PCM Referral — The Bump
Military Families

PCM Referral

I am in the process of trying to get a referral from my PCM here in Japan, to be seen by my old OBGYN back in Nebraska. I am going back to Nebraska for 2 weeks in Jan. And I am hoping I can get in there and be seen (because they can't get me in here, see post on 1st Tri "So upset."). 

So my question is, how long does a referral normally take? Also if I do get the referral before I leave here, do I just call my old doctor and ask for an appointment? I am worried that they won't let me come in since I am no longer a patient there. 

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Re: PCM Referral

  • I really don't know of any doctor who would take you just for an u/s, which is what it seems like you're looking for based on your "So Upset" post. Yes, military healthcare overseas can suck, but that's because they are stretched so thin. An u/s this early in pregnancy isn't standard. Yes, it's common, but it's not a standard of practice. Many insurance companies only cover the 20 week one. I know it's a comfort, but it's not necessary. I know when I was in Korea, a lot of women went out on the economy and paid for an u/s. It wasn't incredibly expensive and gave them a lot of pictures and a CD for them as mementos. I would look into that.

       As far as not having an appt until 18 weeks, that is a little late. I would continue to call each morning and afternoon to see if they have a cancellation. There isn't much else you can do. 

       I really wouldn't attempt to get a referral, as Tricare will probably deny it anyways. Also, you'll still be in the 1st trimester and a lot of MD's won't see you in that time anyways. (Sad to say, but if something goes wrong, there isn't much they can do in the 1st tri). I would just wait until you can get an appt at your base.

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  • imagepanicked228:

    I really don't know of any doctor who would take you just for an u/s, which is what it seems like you're looking for based on your "So Upset" post. Yes, military healthcare overseas can suck, but that's because they are stretched so thin. An u/s this early in pregnancy isn't standard. Yes, it's common, but it's not a standard of practice. Many insurance companies only cover the 20 week one. I know it's a comfort, but it's not necessary. I know when I was in Korea, a lot of women went out on the economy and paid for an u/s. It wasn't incredibly expensive and gave them a lot of pictures and a CD for them as mementos. I would look into that.

       As far as not having an appt until 18 weeks, that is a little late. I would continue to call each morning and afternoon to see if they have a cancellation. There isn't much else you can do. 

       I really wouldn't attempt to get a referral, as Tricare will probably deny it anyways. Also, you'll still be in the 1st trimester and a lot of MD's won't see you in that time anyways. (Sad to say, but if something goes wrong, there isn't much they can do in the 1st tri). I would just wait until you can get an appt at your base.

    I will actually be in 2nd Tri when I get back from the States. The office here is the ones that said I need to get a referral, and said my best bet would be to see a doctor back in the States. They said there are 4 other women in my same situation right now, and they are all going to be seen back in the States. I just don't know what to do. I am looking mostly for peace of mind, because this is my first pregnancy and I am traveling 30+ hours in about 2 weeks, and then will be back in the States for weeks. If I was staying here in Japan the whole time and not traveling I wouldn't really care as much, but with traveling I am just a little worried right now.  

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  • Why are you worried about traveling?  

    To answer your original question I agree with the PP that this early in your pregnancy the standard of care is to wait.  Frustrating but true.  If you can't get an OB appointment in Japan until 18 weeks (which is a minimum of 6 weeks beyond the standard of care for a first appointment) then I would be raising holy hell.  The ultrasound should not even be up for discussion if you want to be taken seriously.  Unless there are problems, the only medically necessary scan is at 20 weeks.  Not even having a medical appointment until well into your second trimester isn't okay, though, no matter how "stretched thin" the clinic is.  If they continue to refuse to see you then I'd start elevating your complaint (again, about the appointment, NOT the ultrasound) up the chain of command at the clinic/hospital.  Start with the patient advocate.

  • I would not worry about traveling. I flew during my first trimester and was fine. My H and I drove from CA to AL at week 33 and then from CA to NY at week 38. I had my LO at 38w 5d. We all were fine, uncomfortable, but fine. I know that travel is not recommended that late in pregnancy but we had no choice, my OB's knew that I would be traveling and checked me out throughly before I left.

    We have to go to civi OB. They won't take you until you are 12+weeks. As far as a referral, it takes about 7-10 days to get it, unless it's an expeidated one, which I had to get twice. They can be done in about 24-48 hrs but you probably wouldn't be able to get one of those. I was able to get one because I was clearly very pregnant when I walked into the base clinic.

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