It is relatively easy at the VA to switch to a different primary care physician with
out prejudice. It requires a written request.
That being said at the VA a patient with
diabetes has two physicians, plus a nurse (usually a nurse-practicioner) specializing in diabetes control. Then they assign a dietician.
When the primary care physician prescribes metformin
, before issuing the prescription the patient is assigned to a pharmacist, who explains that nausea is one of the side effects.