Is Your Doctor in Your Directives? The Often-Overlooked Detail in Your California Advance Health Care Directive

Disclaimer: This blog post is for informational purposes only and does not constitute legal advice. Laws change frequently and there is no guarantee that the information in this post will be applicable or correct when you read this. You should consult with an attorney to discuss your specific situation.

In California estate planning, the Advance Health Care Directive (AHCD) is a cornerstone document. It allows you to appoint a trusted person (your Health Care Agent) to make medical decisions for you if you become unable to speak for yourself, and it allows you to provide instructions about your end-of-life care.

Most people focus, rightly so, on naming an agent and spelling out their wishes for life-sustaining treatments. However, there is one optional but highly valuable detail that often gets overlooked: naming your Primary Care Physician (PCP).

Why Naming Your PCP in Your AHCD Matters

While naming a PCP is not legally required for a valid AHCD in California, it provides a critical bridge between your legal instructions and your medical care. Here is why we often recommend our clients complete this optional section:

1. Centralized Medical Authority and Communication:

Your PCP is the doctor who knows your medical history best. They understand your chronic conditions, past treatments, and overall health trajectory. If you are incapacitated, especially if you are admitted to a hospital where a doctor you don't know takes over your care, the designated PCP acts as a vital resource.

  • Facilitates Informed Decisions: Your PCP can provide essential context to the hospital-based medical team, helping them understand your unique health situation and ensuring that the care plan aligns with your long-term medical history and established preferences.

  • A Familiar Face for Your Agent: Your Health Care Agent may be overwhelmed by the crisis. Knowing that your most familiar doctor is officially designated to consult on your case can provide a huge measure of comfort and confidence, making it easier for them to advocate for your wishes.

2. Clarity for the Hospital System:

In a medical crisis, time is of the essence. By naming a PCP, you are clearly directing hospital staff to the doctor who should be consulted regarding your care. This eliminates ambiguity and streamlines the communication process, ensuring your care team is well-informed from the start.

3. Alignment of Instructions:

Many people discuss their preferences with their PCP during routine appointments. Officially designating them in the AHCD reinforces the expectation that they are the primary doctor to coordinate your care and interpret your written instructions alongside your Health Care Agent.

A Note for Our Younger Clients: Why You Don't Have to Worry As Much About This Specific Detail

If you are a younger client—say, under the age of 40 and generally in good health—you may not need to stress over naming a PCP in the same way an older client might, and here’s why:

  • PCP Relationships Are Less Permanent: Younger, healthy individuals often change PCPs more frequently due to changes in insurance, job relocations, or simply not having established a long-term relationship with one specific doctor yet. Your current PCP today might not be your doctor in five years.

  • The Power of the Health Care Agent: For young adults, the most critical part of the AHCD is naming a Health Care Agent. Catastrophic events for younger, healthy people (like accidents) often occur suddenly and require immediate emergency care where a PCP is not typically involved in the initial life-saving measures. Your appointed Agent is the one who will need to step up and make crucial decisions quickly.

  • An AHCD is a Living Document: If you are young, we advise focusing on the non-optional, foundational parts of the AHCD, especially the agent designation and basic instructions. You can and should update your AHCD as you get older, your health changes, and you establish a long-term PCP relationship.

The Takeaway: While naming your PCP is an optional but valuable enhancement for your AHCD, especially for those with complex or chronic health issues, the single most important step for all adults (including those 18 and over) is to appoint a trusted Health Care Agent. Whether you name a PCP now or later, having an AHCD in place ensures your voice is heard, your wishes are followed, and your loved ones are protected from agonizing over impossible decisions during a medical crisis.

Disclaimer: This blog post is for informational purposes only and does not constitute legal advice. Laws change frequently and there is no guarantee that the information in this post will be applicable or correct when you read this. You should consult with an attorney to discuss your specific situation.