Your Primary Care Team
When it comes to lowering your risk for cardiovascular disease (CVD), your primary care physician is likely to recommend lifestyle changes to reduce your risk. A number of professionals may help monitor your health and assist you in making these lifestyle changes. Your preventive and management program may include visits with physician assistants, nurse practitioners, dieticians, a smoking cessation team, and diabetes educators. Here’s a brief look at what each of these and other healthcare providers do.
Primary care physician
A primary care physician is a Physician of Medicine (M.D.) or Physician of Osteopathy (D.O.) who’s trained to evaluate a patient for overall health and to treat illnesses. Family physicians, internists, obstetrician/gynecologists (OB-GYNs), and pediatricians are all primary care physicians. In order to diagnose health problems, a primary care physician may request lab tests or refer a patient to a specialist. Once a patient is under the care of a specialist for diagnosis and treatment, the primary care physician continues to serve as the coordinator for the patient's care team.
Becoming a primary care physician requires four years of medical school and a three- or four-year residency (working in a hospital or clinic under supervision). Additionally, the primary care physician must obtain a license to practice medicine and is required by some states to complete continuing medical education (CME) credits. Primary care physicians who are board certified must also pass periodic exams that test their knowledge.
Physician assistants are licensed to practice medicine with physician supervision. Training for physician assistants, which includes classroom and laboratory instruction across a wide range of medical specialties, typically takes two to three years. Most physician assistant programs are graduate-level programs that require a bachelor's degree for admittance. All physician assistants must pass a certification exam to receive their license and take ongoing CME courses throughout their careers.
Physician assistants provide care by performing exams and some types of procedures, taking medical histories, ordering diagnostic tests and treatments, making diagnoses, prescribing medications, and making referrals to other specialists. Many physician assistants work in primary care clinics.
Nurse practitioners are registered nurses (RNs) who have completed advanced education (in most states, a master’s degree) and training in diagnosing and managing common health concerns, including chronic illnesses such as high blood pressure and diabetes. Nurse practitioners collaborate with physicians and other health professionals and can refer you to specialists, as needed.
You also may be referred to a dietician, a healthcare professional who can help guide you in eating a heart-healthy diet. Dieticians are trained to evaluate your diet and suggest changes in your eating that may help reduce your cholesterol level, lower blood pressure, and manage diabetes if you have it. Their training includes a bachelor's degree in dietetics, foods and nutrition, food service systems management or a related area, a 6–12 month internship, and completion of a national exam given by the Commission on Dietetic Registration.
Smoking cessation team
If you smoke and want help quitting, your primary care physician may suggest you work with a smoking cessation team. Members of the team will work with you to determine the best ways for you to manage cravings, minimize nicotine withdrawal symptoms, and understand what situations trigger your desire to smoke. They also will help you learn ways to manage stress and cope with not smoking, even in situations that might encourage you to light up again. Smoking cessation programs are led by counselors with special training and experience in helping people end their addictions. Often, the program is supervised by a physician so that your addiction to nicotine is treated in a way that takes into account any other medical problems for which you may also be receiving treatment.
If you have diabetes, your primary care physician may refer you to a diabetes educator. Diabetes educators are trained to help patients understand diabetes and what they need to do to manage their condition. They can provide support as you develop a plan for managing your disease and set goals for adopting behaviors to help you maintain targeted blood glucose levels.
Diabetes educators may come from the ranks of RNs, registered dietitians, pharmacists, or other medical specialty areas. They may be credentialed either as a Certified Diabetes Educator (CDE) or as Board Certified in Advanced Diabetes Management (BC-ADM).