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There I Was: TRICARE Appointment Passes Muster

By Douglas J. Gillert
American Forces Press Service

WASHINGTON, Sept. 24, 1998 – She nagged me for weeks to call a doctor and get a prescription. "I could hear you trying to swallow all night," she complained groggily one morning. "It's starting to bug me."

It was bugging me, too -- the steady flow of nasal drainage down my throat, the waking up at night almost choking, the phlegm- heavy voice each morning. She was right -- I needed something stronger or at least more effective than the over-the-counter stuff I'd taken for allergies the past eight years.

Eight years. It seemed like so long ago when I last visited a military health clinic as a patient. Now, I had my chance. In June, I enrolled in TRICARE Prime, DoD's managed health care plan. I asked to be assigned to the primary care team at a nearby military clinic.

Then, I didn't hear anything. After two months, I called somebody in TRICARE management whom I work with regularly. Through her I learned I was, indeed, enrolled in Prime. The contractor, Sierra Military Health Services, told her my notification was "in the mail." A month later, I still hadn't received anything.

"Just call the toll-free number at Sierra, and they'll set up an appointment for you," she told me.

I found the number under "TRICARE" on the World Wide Web (http://www.ha.osd.mil/tricare/), where it's listed with information and claims numbers for all of the TRICARE regions.

I called, and got put on hold. "Here we go," I muttered to myself.

But only a few seconds passed before an operator answered and asked how she could help me. I told her I needed an appointment for my allergies. She checked a computerized appointment system and in seconds asked if I could be there at 9:20 that morning. I couldn't but we shortly agreed on 9 a.m. the following Monday (three days later). She told me the doctor's name and asked me to hand-carry my medical records to the appointment.

Eager to see how the "new" system works, I arrived at 8:30 and checked in at the information desk. A youthful and pleasant soldier greeted me, confirmed my appointment and invited me to take a seat in the waiting room. A few minutes later, another soldier came and got me and checked my blood pressure and temperature. I then returned to the waiting room.

While I was waiting to see the doctor, I talked to another patient who was a little worried about her initial appointment under TRICARE. Her doctor said her ear canals needed irrigation, but first required medication.

"'We'll do the irrigation after the medicine breaks down the wax buildup,'" she said the doctor told her. "But then," she added, "he told me I was lucky I wasn't ready today, because nobody was available to do the irrigation." She said the physician blamed TRICARE for the clinic being understaffed.

I told her the doctor is right to be concerned about understaffing, but it's not TRICARE's fault. TRICARE is the answer to military downsizing, the response to fewer uniformed medics and clinics and hospitals. If the clinic can't provide the care you require in-house, I said, it's obligated to provide the care within the contract region.

I told her she could learn a lot more by reading the "frequently asked questions" and answers posted on the TRICARE Web site. She asked if I worked for TRICARE.

"No," I said. "I write about it."

I was still waiting at 9:15 to see my doctor. Meanwhile, several patients who arrived after me had already been seen. OK, 15 minutes isn't long, but I was beginning to think nothing much had changed from the old days when military doctors were almost always late. Then, my doc showed. He was an older man, not real talkative, but courteous. He knew why I was there, which tells me he read my record before he called me in. I liked that; it saved time.

After I told him my history of over-the-counter drugs and prescriptive medicines I'd tried earlier, he asked a few questions then prescribed a non-drowsiness daytime drug and a slightly stronger nighttime formula. The latter was available at the pharmacy; the daytime one would have to come from Walter Reed Army Medical Center, a delay of about 10 days. "That's OK. I can wait," I said.

The soldier at the information desk said she gets the same prescription filled and it only takes a week. Ten days, a week, doesn't matter, I thought; not after waiting eight years to be able to see a DoD physician, again.

She told me to take the prescription and request to the pharmacy down the hall. When I got there, my nighttime prescription was already filled and waiting. I didn't realize it, but the doctor had typed it into the computer, hit a key, and sent the request electronically -- another big time-saver. I'm beginning to like this new medical system.

Granted, I wasn't really sick, and my visit didn't constitute a medical emergency. Still, my time's as valuable as any other working stiff's and I appreciate the relative speed with which I was "treated and released." If I hadn't hung around to talk to other patients and the medical staff before leaving, I would easily have completed my appointment in an hour.

My initial medical appointment under TRICARE tells me this: The system is smoother and faster than it was when I was in uniform in the '70s and '80s. There are still a few wrinkles that need to be ironed out; for example, staffing to meet patient requirements, as well as educating patients better about TRICARE.

How do I rate TRICARE personally? So far, so good. Time will tell if my initial experience reflects DoD health care overall. If it does, the $230 a year I paid to enroll will be money well spent. Sure, I'd like to have free health care for life -- a commitment we military retirees expected to be fulfilled. That's not going to happen, however, and I could be paying much, much more for a different plan.

Funny thing, though -- I still haven't been officially notified of my enrollment. I didn't get a letter welcoming me, and I didn't get a card for my wallet with the toll-free appointment and assistance numbers on it.

I'd really like to have the card.

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