A Runner’s Guide to Finding a Primary Care Doctor

Chances are, you have seen an orthopedist at some point or another since you started your life as a runner. Or a physical therapist. Or maybe another specialist of some sort. Or even a chiropractor.

But have you been to your primary care physician for a check-up recently? You exercise, probably don’t smoke and eat a healthy diet. How often do you really need to go, if at all?

Do I Need to Go and If So, How Often?

The annual physical exam, once touted as necessary to maintain good health, has been called in to question during the last decade or so. As health care, insurance and testing costs have risen, the efficacy of the annual physical has been scrutinized by a number of different experts as well as professional medical and financial organizations.

The American Medical Association, among others, currently recommends that routine examinations occur every five years between the ages of 18 and 40 and then between one and three years subsequently.

Obviously those who have chronic conditions like heart disease, high blood pressure, high cholesterol or diabetes, or those who smoke, should see a medical professional on a regular basis.

But those who are healthy, exercise regularly, eat well and don’t smoke can probably go longer between regular check-ups and some may feel comfortable going only on an as-needed basis. Many doctors would agree that more important than a yearly physical are the things you do the other 364 days to maintain your health and prevent illness and injury.

What to Look for in a Primary Care Doctor

So, you’ve decided you should go for an annual physical because you haven’t been in years or maybe you are looking for a new doctor or maybe despite your healthy lifestyle, you have a medical issue that you need to have addressed. As a runner (or cyclist, swimmer, etc.), what should you look for in a primary care physician?

Also called family or general practitioners, primary care physicians are doctors (medical doctors—MDs or doctors of osteopathy–DOs) who have completed postgraduate training in primary care programs such as family medicine, pediatrics or internal medicine. Primary care physicians are often the first points of contact for patients who need diagnosis and treatment of common illnesses and medical conditions. They also promote preventive measures and healthy lifestyles as ways to maintain optimum health.

There are three main things that anyone looking for a primary care doctor considers:

• Location. Is their office close to home or work
• Insurance. Do they take your current insurance plan?
• Availability. Is the practice is accepting new patients?

Once those three things have been determined, what next?

Larry Creswell, MD, a heart surgeon and faculty member at the University of Mississippi School of Medicine, offers the following guidelines:

• Look for a doctor who is an athlete him/herself. Sometimes this type of information will be noted in the doctor’s online bio or background information.
• Ask runner friends who they see. Word of mouth is often the best way to find someone who might be a good fit for you as well. Or, if you are lucky enough to know a runner who also is a physician, ask him/her who they would recommend.
• If you have recently seen another medical professional such as a physical therapist or an orthopedist, ask them for a recommendation.
• Contact your state’s medical society for a listing. For instance, my state medical society maintains a physician finder listing on its web site that is searchable by specialty and geographic location. Two of the specialities listed are “sports medicine–family medicine” and “sports medicine–internal medicine.”

You also may be able to find a physician through your insurance provider as many maintain physician finder listings as well. On my provider’s web site, you can search by whether the doctor is in network or not, accepting new patients or not, location and specialty. The specialty areas were a bit broad but there was an option for patients to leave doctor reviews so more detailed information might be gleaned from them.

When You Go

An important part of your health history and profile is your exercise regimen. It is important for your doctor to know the type(s) of exercise you do, how frequently, how much and how intensely.

It is particularly important for your doctor to know you are a runner and at what level as there are a number of physical characteristics unique to runners that could impact how your doctor diagnoses and treats you.

In her article “Six Reasons Your Doctor Needs to Know You are a Runner,” author Teal Burrell highlights the following reasons:

• Some runners may have athletic heart syndrome, in which an enlarged heart from years of endurance exercise beats slower and pumps more blood but which might be misdiagnosed as other pathological conditions, such as cardiomyopathy. It is important for your doctor to know you are a runner so he or she can distinguish between athletic heart syndrome or another condition.
• Runners who are being treated for hypertension should be up front with their doctors about their running habits. Beta blockers, which are frequently used to treat hypertension, can limit cardiac output, something that is required at a higher level for runners. There are other medications that are more appropriate to treat hypertension in the running population so it is important for your doctor to know.

• Certain antibiotics—fluoroquinolones like Cipro to be exact—can weaken tendons so greatly that the tendons can become damaged or even rupture, which can be extremely debilitating and require a lengthy recovery and rehab period. Fluoroquinolones are used to treat kidney, urinary tract, respiratory and sinus infections, things that are relatively common. Runners should alert their doctors so that a different class of antibiotics can be prescribed in these cases.
• If you notice unexplained weight gain, despite consistency is your running mileage and intensity, it may be a symptom of sleep apnea or hypothyroidism. Tell your doctor if you are gaining weight while continuing your regular running regimen.
• Unless you always train indoors on a treadmill, as a runner you spend a great amount of time outdoors. Your doctor should know this so he or she can pay special attention to your skin and look for any suspicious moles or growths.
• If you are training at the same levels and distances and are maintaining a healthy diet but feel fatigued, it could be a sign of hypothyroidism, a viral illness or low iron levels. Even iron levels on the low side of normal, which aren’t usually diagnosed as anemia, can cause fatigue. If you have unexplained fatigue, share with your doctor that you are a runner. He or she will probably want to test your hemoglobin levels and prescribe an iron supplement if your levels are too low. Anemia is relatively easy to treat but cases that go undiagnosed can result in muscle wasting.

Based on your age, health history and current lifestyle, you and your doctor can agree upon any necessary baseline or follow-up tests that need to be conducted as well as a plan for the frequency of your physicals going forward. The relationship between you and your physician should be one of mutual respect, trust and collaboration.