I am my own PCM

It’s not like I planned it this way. I grew up with the idea that one had a family doctor they saw regularly for checkups, shots, broken bones, and skinned knees. That’s what I looked for when I was older. I have no opposition to specialists, but I would have preferred the continuity of seeing the same doctor each time I go. I really would like to have a primary care manager.That’s not happening under Tricare Prime. I’m assigned to an MTF (military treatment center) and since I’ve been in the plan – 2 years now – I’ve been assigned to five different PCMs. I had 3 visits with the first, 2 with the second, 0 with the third, 3 with the 4th, and one with the current one. Two of these assignments have lasted less than 6 weeks. Three of these visits were for actual illness, the others were to get medication refills. Each new PCM wants to “see” me before refilling scripts I’ve been on for years, or before putting me on an alternate generic because the DOD has made a new deal with a different drug company.

None of these doctors ever had the chance to get to know me, or for me to know them. The MTF has a nice electronic medical records system, but it’s time-consuming and limiting. The doctor or PA is facing the computer, not me.

Before a visit, I do or consider all the things Christine recommends in Preparing for a Doctors Visit. My list of medications includes OTC stuff, meds I previously took, who prescribed them, why I no longer take them, dates of the above, etc.Not only do I write out questions I want to ask, but I include objectives I want to meet during the visit. Those are most often, get a refill written or get a referral to a specialist. Never have I discussed long-term medical goals with any of them. They know as well as I that we may never see each other again.

The closest I’ve come to having continuity of care is always getting the same internist when I’m hospitalized (luck of the draw) and the ongoing relationship I had with my radioncologist. But who wants to go the hospital or have radiation treatments to get a little continuity of care?This is why I am my own PCM. As Christine writes, “You know your body best, and you need to be your own advocate in the doctor’s office.”

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