I know it can seem to be extra work and additional time, but I always download the labs and medical reports from my local doctors and upload them to my nurse coordinator at Mayo. I can even send my blood labs to her before they are faxed by the lab company. If there is something in particular my local doctor is looking at or concerned about, I also make a note to communicate that to my Mayo coordinator. it's just my double security, just like a house alarm or two step security online. I am committed not to let anything fall through the cracks. It took me a little time to understand how to accomplish this technically, but it has helped so much. I just celebrated my second year after my heart transplant and I haven't seen a Mayo heart doctor in 14 months. Still waiting for my 2 year appointments. So my local docs are critical for my health. On the other hand, I was sent to Mayo for a cataract, because my local ophthalmologist did not feel confident operating on a heart transplant patient. Same with my orthopedic surgeon. He wants me to have a hip replacement at Mayo. So it's a game of balance and keeping open and flexible. There is no magic button here. Carry on, my sisters and brothers. We are special!