The term primary care physician is used to describe a medical doctor that is chosen by the patient to provide initial medical care. A primary care physician is usually designated at the time of medical plan enrollment, and can be changed at any time during the year.
Primary care physicians, also known as PCPs, are typically general practitioners, meaning they are usually not medical specialists. Primary care physicians are used by health maintenance organizations and preferred provider organizations to help keep costs low by directing the patient to the most cost effective, and appropriate, medical care. This includes referrals to specialists, participating hospitals and laboratories, as well as rehabilitation centers.
Managed care plan participants are responsible for seeking the counsel of their primary care physician before pursuing the help of another doctor. If the insured patient does not get approval from the primary care physician before obtaining medical assistance, the patient will very likely have to pay for all, or part, of the medical services out-of-pocket.