Limited Scope Medical Treatment Facilities: Your care is their priority Published Oct. 12, 2012 By Staff Sgt. Brian Stives 501st Combat Support Wing Public Affairs RAF ALCONBURY, United Kingdom -- As a result of right-sizing, 35 percent of the military treatment facilities that existed in 1987 are closed today. Because of this, few can argue that getting in to see a health care professional has become a problem across the military. As the military has downsized, the number of doctors, nurses and medical technicians has declined along with the number of other servicemembers. Despite this, the total number of people seeking care through the military's health care system has dropped only slightly. While their numbers have decreased, the vision of the Air Force Medical Service has stayed the same: "Provide world-class healthcare for our beneficiaries anywhere, anytime." To help provide excellent care, AFMS appointments are prioritized into the following types: Acute: Designed for non-emergent, urgent care requiring treatment within 24 consecutive hours (An example would be a fever with cold congestion). Established: When the primary care provider or specialist schedules a patient for follow-up care (An example would be for a follow-up on lab results or a broken bone). Routine: Appointment for a new healthcare problem not considered urgent (An example would be congestion without a fever or getting a mole checked). Well: Used for preventive health maintenance (An example would be for well-baby checkups or sports physicals). "We have a variety of appointment types to accommodate our patient population," said Maj. Lea Calderwood, 423rd Medical Squadron clinic administrator. "Getting the right set of appointments is like a puzzle for each treatment facility, due to unique patient populations and varying requirements. It is continuously monitored and tweaked to account for changing requirements, like flu season versus sports physical seasons. This year, we had the unique challenge of trying to meet sports physicals at the beginning of the school year when we were also down one provider due to a PCS gap." "There are a set number of each appointment types on any given day," said Lt. Col. (Dr.) Alison Helmkamp, 501st Combat Support Wing chief of medical services. "The group practice manager and medical staff try to make sure the right mix of appointments is available every day to take care of patients. This is flexible and the group practice manager keeps track of which appointments don't get booked. For example, if we made a whole day of annual physical appointments, most would sit empty. The group practice manager will also change appointment types - if there's an annual physical type appointment that is not taken, it should be changed to an acute appointment a day or two before so we can take care of urgencies." As the MTF works on updating their appointing guidance to improve management of appointment types, the expected wait times between making the appointment and the appointment itself will also fall. "For an acute appointment, you should be seen within 24 hours," said Calderwood. "Established appointments don't have a set standard to be seen within, it is up to your primary care provider or specialist. Routine appointments should be scheduled within seven days and well appointments within 28 days. "If a patient can't get an appointment in the timeline they feel fits their needs, they can request to talk to the nurse or leave a telephone consult with their primary care provider," said Calderwood. "It may take a while to get back to the patient, up to three hours, but if the patient calls in the morning, someone will get back to them that day," said Helmkamp. "It may be that the team nurse or medic can answer their question, arrange a prescription refill, fit them into an appointment slot, or recommend they go to an urgent care/emergency center. The doctor reviews all of these messages and will approve all of the actions recommended by the registered nurse, except making appointments." The clinic now has both primary care providers in place with full appointment capability, which has also cut down on the time it takes to get an appointment. "For most of the summer we were down to one physician due to PCS and with the addition of the new physician we have seen a 60 percent drop in nurse call-back requests," said Calderwood. To schedule an appointment, members can go to Tricare online or call their respective appointment line: RAF Upwood DSN: 268-4503 Commercial: 01480-84-4503) RAF Croughton DSN: 236-8737 Commercial: 01280 708 737 RAF Menwith Hill DSN: 262-7968 Commercial: 01423 777 968 Stavanger DSN: 224-0563 Commercial: 011 47 5195 0563 The 24-Hour Nurse Advice Line (RAF Upwood 0800-896-409; RAF Croughton or RAF Menwith Hill 00 800 47 592 330) is an additional resource for nurse advice if someone needs to find out if an appointment is needed, get advice, etc.