL CARE.

By Elizabeth Davis, RN
Elizabeth Davis, RN, is a health insurance expert and patient liaison. She's held board certifications in emergency nursing and infusion nursing.