Why Is VA Healthcare Dependent On Medical Schools?

55

VA Healthcare

Benjamin KrauseVA healthcare has enhanced its relationship with medical schools for years, but some veterans have noted a rise in healthcare from residents versus doctors.

Instead of medical doctors being directly involved in your care, most veterans interface with residents or medical students on a regular basis. What results for at least some patients is an alarming increase in medical mistakes, some of which are quite dangerous.

In a recent interview, former Undersecretary of Healthcare Carolyn Clancy, MD, lauded the longer-term affiliations between VA and medical schools as mutually beneficial.

“I think our 70-year history has served both academic centers and Veterans very, very well, but I also think that there are additional opportunities. I do think that together we can learn and help each other step up to the needs of 21st century health care, by which I mean care that is more team-based and fundamentally puts the patient at the center of care.”

The relationship between universities and VA was cemented in 1946 by memorandum. Here is an excerpt to give you an idea of what they were thinking back then:

VA HEALTHCARE MEMORANDUM

Necessity for Mutual Understanding and Cooperation. The Department of Medicine and Surgery of the Veterans’ Administration is embarking upon a program that is without precedent in the history of Federal hospitalization. It would, therefore, be most unusual if numerous problems did not arise for which no fully satisfactory solution were immediately apparent. Such problems frequently can be solved only by trial and error; and, until workable solutions are found, both parties in the program must exercise tolerance if the program is not to fail.

There can be no doubt of the good faith of both parties. The schools of medicine and other teaching centers are cooperating with the three-fold purpose of giving the veteran the highest quality of medical care, of affording the medical veteran the opportunity for post-graduate study which he was compelled to forego in serving his country, and of raising generally the standard of medical practice in the United States by the expression of facilities for graduate education.

The purpose of the Veterans’ Administration is simple: affording the veteran a much higher standard of medical care than could be given him with a wholly full-time medical service.

The purposes of both parties being unselfish, and there being no conflict of objectives, there can be no serious disagreement over methods. It will be recognized that the Veterans’ Administration is charged with certain legal responsibilities in connection with the medical care of veterans which it cannot delegate, if it would. Yet the discharge of these responsibilities need not interfere with the exercise by the schools of their prerogatives in the field of education.

All medical authorities of the Veterans’ Administration will cooperate fully at all times with the representatives of associated schools and other centers. It is the earnest desire of the Acting Chief Medical Director that our relations with our colleagues be cordial as well as productive.

If you would like to read the entire memo as posted by VA, you can get it by clicking the below link. Download: https://3mc77e18jo7n1uk8m71my8ml-wpengine.netdna-ssl.com/wp-content/uploads/2016/02/Policy-Memo-2.pdf

Sort by:   newest | oldest | most voted
Don Karg
Don Karg

02.16/2016

Dear Benjamin Krause,

Accidents will happened?

With Long term Planning and Precise placement of effort—anything can be accomplished in plain view of the whole world…and no one sees anything.

Well, Major Manufacturers are scrambling for CNC Machinists in Phoenix at this moment—-“they cannot find the guys.” I stated, “They are all dead and gone.” And the Major Companies are in an emergency mode of operation to get qualified Machinists running their machines.

Last November the US Committee of Employment got a rude awakening in their report—X amount of workers are never coming back to work —because they are gone.

This is the Same severe Problem at the VA—which is causing many of those neglected 293 deaths, per year; and no investigative reporter in this country will write about [CNN, GANNETT, TEGNA, The Arizona Republic, NY Times, Washington Times, LA Times, Chicago Tribune, The Daily Breeze, The Press Telegram, OC Register, Time Magazine, etc…]

The VA Scandal/Sabotage has been out there since John Van de Kamp was Attorney General of California in the late 1980s—Nurse Shortage. All the Students are well rehearsed on this coming Disaster.

Only the Public is not aware of this imminent danger.

Again call it what you want.

Sincerely,

Don Karg

FEB 19, 2016 | Hearing
Best Practices in Veteran Hiring

Stu Steinberg
Stu Steinberg

I have been getting VA care since 1993. Battle Creek, Portland and Bend, Oregon. I have never been treated in a medical situation solely by a resident. When I had my cataract surgery, an ophthalmology surgical resident, supervised by a medical doctor surgeon, did the perfect job. I would need to see some actual statistics that show that more professional negligence is committed by residents than MDs or DOs. I have serious doubts that this is true without seeing proof. As far as hospital affiliations are concerned, in Portland, Oregon Health Sciences University is just across a walkway from our medical center. It is one of the top ten medical institutes in the world. Much of the Portland oncology cases are handled at OHSU and I have had many, many clients successfully treated there. I have not had a single client, in the past 38 years, who was treated in a medical situation by either a resident or an intern, without supervision. Moreover, is this also saying that we should not have a primary care person who is either a nurse practitioner, or a physician’s assistant? Many of my clients see NPs or PAs for primary care and love them. Sorry, but I think this a complete BS issue.

Don Karg
Don Karg

02/16/2016

Dear Stu,

Yeah, it is hard to believe there is problem when everything around you is going good.

Jump out of your shoes and stand in someone elses for awhile.

Back in 1988, I heard a story too hard to believe too! Called the guy nuts—-thought about it for a day and told the guy—I will take that challenge. By Late October I was calling it Treason at the gates of El Segundo Air Force Base [Roy at OSI]. Soon Congress was forced into pumping out the 900 Page Document of Treason called the 1998 Cox Report.

Sorry to say, Stu—the Smell is the same.

Sincerely,

Don Karg

Joe Weil
Joe Weil

Don Karg, you are a nonsensical opportunist. You are not going to find qualified machinists here. Quit bothering brothers looking for care.

Joe Weil
Joe Weil

I agree with Stu. I have received nothing but the best care from students of UCSD Medical School that is also a bridge walk away from the The La Jolla VA Hospital. I do realize that we are very fortunate to have a responsible San Diego area VA. They ain’t perfect… I can tell stories… but overall my care has been very good and very professional. In all cases the resident/fellow/intern will acknowledge the physician they are representing and you have the right to ask for the physician. The students I have been exposed to are very good, and very receptive.
At any time I can contact my health care team by private messaging and this helps clean up any loose strings like prescriptions or appointments. My wife and I are both Vets and her response is better than mine! We find that we have an easier time getting appointments at the VA for referrals than in the private system we had.

DMD53
DMD53

It does sound like they have their act together where you are. Maybe you could encourage the leadership and staff there to get involved in communicating their best practices to other VAs? A big part of the incompetence within the VA involves their lack of fluency with organizational change methods–there is constant churn related to inventing new wheels…which gets compounded by the flushing of senior leadership when the administration changes from repub to demo and back again.

When one organization is doing things well, other organizations can learn from this–just as students learn from those more experienced. What’s needed for this to happen is a group inside to push for it. I hope you’ll consider doing so :- )

91Veteran
91Veteran

Good for you Stu, but your experience doesn’t translate into reality for many vets. I could just as easily claim that because I have been examined by unsupervised students that no student is supervised when seeing vets, but I won’t make that claim because I am not arrogant enough to believe every vets experience is like mine.
As for nurses or PAs, I have had good experiences and bad experiences, to include a nurse practioner who blatantly falsified my paperwork. Again, I am not arrogant enough to believe that my experience is what every vet experiences.
I can say on both subjects that both experiences of mine are much more common given what other veterans have stated. Given their experiences are similar to what I have had, I don’t automatically react that they are BSing me.

Vic
Vic

It may be a BS issue to you, but to those that have/are suffered/suffering it’s 100% bad care.

Don’t miss the point though, it’s absolutely fine to have students giving care under the auspices of the doctor, however in the case of my doctor, when he heard that I told the internet that I had never met my doctor, he barged into the exam room, and lied to me without blinking.

Everyone on here is happy for you receiving good care, and perhaps it has to do with fact that the Naval Hospital had/has a good working relationship. I don’t now the answer, but fact is, veterans do not deserve sub-par care for ANY reason.

Vic
Vic

I’m sincerely happy for those that receive quality care where interns are involved, but please do not deny the facts that show interns being highly used.

I ‘had’ an endocrinologist, and in the time I had him I saw him once, literally, for a few moments, and that was only because I told the intern that I had never met the man, and then the doc came in irritated, lied to me, and left the room.

As it turns out, my private endocrinologist knows the man, knows he’s a bad practitioner, and had to fix his mess…I was the mess. As it turns out, my endocrinologist diagnosed me in 10 seconds flat as being ‘under-medicated’ DESPITE the fact that all the numbers were fine.

Again, happy for those that are getting good treatment, but don’t EVER write off your fellow veterans that have not had your luck, and I do mean luck.

Question: Has anyone discovered that your PCP is usually a NP/RN, and that many are licensed out of state? Yes, out of state where you cannot file a complaint?

91Veteran
91Veteran

Yes I have found many PCPs that are nurses, PAs or other than doctors. Yes I have found many are licensed out of state, but that doesn’t matter. The VA claims, and several state agencies believe that claim that VA medical providers are exempt from state oversight because they are practicing on a federal reservation.

I do notice though that state agencies will investigate if the issue becomes embarrassing enough, like they did in Tomah.
A veterans only recourse is to go to the Patient Advocate and request in writing that you be assigned to another PCP. They likely already have a stack of complaints from other vets wanting to be reassigned, as I found out in my case.

As for complaining to a state agency, I haven’t gotten POd enough to do that yet, but if that time comes, I won’t hesitate to do so.

crazy elf
crazy elf

@Stu and Joe
First, let me congratulate you both for receiving great healthcare!

Now, no one is stating some veterans aren’t receiving good to great healthcare. Problem is, the majority aren’t! This is why veterans seek websites (plural) such as this, to express their concerns and complaints about VA!
This is also why VA has such a bad reputation. Each week, at least one article comes out exploring and explaining the “Who, What, When, Where and How” veterans issues (healthcare & administrative) are NOT being handled properly by VA employees (from administrative personnel, physicians, nurse practitioners and others) and VA upper management!
Yesterday, I gave an “article” for anyone to google! It was from “The Daily Caller News Foundation”, by Luke Rosiak, dated 2/15/2016.
Titled;
“Congress May Fix VA by Merging Them with Military!”
It’s a great article showing “What Could Be” with VA, IF VA were to be “…held to the most stringent rules and regs…” ,(Title 38)! Which, in the majority of VAMC’s and VARO’s is NOT the case!
Here’s another fact. In mid 2014, a local news station here in Central Florida, WOFL, Channel 9, ran a negative article concerning the “dismal healthcare” provided to veterans! At the end of the article, the news caster said these words, quote; “Who would want to work for VA?” Right now, nationwide, VA IS having a hard time recruiting physicians, NP’s, PA’s etc.
There have also been “reports” coming out from the G.A.O. concerning the MANY egregious act of “waste, fraud and abuse” by VA employees, upper management and civilian contractors!
There have been articles coming out about the “hiring practices”, or lack thereof, of VA! One in particular stands out, concerning a “Pain Management Physician” hired at the Illiana, Illionios VA hospital last April 2015. In late June or early July, law enforcement arrested him, and he was extradited back to Indiana on “three (3) counts of murder” over warrents from the previous year! There have been others also. Question; doesn’t VA “vet”, or do a backround check, BEFORE hiring an individual?
Believe it or not, the VA even hired a “convicted mass murderer”! Fact, not fiction on this one!
So, again, you see not all is well within the “Halls of the Veterans Administration”!

Side note to you. Read many of the “Blogs” Ben has researched. Then read the many comments from veterans and others. Before you decide to denigrate those whom have not had the “Great Care” you two have had!

Don Avant
Don Avant

The VA uses interns and residents for one reason…IT’S CHEAPER…

At the two hospitals at which I’ve had experience..Tucson and Birmingham AL…The experience was much different…

In Tucson the VA partners with the UofAZ Health sciences center….Which excels in Heart, Neurology and Urology…The care given by the Interns and Residents is incredible…

In B’ham on the other hand, All of my Heart related issues have been handled by physicians the are from other countries…From the accents probably from India or Pakistan…and they are VERY touchy if you ask them where they’re from…Also very touchy if you ask questions or suggest avenues of treatment other than what to VA line is…

All in all, I’d much rather deal with someone who at least firmly understands the language in which we’re trying to exchange life threatening information…

namnibor
namnibor

I find it rather sad that some people feel just because they have been incredibly lucky in receiving great care from the VA, that it somehow in their minds means that everyone else must be wrong since everything is rosy through their view point. As crazyelf well-stated, this certainly is not the case for the majority of Veterans.

Of the few dozen Veterans I still keep in contact with there’s quite literally only -3- of them that are “okay” with the care they get at the VA…but of those -3-, they also have not had to use the VA for anything more than a yearly exam/check-up, no addressing of serious health conditions.

The unfortunate truth is the majority of Vets are NOT getting great or even marginally satisfactory care. It seems to be the EXCEPTION that a Vet actually gets great care from the VA and the very location of that VAMC can be a night and day difference because the VA lacks standardization of care across the board.

Standardization of Care also is important at the patient level as in wanting a consistent medical team that will actually communicate with each other and veteran about their total care…the VA’s equiv. of this can be found at any fast food drive-up window and imagine the person you are speaking your order to in the intercom is from Pakistan…a LOT gets lost in translation and more.
Way too any VA employees that barely speak English as a second language and some that barely can even pass at that…then you are forced to deal with a Medical Assistant playing Dr. or a Nursing Assistant, both of which could easily place inconsistent line items in your medical chart that impacts a Veteran to point of making them homeless or even their death.
Give me a REAL Dr. anytime and one that is an American and ideally, a fellow Veteran. I welcome the military taking over the VA AS LONG as the upper management are ordered to haunt another agency and never again the VA.

Rant over.

crazy elf
crazy elf

@namnibor
I don’t consider your “comment” a “RANT”. I consider it a sound evaluation of what should be happening Nationwide with all VAMC’s and VARO’s!

We, many on here, have heard physicians, PA’s, Nurses, Nursing assistants etc. explain “Not all VA’s operate the same!” Only, in reality, they’re supposed to follow all rules and regulations set down in “Title 38” and other rules and regulations set down by Congress! Why each VAMC or VARO refuses to abide by these rules is a complete mystery!
After reading the article I posted on here yesterday, “Congress May Fix VA by Merging Them with Military!” I honestly thought some great things might occur. Yet, the article said the VAMC/Military Hospital in question was a “test case”! It has been going on for around four or five years. What caught my eye was this Military Hospital/VAMC was $12 million UNDERBUDGET! Which means, as the article pointed out, this Military Hospital/VAMC will not receive $12 million this year! Which, in my opinion, translates to no one getting their hands dirty!?
Not only that, the “active duty military, veterans and all spouses were receiving great healthcare! Which cannot be said for all VAMC’s and VARO’s Nationwide!

My hopes are the three gentlemen who were contacted, (scripps & WCPO reporter), will investigate by coming on this and VAWatchdog, to see just how screwed up VA really is. I also hope they will read the numerous comments by all. Good or bad, VA needs to learn a lesson!

91Veteran
91Veteran

In some respects being affiliated with a medical school is good for veterans because they might have access to better doctors than are at the VA, but this is rare that the VA will request they look at something. In other respects it is bad for the veteran because these students are often acting alone because the VA doctor is too lazy to be with them supervising them. If the doctor does take their job seriously and are with them, the care is often better because the doctor wants to show the students he/she knows their job. In other instances, you see the student who is misleading and acts like a doctor, or they admit they are a student, cannot answer anything and have to go find the doctor.
I believe this could be a good thing for vets because there is less likely a chance of a quack doctor giving you a BS answer if another person (witness) is present, but that would mean their agreement should be clear in requiring direct supervision.
I am also curious if the VA gets any kind of monetary or other reimbursement for this arrangement. I would not be against a VA doctor being paid extra, so much per student, but only if direct supervision was mandated.

namnibor
namnibor

That’s the rub. When I utilized the VAMC, it got to where I would politely ask if they were the attending or a resident…in more cases than not, like 91veteran stated, they will then tell you they are a student…I never once had both in the exam towards end of visit, usually a med assistant would then be sent in, next!

Now that I use Medicare solely and at a State University Medical Center, they ALWAYS have the resident come in first, you know well-ahead of this, even asked if it was okay with me (for real), then that resident talks with the attending then BOTH **always** are in the exam room latter part and making sure I have all questions answered. It’s the way I am told it is mandated to work, I have asked.

Even though I am fortunate in great care, it does not mean I adopt an attitude of ‘I am doing well, what’s everyone else’s problem’ and live with rose tinted glasses. We were trained to never ever leave a soldier behind and although we are civilians now, our fellow Vets that are being left behind or lacking seriously in quality care need us veterans to help change things for better for them and all future Vets.

The way the VA uses medical residents should be mandated to direct supervision…but that’s way too close of a cousin to that VA Kryptonite called accountability.

So it’s a mixed-bag. It again falls on whether the VA follows the laws, regs, and HIPPA already on books. How well has worked for us?

91Veteran
91Veteran

I’ve had similar experiences at the VA…the doctor comes in with the student and asks if the student can be present, which I never have a problem with because someone is trying to learn.
On the other hand, I have stood in the doorway of the VA hospital room in Houston and had a chat with what I thought was a neurologist at 9:30 at night, and was told that was the extent of the exam I was getting. I found out he was a student a couple days later.
I don’t have a problem with students as long as they identify as students, and not try portray themselves as as the Surgeon General.

namnibor
namnibor

That potential of “The God Syndrome” is very strong with that profession.

Kirk R
Kirk R

Personally I think that Veterans should receive the same protections in their health care as civilians. That includes having qualified medical professionals treating them not leaving their care to students.

Also after reading the trolling Stu Steinberg pontification I do have something to add.

When Stu was an attorney for VVA from 1978 until 2004 he should have been representing veterans and not the VA. One of the many reasons VA healthcare is so screwed up right now is people like Stu and the VSOs they worked for. Protecting the VA instead of representing Veterans.

This new scam involving the recently created “National Veterans Rights Association”, Luminec Corporation and their quest for Veterans Choice Dollars is truly shameful.

A lot of people will be looking into your new scam Stu.

crazy elf
crazy elf

@Kirk R
Thanks, I thought that name, Stu Steinberg, sounded familiar! No wonder he’s receiving great healthcare!
Is he still involved with VVA? If so, what capacity?

I don’t believe Stu will be “visiting” us again any time soon. He’s spread his “line of crap”, and will slink off to another site.

I wonder about the other “troll” – Joe Weil. Seems I’ve seen him on here before!? Same “line of crap” then as now!

namnibor
namnibor

My ‘Troll Senses’ were indeed slightly going off this morning but blame this lousy flu-bug for clouding my ‘Troll Alarm’.
I thought the name ‘Stu’ was familiar as well. What a self-serving lot they are!!!

John
John

This practice is very dangerous…residents have committed malpractice on me ….I now ask for an MD…..but then not all are california MDs…out of state is ok to the VA….

Vic
Vic

‘Out of state is okay for the VA’ That comment got my attention, in that when the nurses and doctors are from out of state, you can’t go to your state to complain, and from what I’ve seen while filing complaints, the state the practitioner is licensed in can NOT take a complaint.

Point is, if you can’t complain to a state board, then in a twisted way they are shielded, and I can’t help but believe that the VA is FULLY aware of that fact. I know two PCP’s I had are free to practice because I can’t go after them.

Ben, what can be done when practitioners are from out of state?

Anyone, what can be done when they are from out of state?

Where’s the recourse?

91Veteran
91Veteran

I would really like to hear more from you about the details of any complaints to a state regulatory agency. Did your state accept any complaint? Did they investigate? If so, what did they do? From everything I have found, VA providers licensed in your state or out of state are exempt from any state regulation because the VA claims they are a federal reservation.
This does not explain the many providers working as contractors at a VA, or those who work at a VA and have a private practice. I’ve found many nurses and doctors that do that, but so far I haven’t found any state that will accept a complaint or investigate.

Jim Hadstate
Jim Hadstate

“Instead of medical doctors being directly involved in your care, most veterans interface with residents or medical students on a regular basis.”

A big fan and read this page regularly. That said, let’s make sure that we are using the proper terminology/descriptions in the reporting. Residents ARE real, live medical doctors. And the plain fact, something that a lawyer should know as it is the same within the legal community, is that medical students generally know far and away more about medicine than the guys who have been out there for 20 years. The reason? Because medical students learn only the most current stuff as opposed to outdated information. Medicine, like most sciences, is advancing in quantum leaps and what was true today will be outdated next week. And…medical students ONLY practice under the direct supervision and in the presence of a medical doctor, whether a resident or a long-time practicing physician.

Sorry, but you touched a nerve with that one since I am the father of a young doctor who is about to finish his fellowship in cardiology. Meaning that he will have been in training for most of his 35 year age. That would be 6 years in primary education, 6 years in secondary education, 5 years in undergraduate training with tree majors and 2 minors, 4 years medical school, 3 years as a resident and, now, 3 years as a postdoctoral fellow. Do the math, and you will find that he has been in some kind of educational training has more than taken up 75% of his entire life-span. He has also spent the last 7 years taking his turn at shift work at the local VA hospital while he has had to do the studying required of a resident and a post-doctoral fellow in very, very demanding schedule of a top ten ranked residency/fellowship programs. I also happen to know that he has not exaggerated his study requirements, since he lives less than a mile away and my wife and I frequently have to babysit while our daughter-in-law and he are finishing their educations.

God knows that I am not a defender of the VA and its misfeasance and malfeasance in its charge to keep us healthy and expeditiously manage the benefits set forth in law. My son does not recommend me seek the VA for health care. He has seen too much of what has become an everyday news item…the latest scandal and/or theft of funds in/from the VA medical and benefits system. He tells me about the poor quality a few of the staff doctors (he does say that these are a very tiny minority of the physicians there) because the doctors can make so much more money in private practice or on a non-VA hospital staff. But, as he says, you only have to draw the incompetent one just a single time to get a one-way ticket to the mortuary.

His recommendation on the needed improvements in the VA healthcare system? Cut the staff of bureaucrats at the VA by 50%, Congress must appropriate enough money to hire enough doctors and nurses to reduce the patient/provider ration by a huge number and Congress needs to raise the pay scale of VA doctors and nurses so that the good ones don’t continuously leave to make more money. And then Congress needs to engage in extensive and meaningful oversight of the Executive branch to ensure that the VA is spending the taxpayers’ money wisely and to accomplish what the law says it should. But, Congress’ oversight has to be more than the facade it has previously done in its oversight role. A Hell of a lot more. That advice from a non-vet, but someone who has actually practiced at the VA and who believes that the VA healthcare system is vital and the VA benefits system are an obligation to the vets owed by a country that asked so much of them. See, I DID raise him right.

crazy elf
crazy elf

@Jim Hadstate
In my opinion, “YES” you definitely raised your son right!

I have a few questions for you. Please do not take offense.
Since your son has basically warned you away from VA for your healthcare. I believe he may not be informing you of ALL the egregious acts committed by VA employees against veterans!
Has your son said anything, or witnessed anything, concerning any form(s) of egregious acts or malpractice committed by ANY healthcare professional? Or any VA employee?
If he is/was privy to any egregious act(s), did he “Report” it? If not, what was his “reason”? If yes, what was the outcome?

The reasons I ask these are simple. We’ve had numerous individuals come on here, and other sites, to explain the “WHY” they wouldn’t report “acts against veterans!”
The worst one, in my opinion, is “I didn’t want to be fired!” Another poor excuse is; “I’ve seen the terrible things that happen to Whistleblowers!”

You and I are about the same age, I’ll bet. I’m 68, be 69 in April. My father used to say: quote; “There’s no reason for an excuse!”
People who look the other way when a possible crime is being committed are, in my opinion, just as guilty as the perpetrator!

Before I forget. I’ve been seen by med students. There were NO other persons in the room, except my wife! We both asked for a physician to be present. Nothing more was done. The med student stood up and said: quote; “This appointment is concluded!” He then walked out. We gave our “concerns”, in writing by my wife, to the “patient advocate”. Nothing came of it. The student was transfered to another clinic!

There’s many stories coming out where physicians, and other healthcare professionals, do not have to be registered in your/my state. I was even informed they don’t have to carry malpractice insurance here in Florida. As is the case in the civilian sector as well. Thanks to Former Gov. Jeb Bush!

Sandy Hale, Retired Nurse, Disabled Combat Veteran
Sandy Hale, Retired Nurse, Disabled Combat Veteran

YOUR DEFENSE OF YOUR STUDENT DOCTOR SON AND HIS PROFESSION MAY SOUND ADMIRABLE TO YOU BUT NOT TO THE THOUSANDS OF VETERANS AND THEIR FAMILIES THAT ARE DEAD OR DISABLED BECAUSE OF VA MEDICAL STUDENT ERRORS. MAYBE YOUR SON IS THE MOST BRILLIANT STUDENT DOCTOR IN THE WORLD, BUT DON’T PUT HIM IN THE SAME CATEGORY AS THE REST OF THE VA STUDENT DOCTORS OUT THERE.

YOU ARE WRONG ABOUT THESE MEDICAL STUDENTS BEING CLOSELY SUPERVISED BY PROCTORS AT VA HOSPITALS, MAYBE ELSEWHERE, BUT NOT VA HOSPITALS. AND YOU ARE WRONG ABOUT STUDENTS KNOWING MORE THAN EXPERIENCED MEDICAL PERSONELL.THAT IS PURE ARROGANCE. I AM A RETIRED NURSE OF 35 YEARS AND MY JOB AT A TEACHING HOSPITAL WAS TO PROTECT MY PATIENTS FROM THE STUDENT DOCTORS WHO WERE BOOK SMART BUT HAD NO REAL LIFE EXPERIENCE.

THE FIRST THING I LEARNED AS A STUDENT NURSE WAS THAT EVERYTHING WAS NOT IN THE BOOKS AND PRACTICING ON A DEAD BODY WAS NOT THE SAME AS A LIVE HUMAN BEING. THE WHOLE IDEA OF INTERNSHIP IS TO GAIN THAT REAL LIFE EXPERIENCE THAT IS NEEDED TO BE A GOOD MEDICAL PROFESSIONAL. DOCTORS NEED HANDS ON EXPERIENCE AND TRAINING TO BE A GOOD DOCTOR AND TRIAL AND ERROR IS NOT THE WAY TO DO IT WHEN YOUR HANDS ARE ON A REAL LIVE HUMAN BEING.

I HAD INSTRUCTORS AND PROCTORS STANDING OVER ME LIKE HAWKS TO MAKE SURE I DIDN’T MAKE A MISTAKE AND IF I DID, THERE WERE RIGHT THERE WITH THEIR HANDS ON IT WITH ADVANCED KNOWLEDGE AND TRAINING AND EXPERIENCE TO CORRECT IT. THE PROUDEST DAY OF MY LIFE WAS WHEN I WAS TOLD I WAS EXPERIENCED ENOUGH TO DO IT MYSELF. THAT’S THE WAY IT SHOULD BE, BUT THAT’S NOT THE WAY IT IS AT THE VA HOSPITALS.AND THAT’S WHY THERE ARE SO MANY MISTAKES AND SO MANY VA LAWSUITS AND SO MANY DEAD AND DISABLED VETERANS.

I REALLY CAN’T STOMACH PEOPLE WHO WANT TO DEFEND SOMETHING BECAUSE IT WAS A GREAT EXPERIENCE FOR THEM. THERE ARE ALWAYS THE EXCEPTION TO THE RULE, BUT THE RULE IS THAT THE VA HOSPITALS ARE KNOWN FOR THEIR STUDENT ERRORS AND VETERAN’S DEATHS BECAUSE OF THEM.

AS FAR AS I’M CONCERNED, THE FEW VETERANS AND THEIR FAMILIES WHO HAD WONDERFUL STUDENT DOCTORS AND MAGICAL EXPERIENCES AT THE VA HOSPITALS CAN ALL GET TOGETHER AND SPRINKLE PIXY DUST ON EACH OTHER AND PRETEND THERE ARE NO BAD THINGS IN THE WORLD. BUT I LIVE IN REALITY AND IT MAY SUCK BUT I’M ALL OUT OF PIXY DUST.

Editorial Staff
Member
Editorial Staff

@Jim, I appreciate the zeal for your son’s sake. But it seems you are conflating a “medical doctorate” degree with being a medical doctor licensed to practice medicine.

The issue here is that a person is not a medical doctor until they are licensed to practice medicine. This is similar to a graduate from a law school who is not a lawyer until they are licensed to practice law as a lawyer following passage of the Bar.

Med school takes 3-4 years. Residency takes 3-4 years. Then the person can get their license to practice medicine. If they want to get a specialty, then a fellowship is required for an additional few years. Then they can even take their boards, which is now a requirement within VA. However, most fellows are able to practice medicine with limited supervision. They run VA emergency departments on weekends or when the facility is short staffed.

The issue I have seen as a lawyer are cases where residents are not receiving adequate supervision and veterans are harmed as a result due to failures to adhere to standards of care. Without staff doctors reviewing the work, errors can and do happen, sometimes at the worst possible times.

sher
sher

…Such as a resident being placed in charge of my treatment and over dosing me with a very dangerous medication resulting in blindness in one eye ( temp), psychosis, kidney stones, loss of memory, failing the testing for dementia, neuropathy, etc. No one will take responsibly of this, tried to put the blame on me. Was put on medical leave at my University that I was attending on Chap 31. I have no idea if the VA will allow me to return. No one cares and there is really nothing I can do about it.

Ken Bennett
Ken Bennett

Yup, he was raised right, perhaps he should go to law school next and I AM serious, he would then truly know both sides of the coin, and then advocate for what he belives

sher
sher

I had a terrible experience recently. My new Neuro at the DTLA clinic passed my chart to his resident. The resident obviously did not read it, and TRIPLED my migraine medication. I was in the Chap 31 program attending a well regarded university. About a month after the meds, I began to have symptoms, which included loss of short term memory, inability to comprehend the materials – Went from A’s- D’s. The symptoms got worse, ending with pseudo blindness, psychoses, voices telling to off myself. the school placed me on medical leave of absence. During this time i was sending word to my neuro about these symptoms, NEVER once did they ask about my meds. Finally some friends intervened and called the DR. Who told me to just stop taking it, cold turkey. Thank goodness my friend was a nurse and told the Dr i could have withdrawals and even a heart attack if stopped cold turkey. The Dr responded = At 50mg she wont…my friend said she on 150. The Dr freaked. and asked why I had tripled the dosage. My friend said its what YOU prescribed. It has taken me two months to detox from the meds. My eyesight is still affected. I Have NO recourse with VA medical care in the wake of this dangerous medical care.

Julia Perry Briggs
Julia Perry Briggs

bless your heart. And, it isn’t true. You have recourse. How about calling me 256-650-5743. I’ve been victorious where others couldn’t be. Regards, Julia

Julia Perry
Julia Perry

do not forget the Student Nurses

Doublespeak Ted
Doublespeak Ted

Wow.. There’s a lot of VA stool pigeon, out today !!
I wonder what the going rate ?

Richard
Richard

I’ve noticed this for years, that trainee doctors/residents without board certification are providing me service. However, I don’t do much of what they say, including for my PCP. She said take aspiring or statins, I said no. She asks for me to take vaccinations, I say no. I read that when I read about a food supplement that I started taking to advise your doctor about it. When I advise my doctor, she says that she is not trained in supplements, but does not even suggest that I go to their nutritionist. When I said I was taking diatomaceous earth, she asked what that was and needed to ask my how to spell it so that she could enter it into my med record.

My most interesting appointments have been with the eye doctors:
1. Eye doctor could not understand why when I had cataracts in both eyes one eye was not affected. She referred me to their super specialist a doctor who only came in once a month. She was a combination eye doctor – neurologist. She was not sure why one eye with a cataract did not have a sight problem. She called in her supervising doctor and she was shown that that cataract was not in the line of sight so did not affect vision in that eye. The supervisor asked why I have an appointment with this specialist (I could see that she was a neurologist and amateur training in eye work), and asked who the eye doctor was that referred me. I said that I can not remember her name from a month ago, but he should look into my record for the name. Then he said that he will not check because he rather not. I said to myself that two of these doctors need to take Eye 101.
2. The VA has been encouraging me for cataract surgery on the eye that has vision problems. So I went for another appointment for one of their resident eye doctors. Before the appointment I did research to update myself on cataracts. From that I learned that there was a contraindication for cataract surgery due to the fact that for many years my eye lashes would stick together at night and were very painful and crusty in the morning. I had to rub my eyes in order to free the eye lashes and be able to open them. Such rubbing can not be avoided and if done after eye surgery could cause a devastating eye infection. After repeating this contraindication several times the eye doctor resident said that I could not have cataract surgery because of this contraindication. I felt as if I had trained her.

My main point is that as a patient at the VA or any other med facility you need to do your research and determine if the advice you are being given is really what you need to do. Then you need to speak up and review the treatment with the doctor. At least the VA doctors are flexible about allowing the veterans to participate in their care. Some civilian doctors, when told that I would not take a vaccination or have my son take a vaccination became extremely hostile.

buddha
buddha

The VA is one of the top clinic’s to get internship at. Who wouldn’t want their foot in the never-get-fired organization? I had an EENT doctor that couldn’t see 2″ in front of him: he smashed paper inside his eye-orbital socket, seriously, moving it around. He didn’t say anything that verified he read anything though after that pathetic display. I wonder if he was a surgeon, lol. Because they can’t get fired, they have no professional drive to learn: not all, but quite a lot for a medical profession. They are the leaches of organizational efficiencies killing motivation in all tiers under them. And what about Vet’s safety? It’s a non-issue evidently.

The VA has no managerial component at all. With their resources, they should rock: but instead are pathetic. Pick and choose the services you use very carefully, and research your provider the by the best means possible. God Bless You!

Vic
Vic

Your’e right, they can’t be fired, and as it appears you can’t even file a complaint on many. What I’ve run into is PCP that are licensed out of state, and the licensing state has nothing in place for complaints from out of state.

I have filed three complaints that were kicked back because the state won’t/can’t investigate out of state complaints, and each referred me to the VA Patient Affairs. Tucson has two Patient Affair representatives, and the ration on that would be 1:250,000..maybe.

I’d rather see military doctors that understand ‘military’ talk/behavior/thinking, I’d stand a fighting chance. Recourse in the military was something that all had access to, but not so in the “VA” world…

I’d like to see a study that gives us facts. How many eligible veterans are there, and of them, how many use the VA. I think what we’ll find, is that the amount of money the VA receives is NOT fully accounted for by the scant number of veterans receiving care…

91Veteran
91Veteran

I recall a quote from Senator Rockefeller in USA Today when he chaired the Senate VA committee in the 1990s.
He said the nation had 26 million veterans, and less than 3% used the VA.

I doubt that number has improved.

Sandy Hale, Retired Nurse, Disabled Combat Veteran
Sandy Hale, Retired Nurse, Disabled Combat Veteran

I had the same experience with my complaints to the Texas Medical Board about VA doctors and nurses. Its not a coincidence that their licenses are out of state or out of country. The Texas Medical Board and your local state board will not discipline them or investigate them claiming they have no jurisdiction. so I sent the complaints to the States that they held the license in and they said the same thing as Texas. They refuse to investigate or discipline because it happened in Texas and not the state that their license is in. They are giving us the run around. Our Congressmen should be all over this, come on Veterans, start complaining. Even if your Congressman is a jerk, if enough of you voters demand action, they’ll pretend to do something. Just bringing it out in the open is waking up other veterans.

I refuse to believe that all this is NOT done deliberately. Last year the cover of Legions Magazine was a VA cementery and the main article was complaining that veterans were dying faster than the VA could bury them. I know why. Its because that’s the plan. Again, anything wrong done at the VA hospitals, clinics and Regional Offices is condoned, encouraged and rewarded. Get ready to become a statistic

The VA always wants to talk to me about my complaints over the telephone because there is no record of it. No evidence. So I put everything in writing now and keep copies. I suggest you do the same thing. You have to sign up to use their website http://www.myhealthevet.va.gov and then use their VA secure message feature. I send emails when I want something documented because these emails actually go into your medical records and you can print them out and download them with the blue button. Just don’t trust the blue button for copies of your medical records because those are the altered medical records, not the real ones. Get the real medical records in person or by mail.

Secure messages are evidence and amunition in Court for when the VA intern makes that fatal mistake and kills you, your family can have some evidence for the FTCA claim. Like, they give you the wrong medicine or dosage, I secure message the doctor and say” Hey, did you change that prescription because I recieved the wrong dosage again from the pharmacy?” They have to answer you and you can send complaints to VA consumer affairs and have a record of it. You can download medical evidence and even upload documents and have proof you sent them. You have to use Firefox browser because Internet Explorer doesn’t let you upload and sent documents thru their VA secure message system.

91Veteran
91Veteran

I would like to use Secure messenging, but I just logged into it and I can’t tell how to address the message to who I want to send it to.
The only two available addresses are Securemessenging tech help and audiology. I would like to send a summary of my ortho appointment to my ortho doctor because she didn’t write anything about the pain shooting down my legs. She indicated problems with my knee replacement, and mentioned I have lower back pain, but it is downplayed from what I reported to her.

DMD53
DMD53

I used to receive care at the Seattle VA and it was only after repeated problems with misdiagnosis, substandard care, and lack of communication/follow up that I finally figured out that residents–and in many cases interns (first year residents)– were seeing me. They used to be very sneaky about this at the Seattle VA. I found that having the scheduler note “patient requests to see attending only” when making appointments cut down on this practice. I would also ask at the start of any new encounter–‘what year are you in your training?’ to make it clear that I knew how the system worked, and that I knew they were using me–and I DO see this medical school training process as a way of using veterans. For the most part the medical trainees benefit far more than veterans do…and I think we should have the absolute right to refuse to participate in medical training and to opt for board certified fully trained MDs. If you think that “new is better” more power to you…but I want experienced doctors who can think systemically and have something besides their textbooks and anatomy classes to draw upon. I also think we should have access to a great deal more alternative, complementary, and integrative therapies as well…but that’s another post/rant.

Once I learned to advocate for myself re: expectation of seeing the attending, that doctor would still sometimes bring a resident/intern/med student with them and do the “would you mind?” routine–and I was sometimes OK with that–so long as I was asked. What I was not OK with was medical trainees (whatever year) pretending to be fully fledged and experienced doctors and seeing me on their own. I think this sort of behavior is totally disrespectful to veterans.

I haven’t sought care at any other VA medical center, but in Seattle I also think there is an assumption that veterans are stupid and this plays into how we get used by the medical training system. For example, I fought for a year to get fee service for a hip surgery and the VA cancelled it at the last moment because (1) they lost the paperwork which led to a delay and expiration of my authorization, and (2) during the delay the attending who had originally fee serviced me out received funding for a dedicated VA surgical center training orthopedic fellows in the same procedure. Instead of honoring the fee service arrangement, this doctor had the nerve to call me to give me the “great news” that even though I could no longer see the world class expert I’d been waiting six months to see on the outside of the VA system, his ortho trainee would be “just as good” because the attending doctor would be watching over his protege’s shoulder. What a bunch of crap. (I passed on this ‘great opportunity’ and fortunately was able to marshall other resources for the surgery.) And this is just one example of a common pattern I experienced over 10+ years, in which doctors, residents, and interns provided substandard care and in many cases treated me like I was an idiot–giving me simplistic answers to my questions, not taking the time to explain alternatives or risks/benefits, etc. It got to the point where I was so tired of the insulting behaviors and the need to run interference on their medical incompetence/indifference that I would introduce myself by saying “I have multiple advanced degrees so you can expect that I will be asking you a lot of questions and I expect thorough answers. If you haven’t factored that into the visit please do so now.” Some of the doctors were OK with this, but many/most were not–and I was never rude, simply assertive. Over time, it just wore me out and I grew to hate going there. Now, honestly, I will do anything to avoid that place. God forbid I get really sick in my older years and need serious care…because I will not go there any more. I haven’t looked for any data regarding medical error rates at the VA but I would certainly look into that data these days before having anything serious done there.

People often talk about culture change at the VA blah blah but I’m more pragmatic, and to help safeguard the rights of veterans I think there should be large signs–like public service announcements–in VA hospitals which explain the medical training process to vets and at minimum, encourage them to insist upon seeing the attending for confirmation of resident diagnoses. It’s one thing to agree to participate in medical training (informed consent) and quite another to be treated like a tool in that process and never even asked. My guess is most vets have NO IDEA how they are being used and that’s the way the med schools and the VA leadership wants it. It’s just one more manifestation of the attitude that we’re charity cases and should be grateful for whatever other people are doing “for” us.

Mike
Mike

All the top private medical centers in the United States, e.g. John Hopkins, Massachusetts General, Mayo clinic, etc. are all linked up with medical schools in which medical school graduates perform their internships and fellowships. So how is this a fault when the VA participates in this process? In order to go to a hospital that does not have medical residents, you have to go to a hospital that is totally disconnected from any current, modern medical academic institution. I wouldn’t exactly think of that as a mark of excellence when I am picking out a hospital to go to. 🙂

91Veteran
91Veteran

You are certainly right Mike, but I cannot see a hospital like Johns Hopkins upholding their reputation long by allowing unsupervised interns to treat patients. That is something the VA does, and has done repeatedly.
To provide more contrast, there is a news article today from Denver in which a medical tech has been fired and is facing 14 years in prison for tampering with patient narcotics. The hospital is contacting almost 3000 people for HIV and Hep C testing. Meanwhile, the VA would ignore the perp, possibly suspend them or look like other way while the perp sold drugs on VA grounds like at Tomah.

You are talking about an organization that had an employee beat an elderly veteran to death, gave the employee a week vacation to recover, and was only reported because the local coroner pressed the issue. Nobody should think the VA would be concerned over unsupervised students treating veterans.

DMD53
DMD53

Mike,

To clarify my point: the issue isn’t medical school affiliated= cutting edge/not medical school affiliated = behind the times (first, that’s NOT my paradigm: superb practitioners can be found in many places, and second, that wasn’t what I said).

I’m saying that what is important to me as a veteran is TRANSPARENCY regarding the relationship between a medical school and an affiliate hospital. As a patient, I have the right to be made aware of the existence of this relationship–and the onus should be on the treating institution to disclose up front…in contrast to me, the patient, having to “figure it out” whenever I need to be seen in a speciality clinic (which is where most of these rotations happen). If I have a complex disease, I do not want a newbie treating me and I think I should have the right to opt out of that process. Ditto you and everyone else–they just need to make it a habit to disclose.

For example, when I receive care at the University of Washington Medical Center, or at Harborview, or at Virginia Mason (all places with medical school affiliations in Seattle), the status of the person treating me is always clearly disclosed. At the VA in Seattle, during the years I was receiving care there, this distinction was NEVER revealed and in fact, was frequently hidden.

As a vet, the fact that this happens at the VA but not at the other teaching hospitals suggests to me that its driven by the culture of the VA, not by the medical school. The attitude I ran into again and again at the Seattle VA was that I was neither smart enough or deserving of understanding the context around me and having input into that context. In other words, “shut up and do what we tell you to do and don’t ask questions.” I have a problem with that. If others don’t mind being treated like mushrooms, well, more power to them…but the standards for disclosure should still be high, even if only 10% of us care to know.

And it’s not difficult or expensive to ensure that this relationship is clearly disclosed. It can be done via consent forms, through signage, verbally, etc. so that each of us can make an informed decision about whether we want to be lab rats. That’s what I’m sayin’.

Sandy Hale, Retired Nurse, Disabled Combat Veteran
Sandy Hale, Retired Nurse, Disabled Combat Veteran

THE DIFFERENCE IS THAT THOSE HOSPITALS AND INSTITUTIONS HAVE A REPUTATION TO UPHOLD FOR EXCELLENCE IN THIER MEDICAL PROGRAMS AND PATIENT CARE.

THE VA COULD CARE LESS AND LETS THEIR STUDENTS, RESIDENTS AND INTERNS RUN THE ENTIRE HOSPITAL WITHOUT ANY TYPE OF SUPERVISION AT ALL. THEY HAVE NO REPUTATION TO UPHOLD, THEY KNOW VETERANS ARE ELDERLY AND DON’T KNOW THE DIFFERENCE BETWEEN GOOD HEALTH CARE AND BAD HEALTH CARE BECAUSE THEY’VE BEEN IN THE MILITARY. DO YOU THINK FOR ONE MINUTE THAT THE AVERAGE PERSON GOING TO ONE OF THOSE HOSPITALS WOULD PUT UP WITH THE CRAPPY MEDICAL CARE THE VA DISHES OUT? i THINK NOT. THEY WOULD COMPLAIN. ON THE OTHER HAND, VETERANS DON’T COMPLAIN BECAUSE THEY THINK ITS FREE AND THEY HAVE NO RIGHT TO COMPLAIN.

PROBLEM IS, ITS NOT FREE. WE EARNED IT AND I COMPLAIN WHEN I GET BAD HEALTH CARE AT THE VA BUT AS FAR AS I KNOW, I’M ONE OF THE FEW. BUT IT DOESN’T DO ANY GOOD BECAUSE THEY DON’T DO ANYTHING ABOUT IT. THE VA WILL JUST TELL YOU IF YOU DON’T LIKE IT, GO SOMEWHERE ELSE. THAT’S THEIR ANSWER TO ANY COMPLAINT.

crazy elf
crazy elf

@Sandy Hale
Your “comments” are great and an inspiration to us all! Please keep up the great work.
I’m sure you know Ben Krause puts a new “blog” on monday’s through friday’s.
On today’s blog, a disabled Vietnam Vet could’ve used your words! He was extremely upset!

Please, if you receive this, go to today’s blog. His comment is, or should be, at the top!

Again thanks for your knowledge and expertise of a government agency which is so damn corrupt!

Sandy Hale, Retired Nurse, Disabled Combat Veteran
Sandy Hale, Retired Nurse, Disabled Combat Veteran

THE ENTIRE VA SYSTEM SHOULD BE ABOLISHED

DO NOT REWARD BAD BEHAVIOR
This is such a simple concept that it’s scary most veterans and veteran organizations just don’t get it. The VA system is never going to get fixed if we keep throwing money at it because the VA only sucks money up like a bottomless pit and spends it on itself, not the veterans.

Know where all that extra funding goes? To lazy VA employees who claim overtime working on your backlog claim that they’ve been sitting on for years and now they are rewarded for that laziness by collecting not only their outrageous federal employee pay that they didn’t earn and don’t deserve, but now they are paid even more for that laziness with extra overtime pay. They claim to work on weekends and holidays for double and triple overtime pay. They don’t actually have to be in the office, just claim to be working on it at home. Who cares? Its free money and a free for all. VA employees are like sharks in a feeding frenzy with extra VA funding money.

That kind of incentive motivates them to let every one of your VA claims become backlog so they can collect more funding for more overtime pay. And, you’re extra funding goes to vacations for those lazy VA employees. That’s right. Seminars in Hawaii on all those new rules and regulations you wanted and seminars on how to spend the new funding money. Paid vacation, plus they don’t have to work on that backlog that they received the money for because they’re too busy going to classes and seminars with luncheons and all expense paid training that can last for weeks at a time because at the VA, there is absolutely no accountability. NONE whatsoever. Nobody questions anybody because they’re all cheating on their overtime and paid expense accounts.

VA employees are not going to rock the cruise boat that they’re sailing in. That’s why VA whistleblowers are few and far between. Plus, that’s why VA whistleblowers are treated so badly by the other employees. What do you mean you don’t want your share of VA blood money? Employees with morals and a conscience are not allowed and are not tolerated by the VA system.

Government con artists have convinced veterans that all we need is more rules and regulations and more funding, more money, more money. WRONG. WRONG and WRONG.

For all of the thousands of veterans who died waiting for appointments you know what the VA doctors who were responsible received for punishment? A bonus. Know what the VA executives that were responsible for murder received? A bonus and a promotion. Know what the VA hospitals, clinics and VA administrative offices received? More funding. Know what the veteran’s families received? A dead loved one. Know what the dead veteran received? An end to VA benefits for them and their families. How fair is that? Do not…I say again. Do not reward BAD behavior with money. It only encourages the VA to act bad more often to receive more money. Does that make sense to anyone?

MONEY IS POWER
The golden rule: He who has the gold- makes all the rules. Money is power. Lobbying power to make laws, rules and regulations so that the VA controls the money and can divert it from its original purpose, the more money, the more power, the more abuse of the money and power. Absolute power corrupts absolutely.

How about new furnished offices with cable television? Don’t laugh. The VA has cable TV everywhere and it’s not for the veterans. The televisions in the clinics and offices are mounted so that they always face the VA desks and VA employees control the TV and watch soap operas and game shows all day long so that absolutely no work gets done. Get a clue.

I wanted to watch the news one time and asked a VA employee to change the channel from her soap opera to the news and she said “NO”. When I asked her “why” she stated that she didn’t want to “upset” the veterans with bad news because they just can’t handle it. Ok, so you can handle combat but not the local news. Really? I’ve never seen a veteran flip out because the news channel was on, but hey, who knows? Because all veterans are considered by VA employees to be mentally deranged children who have to be cared for by VA employees, they know what’s best for us. Sit here honey. Wait here darling. Ok sweetie. Like we’re in a nursing home already. I’ve seen female VA employees sit on male veteran’s laps and talk like a baby to them. Maybe you male veterans like that crap, but I don’t appreciate being treated like a child. Age didn’t take my adulthood from me and I hope it didn’t take your manhood from you.

Controlling power. Bribery power. Power to shut whistleblowers up by paying them off because they can’t fire them. All a VA employee has to do is pretend they’re not with the VA crooked system and get paid extra for it. Can’t beat that with a stick. Maybe you’re lucky enough to witness an illegal VA transaction or catch your boss shipping used prosthetics from VA suppliers who are charging the government for new prosthetics. I actually received an alleged new wheel chair cushion with a big urine stain on it but the federal government paid the VA supplier for a new one. Maybe you stumbled across another VA employee who cooked the books and embezzled VA funds or witnessed a VA doctor injure a veteran with their stupidity and incompetence.

This is your lucky day because you’re about to get paid and in fact, you’re going to be the VA’s star witness against the veteran and his family. Spend that money carefully because you’re going to earn it. It will cost you your morals, but what the heck; you have none because you work for the VA.

THE NON-VA HEALTH CARE SYSTEM HAS SUPERIOR MEDICAL CARE
The VA health care system is worse than charity hospitals and clinics because it takes an act of Congress to get a federal employee fired. They know this. The VA system is federal and their federal employee system is set up so that you cannot get rid of bad federal employees.

It takes years of hearings and appeals and the entire time, this VA employee who murdered your beloved veteran is getting paid to sit home and fight the charges. More paid vacations. Do you think that would happen at your local hospital? No way. The local non-VA institution would immediately suspend the employee without pay and investigate and if found that the charges were valid, they would be fired on the spot. No contest. No hearings. No appeals. That’s because regular non-federal employees are hired “at will” which means they can be fired at the “pleasure” of the hospital, clinic or institution. They don’t even need a reason to fire their employees.

They weed out the bad employees because they are “customer oriented”. They want to please the patrons who come to their hospitals and clinics because they have competition. The VA system has no competition. You have to go there and you have to put up with whatever crap they dish out. VA employees know that. You have NO CHOICE whatsoever. It’s worse than being in the military. At least in the military you can go up the chain of command and hope to find some justice, but not with the VA system because they are the chain of command. They are your masters. They control everything. There is no assistance outside of the VA system.

Do you think the VA hospital or VA Regional Office is afraid of your local Congressman? NO. The VA administrator lunches and golfs with them because the VA system has the MONEY and POWER to control your Congressman because of all that extra funding you wanted them to have. Don’t worry, its being put to a good cause. Greed. Ditto for the Inspector General’s Office and the VA Consumer Affairs Office. All federal employees who profit from extra VA funding. Silly veteran, tricks are for kids.

Wake up veterans. The VA system is not about you, it’s not for you and it never was. I can remember when the Vietnam Veterans returned home from their foreign war and was spit on by the public and denied all their benefits by the same federal system that sent them over there and a few showed their displeasure by blowing up some VA Regional Offices. I would have to let all the veterans get out first. Just kidding. I’m not advocating violence, just controlled rebellion to unite and abolish the entire VA system because it doesn’t serve us veterans. You’re beating a dead horse.

There is already a medical system out there that actually works and we don’t need the federal VA health care system. There are trained civilian administrative people out there and we don’t need VA regional offices with their federal employees. The military and the VA have already out-sourced other areas of federal management to civilians. Remember how the food improved when the military out-sourced the chow halls to civilian companies. It’s time to out-source the entire VA system to the already in place civilian companies and hospitals that are customer oriented and want your business and they don’t profit from your death or neglect. Their business only profits when the customer, which would be you, is satisfied. They are customer friendly and service oriented, which is what the VA system was NOT set up to do.

Sandy Hale, Retired Nurse, Disabled combat veteran

Sandy Hale, Retired Nurse, Disabled combat veteran
Sandy Hale, Retired Nurse, Disabled combat veteran

DO NOT REWARD BAD BEHAVIOR
This is such a simple concept that it’s scary most veterans and veteran organizations just don’t get it. The VA system is never going to get fixed if we keep throwing money at it because the VA only sucks money up like a bottomless pit and spends it on itself, not the veterans.

Know where all that extra funding goes? To lazy VA employees who claim overtime working on your backlog claim that they’ve been sitting on for years and now they are rewarded for that laziness by collecting not only their outrageous federal employee pay that they didn’t earn and don’t deserve, but now they are paid even more for that laziness with extra overtime pay. They claim to work on weekends and holidays for double and triple overtime pay. They don’t actually have to be in the office, just claim to be working on it at home. Who cares? Its free money and a free for all. VA employees are like sharks in a feeding frenzy with extra VA funding money.

That kind of incentive motivates them to let every one of your VA claims become backlog so they can collect more funding for more overtime pay. And, you’re extra funding goes to vacations for those lazy VA employees. That’s right. Seminars in Hawaii on all those new rules and regulations you wanted and seminars on how to spend the new funding money. Paid vacation, plus they don’t have to work on that backlog that they received the money for because they’re too busy going to classes and seminars with luncheons and all expense paid training that can last for weeks at a time because at the VA, there is absolutely no accountability. NONE whatsoever. Nobody questions anybody because they’re all cheating on their overtime and paid expense accounts.

VA employees are not going to rock the cruise boat that they’re sailing in. That’s why VA whistleblowers are few and far between. Plus, that’s why VA whistleblowers are treated so badly by the other employees. What do you mean you don’t want your share of VA blood money? Employees with morals and a conscience are not allowed and are not tolerated by the VA system.
Government con artists have convinced veterans that all we need is more rules and regulations and more funding, more money, more money. WRONG. WRONG and WRONG.

For all of the thousands of veterans who died waiting for appointments you know what the VA doctors who were responsible received for punishment? A bonus. Know what the VA executives that were responsible for murder received? A bonus and a promotion. Know what the VA hospitals, clinics and VA administrative offices received? More funding. Know what the veteran’s families received? A dead loved one. Know what the dead veteran received? An end to VA benefits for them and their families. How fair is that? Do not…I say again. Do not reward BAD behavior with money. It only encourages the VA to act bad more often to receive more money. Does that make sense to anyone?

MONEY IS POWER
The golden rule: He who has the gold- makes all the rules. Money is power. Lobbying power to make laws, rules and regulations so that the VA controls the money and can divert it from its original purpose, the more money, the more power, the more abuse of the money and power. Absolute power corrupts absolutely.

How about new furnished offices with cable television? Don’t laugh. The VA has cable TV everywhere and it’s not for the veterans. The televisions in the clinics and offices are mounted so that they always face the VA desks and VA employees control the TV and watch soap operas and game shows all day long so that absolutely no work gets done. Get a clue.

I wanted to watch the news one time and asked a VA employee to change the channel from her soap opera to the news and she said “NO”. When I asked her “why” she stated that she didn’t want to “upset” the veterans with bad news because they just can’t handle it. Ok, so you can handle combat but not the local news. Really? I’ve never seen a veteran flip out because the news channel was on, but hey, who knows? Because all veterans are considered by VA employees to be mentally deranged children who have to be cared for by VA employees, they know what’s best for us. Sit here honey. Wait here darling. Ok sweetie. Like we’re in a nursing home already. I’ve seen female VA employees sit on male veteran’s laps and talk like a baby to them. Maybe you male veterans like that crap, but I don’t appreciate being treated like a child. Age didn’t take my adulthood from me and I hope it didn’t take your manhood from you.

Controlling power. Bribery power. Power to shut whistleblowers up by paying them off because they can’t fire them. All a VA employee has to do is pretend they’re not with the VA crooked system and get paid extra for it. Can’t beat that with a stick. Maybe you’re lucky enough to witness an illegal VA transaction or catch your boss shipping used prosthetics from VA suppliers who are charging the government for new prosthetics. I actually received an alleged new wheel chair cushion with a big urine stain on it but the federal government paid the VA supplier for a new one. Maybe you stumbled across another VA employee who cooked the books and embezzled VA funds or witnessed a VA doctor injure a veteran with their stupidity and incompetence.

This is your lucky day because you’re about to get paid and in fact, you’re going to be the VA’s star witness against the veteran and his family. Spend that money carefully because you’re going to earn it. It will cost you your morals, but what the heck; you have none because you work for the VA.

THE NON-VA HEALTH CARE SYSTEM HAS SUPERIOR MEDICAL CARE
The VA health care system is worse than charity hospitals and clinics because it takes an act of Congress to get a federal employee fired. They know this. The VA system is federal and their federal employee system is set up so that you cannot get rid of bad federal employees.

It takes years of hearings and appeals and the entire time, this VA employee who murdered your beloved veteran is getting paid to sit home and fight the charges. More paid vacations. Do you think that would happen at your local hospital? No way. The local non-VA institution would immediately suspend the employee without pay and investigate and if found that the charges were valid, they would be fired on the spot. No contest. No hearings. No appeals. That’s because regular non-federal employees are hired “at will” which means they can be fired at the “pleasure” of the hospital, clinic or institution. They don’t even need a reason to fire their employees.

They weed out the bad employees because they are “customer oriented”. They want to please the patrons who come to their hospitals and clinics because they have competition. The VA system has no competition. You have to go there and you have to put up with whatever crap they dish out. VA employees know that. You have NO CHOICE whatsoever. It’s worse than being in the military. At least in the military you can go up the chain of command and hope to find some justice, but not with the VA system because they are the chain of command. They are your masters. They control everything. There is no assistance outside of the VA system.

Do you think the VA hospital or VA Regional Office is afraid of your local Congressman? NO. The VA administrator lunches and golfs with them because the VA system has the MONEY and POWER to control your Congressman because of all that extra funding you wanted them to have. Don’t worry, its being put to a good cause. Greed. Ditto for the Inspector General’s Office and the VA Consumer Affairs Office. All federal employees who profit from extra VA funding. Silly veteran, tricks are for kids.

Wake up veterans. The VA system is not about you, it’s not for you and it never was. I can remember when the Vietnam Veterans returned home from their foreign war and was spit on by the public and denied all their benefits by the same federal system that sent them over there and a few showed their displeasure by blowing up some VA Regional Offices. I would have to let all the veterans get out first. Just kidding. I’m not advocating violence, just controlled rebellion to unite and abolish the entire VA system because it doesn’t serve us veterans. You’re beating a dead horse.

There is already a medical system out there that actually works and we don’t need the federal VA health care system. There are trained civilian administrative people out there and we don’t need VA regional offices with their federal employees. The military and the VA have already out-sourced other areas of federal management to civilians. Remember how the food improved when the military out-sourced the chow halls to civilian companies. It’s time to out-source the entire VA system to the already in place civilian companies and hospitals that are customer oriented and want your business and they don’t profit from your death or neglect. Their business only profits when the customer, which would be you, is satisfied. They are customer friendly and service oriented, which is what the VA system was NOT set up to do.

Mike
Mike

The article needs more accuracy. It contrasts Medical residents with medical doctors where it says “Instead of medical doctors being directly involved in your care, most veterans interface with residents or medical students on a regular basis.” But medical residents are medical doctors. They have graduated from medical school and are licensed to practice medicine. Residents practice under Attendings. Patients are seen by both. Attending’s are required to sign off on resident medical documentation. And you have regular staff doctors who are not residents or attendings. This practice takes place all over America in private industry, not just the VA. In the VA facility I am familiar with, they require all providers to wear badges which clearly state their status as Attendings, staff or resident. It has been that way for years. If there are complaints about how this is being abused in the VA, then I encourage everyone to bring the detailed information on these individual examples forward into public discourse. Unfortunately the media is not very helpful in this regard, of coming up with the facts.

91Veteran
91Veteran

I provided the example of the student neurologist in Houston some years ago, whose status I only found out through other questions.
More recently, I have been usually asked first before students are allowed in an examination. The best example I can give of this is having knee replacement surgery. The surgeon would always have a PA with him, I didn’t mind it because they were upfront and honest about it, and the surgeon tended to talk more when the PA was present. In follow-up appointments, I often saw the surgeon only, but did have appointments with the PA only. I didn’t mind that because he was responsive with prescriptions or referrals.
The biggest problem I have had with this topic is primary care appointments with nurse practioners that pass themselves off as doctors. I had one appointment with a primary care provider that was a nurse practitioner who tried that, and I found out she falsified my records by answering things in the exam questions that she never asked, and then claimed I had no reported problems with things I pointed out to her that were directly the opposite.
I put it in writing to the director that I wanted reassignment to a different primary care doctor because the Patient Advocate refused to do her job and reassign me. She refused to return phone calls, was never in her office, then when I caught her one morning she initially claimed she had no record of the request, then claimed she just forgot to do it.
I had already seen a stack of other requests by veterans to be reassigned from that nurse that the other Patient Advocate had. It was a half inch thick folder.

Sandy Hale
Sandy Hale

Mike,
You just don’t get it. The VA is not like any other institution or facility. Its a completely different entity. Your comparing apples to oranges. Your also creating a debate over a moot issue. Thee’s good and bad in everything, we don’t need to divert our attention to fixing anything that’s NOT broken. End of story.

Your unknowingly using the same trick the trolls and media uses – they create a controversey between good and bad about any issue, but that is strictly there to ENTERTAIN you, not solve the problem. It gives people the ILLUSION that the problem is being addressed by talking it to death, but nobody is actually doing a damn thing about it. It’s good to expose it and talk about it, but not argue over the good doctors, hospitals, clinics or whatever that nobody is complaining about. We’re after the BAD ones. Get it? They need to be EXPOSED.

I can turn on the TV right now and just listen for hours to experts and officals argue with each other. – they debate it to death and that creates a distraction away from the issue itself. In the meantime, people are dying. But everyone is so caught up in the debate and arguments that absolutely NOTHING gets done. ITS A DISTRACTION to keep you away from solutions.

Awake and concerned veterans are doing something. We complain. We expose the wrong-doing, the evil and all the dirty tricks the VA is doing and most important WHY there are doing it. The problem is veterans are ASLEEP and can’t see outside their little bubble. My parents, me and you came from a generation that trusted doctors. Police officers were our FRIENDS. I was taught to run to a police officer when I was in trouble, now adays they would shoot you dead before you got to them screaming for help. Its a whole new ball game out there now. Its pure EVIL. It really is. God help us, we’re outnumbered and out-gunned and we’re dropping dead by the thousands because that’s the plan. I just pray whatever few veterans are left wake up and smell the garbage.. If you keep those rose-colored glasses on you won’t see it coming. You won’t have a clue and you’ll be the next statistic.

Sandy Hale, Retired Nurse, Disabled Combat Veteran

Dr. Ben Casey
Dr. Ben Casey

Hours in school, does not a doctor make. What do you call medical students who get the lowest overall scores in their studies?- Doctor.

Veteran Care, should be a specialty-like cardiology,neurology,pediatrics, etc. It should require a year in a combat zone for qualification.

Sandy Hale, Disabled Combat Veteran
Sandy Hale, Disabled Combat Veteran

THIS IS WHY YOUR VA HEALTH CARE IS FREE – RESEARCH

“The Veterans Affairs (VA) Office of Research and Development is launching the Million Veteran Program (MVP), an important partnership between VA and Veterans. The goal of MVP is to better understand how genes (DNA) affect health and illness in order to improve health care for Veterans”

Go to: http://www.research.va.gov/mvp/veterans.cfm

Right. And, I’m the Easter bunny. This program collects DNA samples from veterans to use in research for among many other things: Biowarfare. They can kill people more efficiently with chemicals if they know how chemicals affect DNA.

That way, the biological weapon can be “race specific”. By studying DNA they have found that they can design chemicals to kill specific races, like Hispanic, Black, Asian, ect. Because of the different DNA sequencing, they can trace your ancestry to see which race DNA you carry and they can design around it to eliminate themselves from being affected by that particular DNA weapon.

Feel violated yet? You will because they are designing bioweapons to be released in the form of epidemics that will kill off that 6 billion people they said they were going to get rid of and it’s written in stone on the Georgia Guidestones. Don’t tell me you never heard of this. It’s in the frigging Wikipedia for heaven’s sake.

Go to: https://en.wikipedia.org/wiki/Georgia_Guidestones

Read and weep. And you and me, being the Patriotic veterans that we are helped make all this possible. God help us.

Oh, the other reason is that the rich and powerful are studying DNA so they can live forever. Yes, they really believe that and they are saying exactly that all over the History Channels and Science Channels. I watched a History Channel program about the 1918 Spanish Flu that killed over fifty million people. They actually dug up dead bodies of victims to study their DNA and took DNA samples of relatives of the survivors of the Spanish Flu and found out that a small group of people had built in immunity to the Spanish Flu.

They are now designing vaccines for themselves, not you, but for them that will make them immune to all these pandemics that will kill you and me. You’re getting the vaccine with the bioweapon. They are getting the vaccine with the cure.

The reason they need more DNA is that they need to find more people with these DNA genes of superior immunity to disease to make more vaccines for themselves. There just isn’t enough to go around for you and your loved ones. Sorry. You guys just have to die, but thanks for the DNA.
Still feel like giving up your DNA? No need to because they’ve already taken it and it’s in a big freezer and biodata computer if you have ever given blood at the VA hospital.

HERE IS WHERE YOUR DNA IS….

Assurex Company has contracted with the Veteran’s Administration to study your DNA whether you like it or not. First things first, MONEY. The VA and these companies are making money off of your patriotic DNA. This is what they are telling us:

“Assurex Health officials didn’t release an estimate on how much revenue the VA deal might generate for the company.”

Obviously, the amount of money these guys are going to make off of your free DNA is ridiculous and they don’t want to reveal it because you might want a cut of it and they’re not sharing. Know what else they want to do with your DNA? Control your mind. Think that sounds crazy. Just listen to GeneSight company tell you themselves with release of this news story:

“The GeneSight psychotropic test analyzes how a patient’s genes might affect his or her metabolism and response to FDA-approved medicines commonly prescribed to treat depression, anxiety, bipolar disease, schizophrenia or other mental health conditions. Variations of the GeneSight brand of tests can help doctors determine the best medications to treat chronic pain or ADHD”

“The privately held firm’s GeneSight psychotropic test is designed to help doctors prescribe the best medications to treat patients with mental issues such as post traumatic stress disorder and depression, and both veterans and active-duty military personnel could benefit from the federal supply schedule contract, Assurex Health officials said. The test will be available for use by doctors at the Veterans Affairs Medical Center in Cincinnati and at other VA facilities nationwide. The contract was effective June 15. 2014.” “We estimate over 1.7 million veterans are already being treated for mental health conditions in the VA”

Go to: https://assurexhealth.com/cbc_va/

WHY THE VA INSTEAD OF OTHER HOSPITALS?

“The Department of Veterans Affairs is gathering blood from 1 million veterans and sequencing their DNA. At the same time, computer scientists are creating a database that combines those genetic sequences with electronic medical records and other information about veterans’ health VA researchers recognized that they might be able to build a biobank with some advantages that others would lack. VA medical records provide a rich source of information about patients, because veterans who join the VA health system can continue to use it no matter where they move in the country. As a result, the VA’s medical records are deep, including information ranging from lab tests to X-rays and prescriptions. The VA has been digitizing medical records since the 1980s, which meant that the researchers at the MVP wouldn’t have to spend years scanning millions of pieces of paper before they could start their research. Yet another advantage was the veterans themselves, who have a long tradition of volunteering in high numbers for research studies. In 2009, Johns Hopkins University researchers surveyed veterans to see what they thought about the idea of a VA biobank, and found that 71 percent said they would definitely or probably participate. When the VA researchers considered the 8.76 million veterans who use the VA health system, they decided to reach for the brass ring: a biobank with 1 million participants.

Go to: http://www.statnews.com/2015/11/11/the-vas-push-for-big-science-one-million-genomes-and-a-medical-revolution/

Gee thanks veteran volunteers. Bet you thought you were doing something patriotic and noble? WRONG. Nothing. Absolutely nothing the VA does for you is for you at all. It’s for them. They need your blood and DNA for research. They need your body, diseases and injuries to practice surgery on and test new drugs and treatments with. They need your medical records for data and they need your blind trust that they are doing something good that will benefit you and humanity. I could just Puke. You are nothing but a laboratory rat to them. A guinea pig and if you haven’t noticed by now, your being treated exactly like that. And, we are contributing to our own demise. God help us.

SO WHAT CAN VETERAN S DO ABOUT IT?
Complain. Tell other veterans. Write your Congressman. Start and sign petitions. Blog about it. Wake up these volunteering veterans and let them know they’re not helping the situation at all.
I met a helicopter pilot who told me that if he knew he was going to crash he would do something crazy like sit on the rotor stick so when the accident board found him like that they would take years to try to figure out what the heck happened. Private Joke. But he had the right idea. That could translate into giving false information to the VA to mess up their research if you knew you were dying. Just a thought. But, that could backfire on you and actually kill you if you didn’t die or you weren’t dying. Another thought.

What the heck. I just don’t give the VA personal information. It’s none of their business. Ever wonder why they want to know if you drink, smoke, feel depressed, take over the counter drugs or herbal supplements? It’s not because they’re concerned, it’s because they need that data for all their research which translates into MONEY.

They just told you that in the above news articles and in the same breath claim they want to identify problems that they can help you with. Like the veterans that died when given a test drug for helping them quit smoking. They quit smoking alright. They will never smoke again. That’s a fact.

Go to: http://www.washingtontimes.com/news/2008/jun/17/va-testing-drugs-on-war-veterans/?page=all

I treat the VA like the enemy they are. I now refuse students, residents and interns; I refuse surgery with the VA and make them find a non-VA surgeon at a non-VA and non- teaching hospital and refuse to allow anyone other than the surgeon and the surgical team to participate, watch, take pictures or use my medical records, tissues or samples for research or data collection. That goes for the Anesthesiologist with their Nurse Anesthetist students.

They tell you that an anesthesiologist will be in charge of your anesthesia. They are in charge, but they won’t actually be there doing the anesthesia. What you’re really getting is a Nurse Anesthetist student who is being supervised by an Anesthesiologist.

Further, there could be three or more surgeries going on at the same time and this Anesthesiologist is merely present and maybe checking in on them once in a while but mainly the Anesthesiologist is only there if something goes terribly wrong, they can try to do something about it. In the VA the real and experienced Anesthesiologist will be at home or at a luncheon somewhere or in his office on another floor and chances of him or her getting there in time is slim and none.

I refuse new drugs and new treatments. I refuse to volunteer for anything (I thought you learned that in boot camp-never volunteer). I read the medical and surgical permits and put a single line thru anything I don’t like or don’t want to be done and initial at the beginning and end of it. That’s legal. Don’t just tell them no and then sign the permit that gives them all the rights to do it with because written overrides verbal contracts. Take control of your healthcare and stop being a willing laboratory rat and for your sake and the sake of humanity.

Please: STOP VOLUNTEERING.

Julia Perry Briggs
Julia Perry Briggs

I’m quite sad you feel this way. The doctor in my Hospital (only 1 afternoon a week, she’s a very busy Professor) who runs the recruitment for MVP is the only doctor who has ever gotten medication for me that really helps the most aggravating of my s/c physical problems. About 3-4 years ago, I enrolled. She told me she believes much will be done for future patients as a result, and she asked me to spread the word that she wants a prominent portion of women vets in the program. Wants females to be represented. She does an awful lot of continence work with geriatrics and then the entire program how I found her is something they only have at certain VA hospitals, GRECC Geriatric Research, Education, and Clinical Care. I was mortified when I was sent to that clinic, but when I met her and found out what she knew, I relaxed. I have nerve damage in my private parts, from an unhealed pubic bone fracture. Anyway, she is enthusiastic about MVP and I trust her.

carlena harned
carlena harned

My colleagues were requiring VA 21-0845 several days ago and located a great service that hosts lots of fillable forms . If others need VA 21-0845 too , here’s https://goo.gl/Fs8jEZ