Primary Care in NH

BY KRYSTEN GODFREY MADDOCKS / ILLUSTRATION BY JOHN R. GOODWIN

If you can’t find a primary care provider, you’re in good company. Like the rest of the country, New Hampshire faces a shortage of doctors and nurse practitioners who are able to see people for annual checkups and other general medical concerns. Your primary care provider helps you assess patients, manage referrals to health care specialists, and refill patient medications — and most health insurance providers require one.

“Your PCP is like the anchor of your health care team,” says Dr. Nancy Pettinari, regional medical director of the Mass General (MGB) Medical Group. “They coordinate your care from one entity to another — from specialty care to primary care and from the emergency room to inpatient care. That person is the link that holds all of your care together.”

Wentworth Health Partners, part of the MGB Medical Group on the Seacoast, just launched a new program that helps patients waiting for primary care providers get seen more quickly. Melisa Bartlett, regional executive director for MGB Medical Group (North Region), said the group’s patient navigation team is actively establishing primary care connections for several hundred new patients in their 11 practices.

The group has locations in Barrington, Dover, Durham, Rochester, Portsmouth, Somersworth, and South Berwick, Maine. Bartlett estimates the need for primary care is high in the general Seacoast and outlying population, consistent with national trends.

In response, the group launched Primary Care Connect, which allows patients to see a provider before their first PCP appointment. The designated Primary Care Connect provider can see up to five patients daily, virtually and in person.

“Sometimes patients have an appointment five months out, and they need care in between that time,” Bartlett says. “The idea is that this provides a bit of bridge care for that patient until they can establish their care with their long-term primary care provider.”

Primary Care Connect also prevents patients from seeking care in busy emergency rooms or urgent care centers when primary care would be more appropriate. Emergency and urgent care costs more and can pose long wait times for patients. Of course, if patients are experiencing an emergency, they should call 9-1-1.

“Even our emergency room has been at a very, very high census for months and months,” Pettinari says. “That is in part attributable to the lack of primary care physicians in the area in general.”

According to Dr. Holly Mintz, senior vice president and chief medical officer of the Elliot Medical Group, several primary care providers in the Elliot group are accepting new patients. Of the 18 offices the group manages, 14 were accepting new patients as of January.

Find A Pcp In Your Region

Appledore Medical Group (affiliated with Portsmouth Hospital and Frisbie Memorial Hospital): appledoremedicalgroup.com/specialties/primary-care

Beth Israel Lahey Health Core Physicians: corephysicians.org/Home

Catholic Medical Center: catholicmedicalcenter.org/find-a-doctor

Concord Hospital: concordhospital.org/find-a-doctor

Dartmouth Health Primary Care: dartmouth-hitchcock.org/primary-care/find-primary-care-provider

DMC Primary Care: dmcprimarycare.com

The Elliot: elliothospital.org/providers

Southern New Hampshire Health: snhhealth.org/primarycare

Wentworth Health Partners: wdhospital.org/whp

Patients looking for a provider at Southern New Hampshire Health or Elliot Health System can call Provider Match at 833-920-7473 to find a provider who is accepting patients.

“We’ve brought on a lot of new providers over the past five years. I think we’re getting better at anticipating retirements and trying to hire people before other providers retire,” she says. “There can often be a six-month lag between providers, but it used to be years.”

Like Wentworth Health Partners, Elliot Medical Group will also see patients while they wait for their first PCP appointments. The group has offices in Allenstown, Bedford, Hooksett, Londonderry, Manchester, Raymond and Windham.

In New Hampshire, nurse practitioners can serve as primary care providers who manage their own patients independently from a doctor, which helps open up access to more patients, Mintz says. Many of the Elliot Medical Group providers are nurse practitioners with specific training in primary care.

“I think we will continue to see more and more advanced care providers taking (patient) panels because so many physicians are specializing,” she says. “We need more doctors to go into primary care. In a dream world, there would be specific medical schools that train for primary care at a lower cost point, because people come out of medical school owing hundreds of thousands of dollars.”

In 2024, Concord Hospital recruited 14 new PCPs throughout its health care system, totaling 144 providers at 19 primary care locations in Belmont, Concord, Epsom, Franklin, Gilford, Hillsboro, Hopkinton, Laconia, Meredith, New London, Pembroke and Warner, says Dawn Beers, public affairs manager at Concord Hospital. Several PCPs at the practices are accepting patients, although new patients can expect to wait more than six weeks for an appointment if they don’t have emergent needs, she says.

Dr. Terry Buchanan, a primary care provider at Downtown Medical Associates in Nashua, a part of the Southern New Hampshire Health System, has worked in family and internal medicine for more than 25 years. He’s enjoyed caring for patients and their families with whom he’s formed deep relationships, but agrees the system must adapt to better meet patients’ primary care needs. Buchanan can see up to 17 patients a day on the three days he cares for patients. Not only are there more patients to see, but often their health care needs are more complex, he says.

“Back in the day, you had a lot more sinus infections and sore throats so you could keep your schedule balanced, but today there are typically 16 complicated patients in a day,” Buchanan says.

The old model placed the physician as “the captain of the ship,” but Buchanan says that’s not sustainable anymore. That’s where physician assistants can work closely with doctors to serve more patients.

Making the Right Match

Although it can be challenging to find a provider, you should feel comfortable with the person you ultimately choose as your PCP. While doctors may have different training than advanced care providers, such as physician assistants and nurse practitioners, you shouldn’t just focus on titles when you’re shopping for a new PCP.

“Most people are looking for someone with whom they can have a long relationship,” Pettinari says. “And that might not be the first person (you choose.) You should look for someone who has a similar philosophy to yours and somebody with whom you can really share decision-making.”

Many practices use a team approach, where other providers can see you if your PCP isn’t available. If you have a more complicated case, nurse practitioners and other health care providers can access your PCP if needed. And for those people who really need to be seen immediately, Wentworth Health Partners has a nurse triage system that will send patients to urgent care or the emergency room if necessary, Pettinari says.

Most hospital systems that manage primary care practices offer phone numbers, websites and even support staff who can help patients find and select providers.

If you’re still struggling to find the right health care system or provider that meets your needs, your health insurance company might be able to help, too. According to Stephanie DuBois, director of public relations for Anthem Connecticut, Maine and New Hampshire, Anthem member service representatives can help subscribers select a PCP at any time.

Some health plans also offer the support of Anthem Health Guides, customer service experts who can offer personalized support to help you find a PCP, address questions and coordinate care. In cases where members are required to have a PCP under their health plan and do not actively select one, Anthem can assign them to a PCP accepting new patients based on geographic location. Members can update their PCP in their profile at any time, DuBois says.

“We also offer a full suite of digital tools, such as our online portal at anthem. com and our mobile app, Sydney Health, where members can search for high-quality PCPs accepting new patients and make their selections,” she says. “Members can set search criteria such as geographic area, language preferences, and gender to sort search results. We also offer a sort option called “personalized match” that can match the member to a list of providers best able to treat the member based on the member’s medical profile.”