From the Guidelines
Having two Primary Care Providers (PCPs) is possible, but it requires careful coordination to avoid fragmented care and ensure comprehensive healthcare. This arrangement might be beneficial in certain situations, such as when you split your time between two geographic locations, need specialized care for specific conditions, or want both a physician and a nurse practitioner or physician assistant on your care team. However, it can lead to challenges including communication gaps between providers, potential medication conflicts, and insurance complications as many plans only designate one provider as primary 1.
To make this arrangement work effectively, it is essential to:
- Ensure both providers know about each other
- Facilitate communication between them
- Maintain complete medical records with both
- Clearly define each provider's responsibilities
- Verify your insurance coverage allows for multiple PCPs
The American College of Physicians strongly advocates for the Patient-Centered Medical Home (PCMH) model, which aims to centralize care across the health system for all of a patient's health care needs, including preventive, acute, and chronic care services 1. This model may be especially promising for patients with complex needs, who often receive care from multiple health care professionals in different settings.
In terms of access to care, the PCMH model strives to deliver accessible, integrated, and coordinated care for patients, which may be compromised when having multiple PCPs 1. Therefore, it is crucial to weigh the benefits and challenges of having two PCPs and ensure that the arrangement prioritizes the patient's overall healthcare needs and well-being.
From the Research
Having Two PCPs
- It is possible for a patient to have two primary care physicians (PCPs) as provider comanagement of the same patient has emerged in practice 2.
- Provider comanagement is defined as two or more PCPs sharing care management responsibilities for the same patient, and it has been reported to increase adherence to recommended care guidelines, improve quality of care, and increase patient access to care 2.
- Effective communication, mutual respect and trust, and a shared philosophy of care are essential attributes of NP-physician comanagement, which can be beneficial for patients who require care from multiple PCPs 2.
Benefits and Challenges
- Having two PCPs can be beneficial for patients, especially those who require specialized care or have complex medical conditions, as it allows for a more comprehensive approach to their care 2.
- However, having two PCPs can also pose challenges, such as coordinating care and ensuring that both PCPs are aware of the patient's medical history and treatment plans 3.
- Insurance-related issues can also be a challenge for patients who have two PCPs, as they may need to navigate different insurance plans and coverage 3.
Primary Care Workforce
- The primary care workforce is facing challenges, including a shortage of PCPs, which can make it difficult for patients to access care from a single PCP, let alone two 4, 5.
- Advanced practice nurses can augment the services of primary care physicians, but they cannot substitute for them, highlighting the need for a comprehensive approach to primary care 5.
- Efforts to promote effective NP-physician comanagement and address primary care workforce shortages are necessary to ensure that patients receive high-quality care 2, 4, 5.