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Building relationships: New program matches families with their own primary care manager

By Airman 1st Class C. Todd Lopez

DOVER AIR FORCE BASE, Del. (April 21, 2000) -- Years ago, health care was simpler. Each family had a family doctor. Bills were paid directly to the family doctor. In some cases, the family doctor even made house calls to the home of patients sick in bed.

Today, health care is more complex. There are more options. There are sometimes confusing billing options, scores of specialists in every field, and a dizzying array of health care acronyms, buzzwords and jargon.

The 436th Medical Group is trying to change part of that. Beginning May, members will be assigned to an individual Primary Care Manager, a person who takes care of or personally arranges all the care needed by a member or member's family.

The new system will eliminate the team concept of health care currently in place at Dover Air Force Base.

"There will be no more Gold Team, Blue Team or Galaxy Team," said Col. Janice I. Lee, 436th Medical Operations Squadron commander.

The new system ensures members can look forward to seeing the same PCM each time they require scheduled medical care, said Lee.

"For example," said Lee, "If I am your PCM, and you call Sierra Military Health to make an appointment at the Dover Clinic, Sierra will call up a schedule of my appointments. Only if I have nothing available, will they look for anybody else to provide care for you."

According to Lee, members were matched up with the PCM they had seen most frequently in the past. Additionally, the 436th Medical Group attempted to ensure all family members were matched with the same PCM, although because of manning and special circumstances, matching an entire family to one PCM may not be possible.

Lee pointed out that members have the option to change their PCM if they choose.

"People still have a choice," said Lee. "If members prefer a different PCM, and if we are able to do it, we will honor the request."

The change in health care at Dover Air Force Base is part of a program being implemented at all Department of Defense health care centers because of a new directive from the Assistant Secretary of Defense for Health Affairs. However, Dover Air Force Base has actually been planning the change in advance of the recent announcement.

Lee explained the program returns the patient/doctor relationship she became familiar with during her Air Force medical training.

"When I was training, you had to have an impaneled group of patients that belonged to you," said Lee. "These were your patients. You had a real sense of ownership, both on the part of the PCM, and on the part of the patient."

"When I got to Dover, it was my number one goal for my tenure here to get impanelment of patients to an individual PCM," said Lee.

With that goal in mind, the 436th Medical Group began looking for ways to match individual members with individual PCMs.

"Because of what we were doing at Dover, we were already ahead of the game," said Lee. "The efforts we began putting into this program, well in advance of this new directive, will make us the first military facility in all of DoD to come on line with this new program."

The change to one PCM per member will provide valuable benefits to both members and PCMs, said Lee.

"For the patient, they will primarily deal with the same person each time they need care," said Lee. "They will deal with someone familiar with their history and their background. Less time will be spent explaining problems of the past, and more time will be spent dealing with current problems."

Dover Team members agree with the observation.

"It's a wonderful idea," said Senior Airman Agnes Gause, 436th Aerial Port Squadron. Gause has two children, her husband works in the Security Forces Squadron.

"My older daughter just had a rash," said Gause, "We've seen three or four different doctors. Each doctor said it was something different. If it was just one doctor, I could call back and he would be better able to help me out.

"My younger daughter is now getting the same rash," added Gause. "It is the same problem with her, we get more than one story. It would be wonderful to have one name and one number to call when there is a problem. "

Dover Team PCMs are just as enthusiastic of the change.

"I've been at Dover for a year now, and not having a panel of patients has been the most frustrating year of my practice. I am looking forward to this change," said Dr. Duncan Hughes, 436th Medical Operations Squadron. "This is going to be a huge benefit to the patient population and to the providers. For providers, this will improve ownership of patients. You will know those are your patients and they will follow up with you. It really improves continuity of care for patients."

The switch from the team health care concept to the one PCM per member concept is scheduled to begin May 3.

"On that day, the switch will get flipped in the computer," said Lee. "Sierra Military Health will begin seeing those matches in the computer when they go to make appointments."

A complete changeover to the new system is expected by May 12. The 436th Medical Group will notify members of their new PCM assignments.

"We will send out a letter to members. If anyone does not receive a letter, they should contact us," said Lee. "If the letter addresses some members of the family and not others, they should contact us."

Lee noted that only those members enrolled in TRICARE Prime or TRICARE Senior Prime will be assigned to a primary PCM. Members who have chosen the TRICARE Standard or TRICARE Extra option, may continue to receive space-available care.

Members should contact the 436th Medical Group at 677-2973 for information about the new PCM assignment system, or for information about changing assignments.

While the intricacies of the modern day health care system remain confusing to many, the 436th Medical Group is doing what it can to alleviate confusion through familiarity. Members will receive better health care because they will have their own PCM who is familiar with them, familiar with their families, and familiar with their families health history.