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Whats in a Name? Plenty, When Its Your Docs

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

ARLINGTON, Va., March 2, 2001 – Gone are the days when you go to a military treatment facility and see whoever's available. By June, most TRICARE Prime enrollees should know their doctors name.

TRICARE policy used to be to assign patients to a group of primary care providers. Now, patients are being assigned to an individual to manage their healthcare, said Army Dr. (Lt. Col.) Scott Goodrich, a project officer at the TRICARE Management Activity here.

Previously, people would be looking for physicians to call their own. Theyd request the same physician each visit, he said. But the system wasn't set up to ensure that would happen.

Goodrich, a family practitioner himself, said people have often asked him to be their doctor. He said hed always agree, but outdated computer systems and inadequate infrastructure sometimes kept patients from getting appointments with him.

Ive never been able to guarantee that promise could be kept, he said. This is something patients always wanted, but were just now able to deliver.

Managers in the various TRICARE regions are currently assigning patients to specific providers, Goodrich said, noting that several regions are already finished. Many beneficiaries have already been notified by mail who their assigned provider is, he said.

The initial migration from the group system to by-name assignments should be complete by June, he said. After that, TRICARE's ideal would be that 100 percent of newly assigned patients receive a provider-by-name notification 100 percent of the time, he added.

Goodrich asked for patience, though -- beneficiaries should expect localized glitches. Until the migration is done, those who want to know their assigned providers should contact their local clinic staff or appointment clerk, he said.

"This is a huge burden on medical treatment facilities, but many have been very good about notifying patients all the same," he said. They think the program's as good for them as for beneficiaries, he added.

They dont need to spend valuable patient/provider time collecting your history every time you come in for a visit, Goodrich said. That time can be used to focus on other things, like prevention and wellness. He said healthcare providers also appreciate not being surprised by a new batch of patients every single day.

Although the mobile nature of military life prevents the cradle-to-grave care seen in some civilian communities, Goodrich said, TRICARE's shift goes a long way toward improving the healthcare benefit.

We can still provide a whole lot more continuity than weve been providing in the past, he said.

Patients shouldnt be too surprised if their primary care manager isnt a doctor. Many facilities use advanced- practice nurses -- nurse midwives and licensed nurse practitioners -- and physician assistants in this capacity for beneficiaries with straightforward medical needs.

Beneficiaries neednt be concerned about getting stuck with a provider theyre uncomfortable with, though. They can choose who their primary care manager will be or request a change at any point, Goodrich said.

The only possible reasons we wouldnt honor your choice are if you request a physician who's already full up, he said, "or if you request one who really cant fulfill your medical needs. By that, I mean you are requesting someone who can take care of general types of problems but you have a complicated disease. Wed have to talk to you about that because its not in your best interest.

He also said unit commanders might have some say in the process for active duty patients. For instance, some commanders may require everyone on flight status in their units be treated by a flight surgeon, he said.

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