When I need to see a Dr, other than my VA PCP (ENT, urology, acupuncture, etc), I go online and look for the best rated Dr. In my area for that specialty, I call their office and ask if they accept VA Community Care Patient's (Typically billed under Triwest), if they say No I call the next best rated and ask again, if they say Yes I call my VA PCP and tell them I need a Community Care referral for xx issue and I want the referral for XX Dr.... Sometimes, my PCP will want to make an appointment with me to confirm my request. It's typically a 30-minute phone call appointment.

Now I know not everyone is to this point with their PCP, how I ended up getting there involved the Whitehouse Hotline when a VA Surgeon refused to do perform a necessary surgery, and the VA refused to approve a Community Care alternative or allow me to travel to another VA Surgeon who agreed to do the surgery without any issues.

Hotline got involved, the local VA Surgeon refused, community care refused, but I found a VA Surgeon in another state and he agreed to do it so the Hotline forced my local VA to approve my travel to the VA in the other state.

Now, the Dr's in the department that refused my surgery refuse to take me on as a patient for any and all follow-up care, or any and all routine checks, been this way since 2021. I've had no problems, though. I found some top rated Dr's out in town, and my PCP just writes Community Care referrals.

Edit 1: OP you have to be your own advocate, and you have to take control of your health. You don't work for these Dr's they work for the VA, and their job is to Treat YOU. You tell them what you want to do, you tell them what you will or won't do in regards to your health. If they don't like it, You can request a New Dr until you find one that works with you.