Primary Care Physician

Definition

• A physician who is responsible for the bulk of a individual's health care, personally treating routine and remedial health conditions and setting up referrals for those outside their expertise. If the patient is a member of a health maintenance organization (HMO), the primary care physician will act as a gatekeeper and only prescribe treatments covered by the HMO.

Synonyms
primary doctor, primary physician

Related Terms and Acronyms

• Case Management — Definition,
  • A system where medical services and patient treatments are coordinated by a case manager.
• Disease Management (DM) — Acronym, Important,
  • The process of discussing and agreeing to treatments and care plans for individuals with long-term health care needs.
  ➥ Heath care decisions made to manage a disease.
• Gatekeeper — Definition,
  • In relation to health maintenance organizations, a gatekeeper is a primary care physician that arranges medical care for policyholders.
• Health Insurance (HI) — Acronym,
  • Insurance that covers the costs of medical expenses for insured persons.
• Health Maintenance Organization (HMO) — Acronym, Important,
  • A healthcare plan where insured people receive reasonably priced health insurance through an organization with firm guidelines on the scope of care.
• Least Expensive Alternative Treatment (LEAT) — Acronym,
  • When multiple treatment options exist for the same illness, insurers are only obligated to provide the most cost effective treatment.
• Medical Specialist — Definition,
  • A doctor with training in a specific medical field.
• Point of Service Plan — Definition,
  • A health insurance plan that combines the features of both health maintenance organizations and preferred provider organizations.
• Preferred Provider Organization (PPO) — Acronym,
  • A health care program that gives its members a level of freedom and independence when choosing health care options.
• Usual, Customary and Reasonable Fees — Definition,
  • The expected cost of a medical treatment, and what an insurance company is willing to pay.