I'm a lot late coming to this conversation and I agree with the comments. My question is what do you do if when you need a PCP to take the lead, he/she doesn't after years of seeing this patient? All that time invested in the "relationship" is pretty much gone if you move to another physician. I've seen it a number of times where the physician begins a relationship with the patient, listening, making recommendations, only to suddenly seem disinterested or not check records or make recommendations as the patient continues with years of followup. Especially when dealing with older patients . . . "whatever you say doc" when there might be something going on.