One out of every three Americans planned to make a New Year’s resolution in 2024, according to a December survey, with 21% resolving to exercise more and 20% to eat healthier. But if you’re serious about improving your physical and mental health, you might begin with a primary care check-up.

By this I don’t just mean a visit with your primary care provider or PCP, although that is important. Your PCP can offer an objective measure of your current health status, guide you to make safe changes to your dietary pattern and physical activities, and measure the effectiveness of those changes. And if something goes wrong — an injury, for instance — it’s helpful having a provider who knows you help get you back on track. But I’m also suggesting that you kick the tires on your relationship with your PCP. To really evaluate the quality of your care, it’s necessary to look beyond the factors typically considered when choosing a new PCP, like licensure, insurance, reviews and location.

For example, are you getting continuity of care? Most providers are now part of large systems offering “team-based care.” When done well, the PCP coordinates care among nurses, pharmacists, and other clinicians according to a plan. When done poorly, patients bounce between providers and get lost. Does your PCP encourage follow-up, especially after a new diagnosis or medication? Do they come into the room prepared, having reviewed your chart in advance? Or does it feel more like an urgent care where you’re starting from scratch at each visit? Continuity matters less for an acute injury or a simple problem, but it is extremely important when it comes to your wellness goals and chronic conditions.

Second, consider the timeliness of care. With health systems seeking organizational scale and efficiency, providers have many patients scheduled in short appointment slots, and a deluge of results, specialist charts and patient messages piling up in their electronic in baskets throughout the day. This is a major driver of provider burnout. Nonetheless, I have worked with providers who (barring the occasional emergency) manage to stay on schedule and get their work done, and others who regularly run behind schedule and sit on abnormal lab and imaging results for months. This is a two-way street, of course — you need to show up on time, answer your phone, and only send messages for simple, clarifying questions. But routinely being made to wait and not being promptly informed of results are signs your provider may be overwhelmed and letting important details fall through the cracks.

It’s also important your PCP follows standards of care. Pain medications, stimulants, and antibiotics have their place, but they have been overprescribed. Vaccines are safe and effective. Smoking, drinking alcohol, and taking recreational drugs are harmful. While you may not want to ween off a medication, get the latest booster, or reduce your alcohol intake, your PCP should be willing to have uncomfortable conversations with you. These conversations should be evidence-based, however. I worked with a physician who claimed to see literal demons during patient visits and used them to inform the diagnosis. That’s a red flag.

If your PCP doesn’t pass muster, it may be time to transfer care. You can transfer within clinics if you’re happy with the rest of the team or change organizations altogether. And now is an opportune time to make an appointment — your insurance deductible has reset, and if you’re referred for additional care it’s best to capture all those expenses in the same year. Fortunately, there are excellent providers throughout Central Oregon. I love my doc at St. Charles. My mother just transferred to a great team at Mosaic. And my wife (herself a PCP) goes to Summit for her primary care. But they can be booked months out — so resolve to call today!

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