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Registering with a physician

Registering with a physician

Old May 13th 2015, 12:37 pm
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Default Registering with a physician

When we arrive in the States do we go register with a physician straight away please, rather than when someone falls ill?

Are some health care providers/practices better than others in an area or are they all pretty much the same?

Also do we have to find a separate pediatrician to register our children with?

Sorry for all the questions!!

and thanks
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Old May 13th 2015, 4:00 pm
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Default Re: Registering with a physician

Hi Eddie, unlike the UK, there is no legal obligation to register with a doctor here in the USA.
First off, you need to get a list of doctors that are "in-network" with your insurance company. Personal recommendation for a physician is best, ask around at work, ask the other parents at school - or in my case, I asked our relocation agent.

It is better to register as a new patient rather than wait until you need a doctor urgently. They also do a whole raft of tests to assess your current state of health and you may find that the kids need some vaccinations for school.

Most of the people I know here send their kids to a pediatric clinic, if your physicians office has a pediatrician in it then that makes it a bit easier to organise. It's also normal for the kids' to have annual check-ups.

As I found out last week, it's also better to find out where your nearest IN-NETWORK ER is. Like I didn't and I took my daughter with her arm dripping blood from a kung-fu sword cut to the nearest ER centre only to find out afterwards that they are not in-network. Tense weekend until we found out that our insurance would cover it anyway....phew.
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Old May 13th 2015, 4:06 pm
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Default Re: Registering with a physician

Per the above and plan to spend a couple of hours at least every time you go to a new doctor's office. Conversely, once you're all set up, you can be in and out in <10 minutes (but be prepared for loooong waits on occasion). Pediatricians are usually separate from your own doctor but there are some family doctors that do both.
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Old May 13th 2015, 5:04 pm
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Default Re: Registering with a physician

Originally Posted by Eddie35
When we arrive in the States do we go register with a physician straight away please, rather than when someone falls ill? ....
It's a good idea to register as soon as you know who is "in network" on your insurance. Personally I would recommend convenience as a factor to consider, registering near home or work if you don't have children, or near home or school if you do.

When you register you may be offered an initial physical, as it seems to be the norm for new patients. ..... After not going to see my GP for 18 months because I wasn't sick, I was told I would have to have a physical before I could reregister! I switched to a more convenient local practice, and still had to have physical there. .....I was asked what medications I took, and the doctor was more than surprised when I told him "none". In fact he double checked that he had heard me right!
.... Are some health care providers/practices better than others in an area or are they all pretty much the same? .....
Rather like schools and school districts I think that most people who enthuse about their doctor are looking for some sort of validation that they made the "best" choice. So I am sceptical about placing too much weight on recommendations. ..... I doubt there is a huge difference, and you can change to another doctor fairly easily if the first one doesn't work out. I would, other things being equal, lean towards a larger practice as they likely have more equipment to handle tests and procedures "on site", and may offer extended hours. The practice we registered with started offering Saturday hours a few years ago, and then recently added Sunday hours.
.... Also do we have to find a separate pediatrician to register our children with? .....
That's entirely a personal choice. As our contact with the medical profession is relatively limited, despite little Miss P's allergy problem, we didn't see any point/ need for a pediatrician and we will not be made to feel bad that we didn't register our little darling with a pediatrician!
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Old May 13th 2015, 5:09 pm
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Default Re: Registering with a physician

Originally Posted by petitefrancaise
As I found out last week, it's also better to find out where your nearest IN-NETWORK ER is. Like I didn't and I took my daughter with her arm dripping blood from a kung-fu sword cut to the nearest ER centre only to find out afterwards that they are not in-network. Tense weekend until we found out that our insurance would cover it anyway....phew.
Also find out where your nearest urgent care clinic is. Something like CVS Minuteclinic is ok for small things but there are often better ones with essentially ER level service without the ER price tag (the one near me is part of a chain called NextCare).

I recommend only going to ER (A&E) if you are being driven there close to death in an ambulance. Do not use ER as you would a British A&E, use urgent care clinics instead.
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Old May 13th 2015, 5:26 pm
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Default Re: Registering with a physician

Originally Posted by sir_eccles
Also find out where your nearest urgent care clinic is. Something like CVS Minuteclinic is ok for small things but there are often better ones with essentially ER level service without the ER price tag (the one near me is part of a chain called NextCare).

I recommend only going to ER (A&E) if you are being driven there close to death in an ambulance. Do not use ER as you would a British A&E, use urgent care clinics instead.
To which I would add, clarifying my post above, if you register with a GP practice with extended hours you can often avoid the elevated cost of attending an "urgent care clinic", because even though an urgent care clinic costs less than the ER (A&E) it still costs substantially more than a visit to your GP. ..... Know your GP's hours and make sure you use them for as many of your medical needs as possible.

I had an issue with blood poisoning a few years ago and went to my GP first. He referred me to the hospital and I was admitted without going through the ER. ....... After three nights in hospital and very minor surgery (two skin incisions to remove ulcers) I left with a bill for over $20,000!
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Old May 13th 2015, 5:29 pm
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Default Re: Registering with a physician

Originally Posted by sir_eccles
Also find out where your nearest urgent care clinic is. Something like CVS Minuteclinic is ok for small things but there are often better ones with essentially ER level service without the ER price tag (the one near me is part of a chain called NextCare).

I recommend only going to ER (A&E) if you are being driven there close to death in an ambulance. Do not use ER as you would a British A&E, use urgent care clinics instead.
Our insurance costs are $10 for normal doctor, $10 for urgent care, $25 for ER (I think we were previously 10/10/50 under Kaiser Permanente), ambulance extra. So CVS is the last place I'd consider going at $79-99! I'm not sure our insurance covers CVS at all (it's pretty crap).
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Old May 13th 2015, 5:31 pm
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Default Re: Registering with a physician

Originally Posted by Pulaski
To which I would add, clarifying my post above, if you register with a GP practice with extended hours you can often avoid the elevated cost of attending an "urgent care clinic", because even though an urgent care clinic costs less than the ER (A&E) it still costs substantially more than a visit to your GP. ..... Know your GP's hours and make sure you use them for as many of your medical needs as possible.
Maybe it depends on your insurance. The NextCare I mentioned above (and the CVS minuteclinic) charges me the same $20 copay as my regular Dr. (ER would be $500 copay plus whatever else they feel like).

Bottom line, know what your insurance covers, what the copays/deductibles/co-insurance or whatever else is hidden in the fine print is and who is in network.
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Old May 13th 2015, 5:33 pm
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Default Re: Registering with a physician

Originally Posted by Pulaski
the elevated cost of attending an "urgent care clinic", because even though an urgent care clinic costs less than the ER (A&E) it still costs substantially more than a visit to your GP.
Per Sir, depends on your insurance. Our current and previous were the same cost for family doctor and urgent care.
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Old May 13th 2015, 5:35 pm
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Default Re: Registering with a physician

Originally Posted by GeoffM
Our insurance costs are $10 for normal doctor, $10 for urgent care, $25 for ER (I think we were previously 10/10/50 under Kaiser Permanente), ambulance extra. So CVS is the last place I'd consider going at $79-99! I'm not sure our insurance covers CVS at all (it's pretty crap).
$25 ER copay! Seriously? wow!

Just to clarify, yes CVS is crap. I generally only use it when visiting the in-laws and I end up needing a quick antibiotic rx for a nasty sinus infection.
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Old May 13th 2015, 5:44 pm
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Default Re: Registering with a physician

Originally Posted by sir_eccles
$25 ER copay! Seriously? wow!
Yeah... not all good though, EPO and a very small network so quite often there is a choice of exactly one specialist. Three peds but the 3rd only came online recently; the other two were massively oversubscribed. Wife is an RN so health insurance is usually (but not always) good.
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Old May 13th 2015, 5:51 pm
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Default Re: Registering with a physician

Originally Posted by GeoffM
Per Sir, depends on your insurance. Our current and previous were the same cost for family doctor and urgent care.
Ah yes. That would be my high deductible insurance - the total cost of a visit to our GP is less than the total cost of a visit to the urgent care clinic.
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Old May 13th 2015, 6:25 pm
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Default Re: Registering with a physician

Oh great! I still don't know how I got through the exam to end up over here thanks to my completely irrational fear of Dr's. Now I find out I have to a medical just to register with a Dr. ****!!!!! Talking of Dr's, I'm currently in a surgery waiting to be called to give a urine sample for a pre employment drugs test. Problem is, I don't need a wee!!!!!
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Old May 13th 2015, 9:12 pm
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Default Re: Registering with a physician

A lot of doctors do a "open" day kind of thing, where you can go check out the offices and talk to the doctors if you want to register with them, then you fill in your history etc. Seems nicer than going when you have something wrong, but usually they want to set up a physical. Though my doctor is already booked up till the middle of July next year for annual physicals.

As for the kids, some states, they have to see a ped's, such as CT, till they're 21. In MA, kid has to see the one they're registered with for their regular health check ups but illnesses and the like, they can see anyone, so can be a hassle if your doctor has to cancel on you.

Our current place, the doctors are a full service, so GP/OBG/Peds all in one office, which is handy, but seems to be rare where I am.
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Old May 13th 2015, 9:28 pm
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Default Re: Registering with a physician

Originally Posted by Bob
A lot of doctors do a "open" day kind of thing, where you can go check out the offices and talk to the doctors if you want to register with them, then you fill in your history etc.
I've never heard of that around here!
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