What are some reasons someone should/might choose to switch primary care doctors? how do i determine if my current dr is no longer a good fit for me?

That depends : Comfort with, and confidence in, your PCP are critical to an effective patient-physician experience. Does your PCP listen to you and engage your active participation in your healthcare treatments? Is your PCP empathetic and a good communicator? Is your PCP accessible? Is your PCP/staff responsive to calls and questions? These are factors that should help you decide. Best to you!