Dr. Barr, who is a civilian, is my PCM. She is the only primary care physician that I have dealt with at Makalapa in regards to my condition. I dislike the rule that an Active Duty Doc has to write the NARSUM. I decided I didn't want a complete stranger that has never dealt with my case writing my NARSUM. I asked my Nephrologist (Kidney Specialist) at Tripler to write it, despite him being an Army Doctor, because he has been treating me since i came into the military 3 years ago. Let me tell you that made ALL THE DIFFERENCE! There was no way a Primary care doc could gone into that much detail about my medical history and severity of my condition in my NARSUM. It still was a challenge because I have a pre-existing Kidney condition AND one that occurred while on Active Duty. I was nervous the VA and DOD would just lump it all together and just put No rating, Existed Prior to Service. My Nephrologist made sure to break apart the two kidney diseases so they would not try to screw me out of a rating. I am not sure if anyone has a Specialist treating their condition but if you do try talking them into writing the NARSUM because it seems to produce better results(in my experience) than a PCM.