Should VA Violate Constitution To Destroy Physician Led Care?

105

physician led care

To solve the wait list problem, VA now proposes to trump state laws that prohibit nurses from treating patients without supervision of a physician. Do you agree?

I generally oppose any move by any federal agency to trump state laws when those laws focus on the policing powers that each state should be allowed under the Constitution.

But under former President Bill Clinton’s Executive Order on Federalism, agencies currently have an opportunity to run rough shod over the interests of each state so long as they coordinate with the state. But what does that mean exactly, and what if an agency decides to merely coordinate only with the group of state citizens who would benefit from the decision, as VA has done here? (view Petzel’s letter at bottom)

Normally, each state has the right to police its professionals including physicians and nurses. That is a Constitutional right. VA wants to take that right away when it comes to caring for veterans with VA.

Scary times.

Or was this whole thing manufactured from the beginning? Create the problem to then propose your own solution?

One interesting support for the change is the long wait times for veterans to access care that was originally highlighted through the high profile wait list scandal.

RELATED: Probation For Ex-VA Chief Who Presided Over Wait List Manipulations

VA knew the wait list manipulations was going on for over a decade before the issue was highlighted by Phoenix VA and CNN back in 2014. It likely started under former President Bill Clinton. In 2011, VA was already working on this nursing scheme. My guess is, the agency was looking for the right problem to present the solution.

Is it just me, or does the timing with the wait list seem curious?

So how much of a coincidence is it that his Executive Order for Federalism is now used to ‘fix’ the problem that also started on Clinton’s watch in the 90’s? What would a potential President Hillary Clinton do to resolve the issues if elected?

These questions aside, I wanted to ask you what you think about the proposal to change VA regulations to allow advanced practice nurses to treat veterans without physician supervision nationwide.

I will be writing an op-ed on the subject possibly next week, so getting your feedback on this issue would be incredibly helpful.

What do you think? Will this lower the quality of care? Will it affect a state’s right to police nurses? Why do civilians get higher quality forms of care than veterans?

WHAT WE KNOW ABOUT THE REGULATION PROPOSAL

COMMENT: You Can Comment On Proposal Here

Here is what we know.

1. We know VA is struggling to hire doctors because of problems with whistleblower harassment and low morale.

2. We know Secretary Bob received millions to hire new doctors but has been unable to fill the billet, so to speak.

3. We know VA employees engaged in criminal fraud to game the scheduling system for the purpose of presenting more positive performance numbers to receive higher bonuses that created the wait time scandal.

4. We know the wait list issue was a manufactured scandal created by VA employees that resulted in deaths and injuries to thousands of veterans nationwide. Most VA employees involved were unpunished.

5. We know physicians have more training than advanced practice nurses, and we know that civilian hospitals are generally required to adhere to the physician led care model in the majority of states.

6. We know VA’s regulation change will override the policing powers of many states who oppose moving away from the time tested physician led care model, and that in those states, veterans affected will get inferior care than their civilian counterparts.

7. We know this move will be great for unions because most nurses belong to unions, but it will erode the roll of physicians within VA health care.

8. We know it will make lawsuits against VA for malpractice harder because deviations from the community standards by allowing nurses to provide the care previously only provided by physicians will not be something you can sue under, and the lawsuit malpractice bar might be more difficult to prove up.

Will changing who provides care within VA help VA stop violating the law and provide safe and effective health care? Why does VA seem to fixate on “efficient” provision of health care instead of fixating on the “highest quality” of health care? Do veterans not deserve the best, only the most efficient solutions?

WHO OPPOSES THE CHANGE

So far, it looks like a lot of professionals outside VA and within VA oppose the move because it supports using lesser-trained professionals as substitutes.

According to VA Chiefs’ letter to Secretary Shinseki in 2013:

It has come to our attention that a new policy is being circulated that will result in certified registered nurse anesthetists (CRNAs) becoming licensed independent providers (LIPs) throughout the VA system. We write today to express our opposition to this policy and to express genuine distress that such a profound change to the way anesthesia services are rendered in the VA system would be considered without input from the VA anesthesia leadership….

The national press regarding this has already been very negative for the VA. At a time when Americans are being asked to embrace further government involvement in health care, the revelation that such profound changes could be made by the VA administration without the input of clinical leaders would undoubtedly produce significant additional negative publicity.

It is our belief that this situation represents a “Stop the Line” moment. We strongly urge you to stop this policy from being activated and open a transparent dialogue with us in order to explore and discuss all potential consequences, intended and unintended. We are committed to work closely with all parties to discuss this important patient safety issue.

READ IT: VA Chiefs’ Letter Against Regulation

AMVETS also sent a letter opposing the change earlier this year. In that letter, AMVETS said:

It has come to our attention that the draft nursing services handbook, VHA Handbook 1180.03: VHA Nursing Handbook, proposes changes to VHA policies which would fundamentally, and we feel adversely, impact the delivery of care to veterans. For the purpose of this letter, our focus will be the substandard way in which anesthesia would be delivered to our nation’s veterans….

Finally, this situation appears to be a case of comparing apples to oranges. The training, clinical experience and credential requirements between physicians and nurses are vastly different. A CRNA requires an average of 2 – 3 years post-baccalaureate education plus at least one year’s experience in an acute care nursing setting, while an Anesthesiologist is required to successfully complete 8 years of post-baccalaureate education including a residency. With these types of disparities, and others, separating CRNAs from Anesthesiologists it would seem to be impossible to say that the two positions are in any way equivalent.

READ: Entire AMVETS Opposition Letter

The Congressional Doctors’ Caucus also wrote a letter of opposition to the proposed changes that said, in part, that the change would “directly compromise patient safety…”:

VA’s own internal stakeholders have argued that the application of the Nursing Handbook represents a risk to veterans. Over 200 of VA’s own anesthesia experts, including Chiefs of Anesthesiology and VA anesthesiologists- have argued that this policy will “directly compromise patient safety and limit our ability to provide quality care to Veterans.”

We join other Veteran heath care stakeholders, including AMVETs, the Association of the U.S. Navy and the National Guard Association of the United States, in urging preservation of the current Anesthesia Service Handbook, as currently written, and the exclusion of anesthesia and pain management from the Nursing Handbook.

READ IT: Entire Caucus Letter Of Opposition

LETTERS SUPPORTING CONSTITUTIONAL VIOLATION

Below are some comments I found from individuals supporting the proposal. You can click on the hyperlinked name to see it on the Regulations.gov website. If you change the last number in the query in the url on that website, you can see other’s letters to view any potential patterns.

Let me know if any of the comments look suspicious. Why do these all support the change while making use of strict formatting? Is a PR firm putting in the comments? What about the union?

After you look at these, check out the comments in opposition to the regulation change. You will notice an alarming difference.

COMMENT EXAMPLE 1

Dear Secretary Robert A. McDonald:

As a practicing CRNA, I would like to express my full support for the proposal to recognize Advanced Practice Registered Nurses (APRNs), including Certified Registered Nurse Anesthetists (CRNAs), with Full Practice Authority. This policy is supported not only by CRNAs, but by individual Veterans, national and local Veteran’s organizations, and other healthcare providers around the country.

Granting APRNs, including CRNAs, the authority to practice to the full extent of their scope of practice and expertise will give the VHA the flexibility it needs to provide our Veterans with timely access to the high quality care they have earned. The wait-times our Veterans are experiencing are unacceptable, especially when there is a highly-trained, highly-skilled workforce already within the VHA ready to provide care.

I strongly urge you to move forward with the proposed change for APRNs and CRNAs. Thank you for your time and consideration.

Sincerely,

Dustin Fontenot

12515 Oak Park Dr

Houston, TX 77070-2250

COMMENT EXAMPLE 2

Dear Secretary Robert A. McDonald:

As a concerned citizen, I am in full support of a proposed update by the Veterans Health Administration (VHA) to recognize all advanced practice registered nurses (APRNs) to the full extent of their education and training. Given our Veterans need for high quality healthcare, fully utilizing APRNs like nurse practitioners and certified registered nurse anesthetists (CRNAs) in the VHA is a tested solution that puts our Veterans first. In the interest of the Veterans, their family members, and the healthcare providers who administer their care, please support efforts to recognize all APRNs with Full Practice Authority.

Sincerely,

Dick Uhlenkott

1713 7th Ave

Clarkston, WA 99403-1510

COMMENT EXAMPLE 3

Dear Secretary Robert A. McDonald:

I am in full support of recognizing all advanced practice registered nurses (APRNs) in the VA to their Full Practice Authority.

Our Veterans rely on and deserve access to timely, efficient, and high-quality care. APRNs are skilled practitioners that increase access to care, reduce costs and ensure quality. As Full Practice Providers, APRNs will deliver care to the full scope of their education and training and ensure that the VA has the flexibility to utilize all providers within the healthcare team, maximizing the effective use of resources and providing optimal care for the men and women who have served our country in uniform.

In the interest of the Veterans, their family members, and the healthcare providers who administer their care, please support efforts to recognize APRNs as Full Practice Providers.

Sincerely,

Jennifer Marlowe

659 Zion Liberty Rd

Harmony, NC 28634-9303

COMMENT EXAMPLE 4

Dear Secretary Robert A. McDonald:

I am in full support of recognizing all advanced practice registered nurses (APRNs) in the VA to their Full Practice Authority.

Our Veterans rely on and deserve access to timely, efficient, and high-quality care. APRNs are skilled practitioners that increase access to care, reduce costs and ensure quality. As Full Practice Providers, APRNs will deliver care to the full scope of their education and training and ensure that the VA has the flexibility to utilize all providers within the healthcare team, maximizing the effective use of resources and providing optimal care for the men and women who have served our country in uniform.

In the interest of the Veterans, their family members, and the healthcare providers who administer their care, please support efforts to recognize APRNs as Full Practice Providers.

Sincerely,

Cathy Shinn

6250 Gemstone Way

Colorado Springs, CO 80918-5518

COMMENT EXAMPLE 5

Dear Secretary Robert A. McDonald:

As a practicing Certified Registered Nurse Anesthetist (CRNA), I would like to express my full support for the VA’s efforts to recognize Advanced Practice Registered Nurses (APRNs), including CRNAs, with Full Practice Authority.

APRN’s and CRNAs practicing to the top of their training and expertise has been backed by decades of research and aligns with current APRN policy in the Army, Navy, Air Force, Combat Support Hospitals, Forward Surgical Teams and Indian and Public Health Services. The safety of CRNA services is further underscored in that the VHA currently does not require anesthesiologist or physician supervision of CRNAs, and in a number of VHA facilities CRNAs are the sole anesthesia providers.

Our Veterans have waited too long for the healthcare they have earned and deserve, and that we owe them. Recognizing APRN Full Practice Authority (FPA) expands our Veterans access to care and helps to end our Veterans’ waiting. Please implement this commonsense proposal without further delay.

Sincerely,

Melinda Stone

29149 County Road 181

Paynesville, MN 56362-9385

COMMENT EXAMPLE 6

Dear Secretary Robert A. McDonald:

I am a family member of a Veteran. My father and brother are Veterans. I am also a registered nurse. I am extremely concerned about the wait times our Veterans are experiencing to receive quality care in the VA system. I strongly believe the VA should take immediate action to grant Veterans access to the healthcare they need and deserve through the use of advanced practice registered nurses. Not only do these individuals have the professional skill to help with patient influx, they’ll also ensure that all of our Veterans — regardless of age, branch, or service — receive superior and timely care. The Department of Defense already gives APRNs the ability to treat the service men and women of our active military to the full extent of their practice authority, and I feel it is now time for the VA to reflect that policy as well.

Sincerely,

Carolyn Owens

507 Oakridge Dr

Cheswick, PA 15024-2242

LETTERS SUPPORTING PHYSICIAN LED CARE

Notice the total lack of pattern and formatting of the comments opposing the proposal below. This is what causes me to believe the opposition is up against a very organized campaign to erode VA health care quality and standards.

I am specifically referencing the fact that there is no opening to the Secretary and no addresses at the end. While not all opposing comments are like this, my brief review revealed this possible pattern.

COMMENT EXAMPLE 1

Under no circumstance should VA lower the standard of care that our nation’s Veterans receive. To lower the standards for those who have sacrificed so much is unthinkable. I oppose any policy that would lead to the removal of physicians practicing anesthesia in the operating rooms of American heroes.

Karen Steffer

COMMENT EXAMPLE 2

Physician involvement in surgical anesthesia care is an imperative for Veterans. Please protect our nation’s Vets by preserving physician-led, team-based surgical anesthesia care in VA medical facilities.

Daniel Becker

COMMENT EXAMPLE 3

There is no shortage of physician anesthesiologists in VA. VA’s own Independent Assessment of the Health Care Delivery Systems and Management Processes of the Department of Veterans Affairs failed to identify physician anesthesiologists as a medical specialty in shortage within VA. VA should let these highly skilled physicians continue to serve our Veterans. I oppose any effort to substitute nurses for physician anesthesiologists. My grandfathers both served in the military, and I would want them to have the benefit of the best trained people for their care for something as impotant as anesthesia.

Jacob Harter

COMMENT EXAMPLE 4

I’m a veteran: I put my life on the line in service to my country, and I believe that I deserve quality healthcare. I oppose any mandate that would force the best trained physicians out of the operating room. I urge the VA to preserve physician-led, team-based surgical anesthesia care.

Frances Kasarda

COMMENT EXAMPLE 5

Veterans receiving care within VA often have complex medical conditions that pose a heightened risk of complications during surgery. Physician involvement is the best way to ensure that the lives and safety of our nation’s Veterans are not put at risk. Veterans have earned and deserve safe, high quality anesthesia care in VA facilities.

Jacob Savidson

VETS DESERVE SAME CARE AS SOLDIERS, INDIGENOUS TRIBES

Another commenter applauded the move because it would bring VHA health care in line with the care of the US Armed Forces and the Indian Health Service. Is that a good thing? Do we want to strive for economic consistency versus consistency in high quality?

How is it that an agency with a $160 billion budget cannot afford to hire doctors? Where did the money go? Oh, it went to cover IT spending for companies to not update VA health care systems including wait times.

“Wait a second” you might be thinking. “Didn’t I just read yesterday that VA was admonished for not updating its computer systems that would have prevented the wait list / wait times scandal? And that failure resulted in VHA hospitals been deemed unsafe?”

Yes, yesterday I published an article where VA was admonished for wasting billions in IT fixes that should have gone to modernize the VA health care IT system which would have prevented the wait list scam. This leads me to be suspicious that the wait list scandal and brew ha is being used as a device to push through this questionable regulation change.

RELATED: GAO Scolds VA For Unsafe VHA IT System

2013 LETTER FROM WILL GUNN AND ROBERT PETZEL

In 2013, at least one year before the wait list scandal broke, VA was already working to propose the regulation change.

According to the letter:

The Department of Veterans Affairs (VA) is pursuing national policy that will recognize the full practice status of all VA Advanced Practice Registered Nurses (APRN) and the ability of VA nurses to use protocols in the delivery of patient care.

The National Council of State Boards of Nursing (NCSBN) Consensus Model for APRN Regulation will provide the foundation for VA’s qualification requirements for all APRN employment including: Completion of an accredited post-graduate program; board certification by a VA approved accrediting body; and demonstrated ongoing competence in the area of practice. APRNs currently licensed in states with collaborative practice agreement requirements will have the opportunity to request additional time (up to 2 years) to transition to independent practice through a formal program that may include mini residencies, continuing education, and formal preceptorships. Nurses other than

APRNs will receive additional education and training to ensure they can safely and effectively engage in protocol-driven practice as authorized elements of practice.

The authority for this national policy is title 38, United States Code, which authorizes VA to prescribe all rules and regulations which are necessary and appropriate to carry out its statutory role as a provider of a national health care system for the Nation’s Veterans. This includes the authority to establish the qualifications of its health care practitioners and regulate their professional conduct. With the exception of controlled substances prescribing, which by Federal law requires adherence to state licensure requirements for such prescribing, VA determines the elements of clinical practice for its health care practitioners.

READ IT ALL: Robert Petzel, Will Gunn Letter Of Support

But does the US Code also allow the federal agency to violate the rights of states to police their medical care professionals operating within their own states?

It may be instructive to know Robert Petzel resigned in shame once he was linked to a contractor with whom he allegedly gave preferential insider treatment. Petzel quickly resigned after that information surfaced and at the beginning of the wait list cover-up.

RELATED: Robert Petzel Set To Resign

Will Gunn also resigned swiftly after sending a memo to Phoenix VA that was interpreted to allow Phoenix VA employees to destroy certain evidence despite being placed on an litigation hold where they should not have destroyed records.

RELATED: Will Gunn Shoots Self In Foot Before Resignation

2011 OGC LETTER SUPPORTING REGULATION CHANGE

How is this for unoriginal? VA’s attorneys concluded VA has the authority to violate the rights of states to police professionals working within their state. Where is Congress on this issue? Why am I not seeing an Congressional assessment of the regulation proposal?

TAKE A LOOK: VA OGC Supporting Letter

I have not shepardized the letter, but I would be very curious to read from someone who does evaluate the OGC justification.

It could be that you read this, in connection with the Executive Order, and conclude the proposal is totally legal on its face. However, take a quick look at the history of executive orders and whether the Constitution allows for such creation of laws by the President so as to usurp Constitutional guarantees to the states.

BACK TO REGULATION CHANGE

There are obviously many sides to this issue. Some advanced nurses who failed to attend medical school or were unable to get in want to have the same privileges as doctors who were trained at medical school for three years and spent another three years in a residency.

Nurses do not have that same level of expertise. But maybe that is the point. Maybe some of our leaders in the insurance industry and health care industry want to provide cheaper, less comprehensive care to the poor. If the poor die, then it is one less poor person needing health care = money saved.

Do you think Secretary Bob would allow his family members to receive the kind of care VA is now pushing for? Would any millionaire ever do this? Absolutely not.

So why do they push it onto veterans? According to one commenter, the care is sufficient for Native Americans and Soldiers, so why not give it to veterans to save a buck?

I can imagine the backroom dealings on this one. One side discusses the wait list. The other side discusses ways they can exploit the known problem once it surfaces. Shazam – nurse led care.

Nurses win. VA wins. Big insurance wins. Unions win. Health care institutions win.

Patients lose.

So what do you think we should do? Allow another violation of the Constitution to save some money in the short term? Is that really what we are forced to do here?

READ: VA Proposed Regulation Change For Nurses

Stay informed on VA news, scandals and benefits. Get our daily newsletter via email.

17343

DisabledVeterans.org

Get our free daily newsletter.

105 COMMENTS

  1. I think that dept of veterans affairs should be renamed to the dept of we dont give a shit about veterans.

    Please keep sending us our pay checks.

    I am fed up and i vote, i just wish there was some one worth spending my vote on.

  2. The VA seems to be doing their best to force veterans away from the VA. They claim to have a shortage and don’t want to hire any doctors. What news is spread from the media makes them look bad.The VA doctors have a conflict of interest in even helping some veterans to get benefits. Most VA doctors refuse even to fill out a DBQ for a veteran. It seems as if somebody at the VA must have some kind of racket going on. Where the BVA denies veterans. Where does it go?? Who benefits from this if the veteran don’t get anything?? It feels like the BVA is running a health benefit lottery?? Pick a lucky ticket and you don’t have to wait another 2 to 10 years after denials!! I have been waiting for Congress to repeat history and pay equitable relief (1936 Adjusted Compensation Payment Act) It must be a racket for Congress to keep doing nothing also?? So many band aids but never fixing the real problem. Veterans are getting wrongfully denied and the length is harmful, abusive and offers no resolution. This clearly effects the well being and the quality of life of the veteran. Now does this now sound like it is a VA lottery??? I hope everyone will be at the Lincoln Memorial 7-16-16 as Congress will see that veterans are tired of VA neglect!! Pay us all off and we will seek health care privately if we choose. We then will have a real choice as the VA seems to force vets away from the VA in the first place!!!

    • @Veteran Stimulus Act

      Can you tell me, and others on here, more about what’s happening at the Lincoln Memorial on 16 July 2016.

  3. This is just another way for the VA to shortchange veterans who seek to use the rights granted them in the chartering statutes governing the VA. If the two proposed professional’s qualifications are compared, the answer is clearly that quality healthcare demands the continuation of the physician led model and rejection of the nurse independent (meaning unsupervised) practice. The standards of admission to practice between the two hypothetical providers instantly reveals the proposed changes’ derogatory impact on the standard of care. To wit:

    Anesthesiologists are required to attend 4 years of medical school after completing the standard 4 year undergraduate degree program. They are then required to perform a 2 year internship followed by a 2 year residency training program. For more complex anesthesia surgical practices, an additional 2 years of a fellowship may be required for those specialized areas of practice.

    Nurse Anesthetists are required to complete 2 years of post-graduate NURSING study and then 1 year of residency in the field to be a licensed Nurse Anesthetists. Notice the subtle but incredibly important title conferred by each program. A medical doctor who specializes in the administration of anesthesia is called an ANESTHESIOLOGIST. The Nurse Practitioner who specializes in the administration of anesthesia is called an ANESTHETIST. Very akin to the distinction between an Ophthalmologist and an Optometrist. One is a medical doctor and the other completed a less rigorous discipline. The distinction of the titling of the two positions is critical.

    The original idea of the Nurse Practitioner Anesthetist was for the position to allow an Anesthesiologist to supervise more than one surgery at a time. The Nurse Anesthetist monitors course of the operation and adjusts things within the parameters specified by the physician. The Anesthesiologist then goes and has a second or even a third surgery initiated with its own Nurse Anesthetist in each of the other surgeries. The physician then moves between each surgical theater monitoring the progress of the operation, the level of stress each patient is encountering and is immediately available if one of the surgeries goes South and the physician’s presence is demanded. I which case, another Anesthesiologist is pressed into service to monitor the remaining surgeries that only require monitoring, not actual emergency or complex adjustments to anesthesia.

    That is the way the system was initially conceived and sold to the skeptical physician community. It relieves the demand for the much larger requirements of individual Anesthesiologists in each surgery where most surgeries only require monitoring and a trained hand to provide initial corrective steps until the supervising Anesthesiologist physician can scrub in again. This system uses trained, but far less trained, nurses to perform the monitoring tasks and provide the initial corrections in an unusual situation until the physician is able to make the real-time changes the patient requires.

    For these reason, I am vehemently opposed to the proposed changes. The VA is attempting to end-run a time-tested method of patient care with some off the wall level of care by a person who is trained in a much more inferior manner.

    As to the “pro” and “against” comments provided on this issue, it is clear to me that the letters in the “pro” group were written by a common source. The wording is so similar, some of these letters could have been written on the same computer. These letters would be considered plagiarism in another context. The “against” letters are obviously from actually different persons. The syntax of the writing, the sentence structure, the vocabulary all speak to different authorship. The “pro” letters lack the originality of the “against” letters.

    • @Jim Hadstate

      Nicely written.

      I especially like your distinctions between “Ophthalmologists vs. Optometrists”!
      I personally am stuck with an optometrist. I had a “well documented” injury to my eyes, (explosion), while serving in Vietnam. Which has caused problems since.
      Yet not once has he referred me to an ophthalmologist.

      In my opinion, seeing a nurse, pretending to be a doctor, would not be conducive to receiving proper medical care!

  4. I am simply FED-UP!

    I can just see the potential future mess this would cause in granting advanced nurse practitioners to act as M.D.’s without any M.D. supervision.

    Veterans will potentially have Independent Medical Opinions from private M.D.’s superseded by much less qualified medical personnel, and then to the Black Hole of VBA. Not a fan nor supporter of this in any situation. This will NOT benefit Veterans but rather the VA. Period.
    Will AG Loretta Lynch override State Laws and allow this? I am thinking yes.

    Off Topic but related: Interesting how AG Loretta Lynch was initially trying to claim that she and Pres. Clinton’s airport tarmac meeting was entirely *coincidental* and they just *happened* to be using same airstrip…LOL LOL LOL LOL

    NOW she has recused herself. I think this was entirely orchestrated to ensure Killary can still run…too bad.
    Loretta Lynch needs to be looking at the world through metal bars and three meals and a cot. She also happens to be one of many Muslims on Obama’s Cabinet…do the math and her track record of ignoring THE LAW.
    If I were an Attorney, I would be ashamed to have an Attorney General of USA such as this…January, 2017 could not come fast enough.

    • Yep. Can’t sit and read or type much longer but “Fed Up” is the words of the day and has been for years.

      Dear Miss Piggy Lynch was on NBC and reported she would follow the lead and request of the FBI and other agencies. So she must not have recused herself very far away.

      Oops. More important today as the media is all about is ta da… entertainment. Not much about more serious issues or higher priorities needful for this country and our people/vets. Aww hell who cares as long as the sheep have entertainment, drink, bread, crack, the girlies with short skirts and singing about things they don’t have a clue about, like fight songs or freedoms. LOL

      • Actually, JUST a few moments ago on National News the *only* thing I have heard regarding Veterans on this start of July 4th weekend is…wait for it…that President Obama announced that the *currently serving active duty* 2,500 Transgender Military Members will be allowed FULL Transgender Surgical and FULL benefits…WTF? 2,500? WHO KNEW?

        What’s next? The totally dismantling of the UCMJ and just invite all the L.A. and Detroit/Chicago Gangs to join military, no questions asked? Face tattoos, NO problem?!!!!!

        I am FED UP with this Liberal Agenda.

        I consider myself a pretty open-minded person without being a crazed liberal (God no), but it bothers me immensely KNOWING we have 1000’s of HOMELESS VETERANS in this USA and Veterans STILL not getting THEIR SQUARE DEAL *and* 22 Veteran Suicides A DAY…yet…let’s focus our Tax $ and priority on making the men woman and women to men…I actually would not have too many mixed feeling about this IF current Veterans and the VA were in a better place now.
        I love my USA but at the same time I am not so PROUD of my USA. Does this make sense without sounding like a callous insensitive ass?

      • Nambor,

        Several articles worth mentioning:

        “VA Denies Claims It Colluded With Union To Oppose Reforms”

        “The Department of Veterans Affairs countered claims that it has colluded with organized labor Thursday in opposition to those trying to reform the agency.

        The American Federation of Government Employees (AFGE) has held dozens of protests opposing lawmakers and critics who have sought to reform the agency, and the Cheyenne VA Medical Center in Wyoming sent out an email which appeared to promote an upcoming union protest July 6.

        Veterans Affairs has been under increased scrutiny for systematic issues that left dozens of veterans dead.

        “Once our union decided to do this I decided to let our community partners know,” Cheyenne VA Public Affairs Officer Samuel House told The Daily Caller News Foundation. “I am not colluding with anyone. I was just letting our community partners know.””

        There is a lot more to the article at:

        “http://dailycaller.com/2016/06/30/va-denies-claims-it-colluded-with-union-to-oppose-reforms/”

        ~~~~

        Also on the Clinton Lynch secret meeting.

        “FBI at Clinton/Lynch Meeting Ordered Press Blackout: No Photos, No Video”

        “‘No recording’ order points to conspiracy to subvert Clinton investigation”

        “Kit Daniels – July 1, 2016”

        “The FBI blocked journalists from taking videos and pictures outside the secret airport meeting between former President Bill Clinton and Attorney General Loretta Lynch.

        “The former president steps into her plane, and they then speak for 30 minutes privately,” ABC 15 reporter Christopher Sign said about the Phoenix meeting. “The FBI there on the tarmac instructing everybody around ‘no photos, no pictures, no cell phones.’”

        That doesn’t sound legal for FBI agents to block the press from filming outside a government meeting that’s clearly in the public’s interest, and the fact they did reveals the meeting wasn’t as innocent as the Obama administration wants you to believe.

        “With the FBI swooping in and preventing video evidence, is there any doubt in your mind this meeting was planned well before hand, and not some random event like Bill Clinton said?” a forum commenter at Godlike Productions pointed out. “In other words, Clinton used his influence to arrange this meeting with Lynch days before and making it look happenstance.””

        “The FBI order may have even violated 18 U.S. Code § 242, deprivation of rights under color of law, and it points to a conspiracy to subvert investigations targeting the Clintons because it’s not the FBI’s job to block journalists – or even private citizens – from filming public officials who are meeting in an official capacity.

        Interestingly, a day after the secret meeting, Lynch’s Justice Dept. blocked the timely release of emails between the Clinton Foundation and Clinton’s State Dept.

        “Department of Justice officials filed a motion in federal court late Wednesday seeking a 27-month delay in producing correspondence between former Secretary of State Hillary Clinton’s four top aides and officials with the Clinton Foundation and Teneo Holdings, a closely allied public relations firm that Bill Clinton helped launch,” the Daily Caller reported. “If the court permits the delay, the public won’t be able to read the communications until October 2018, about 22 months into her prospective first term as President [if she’s elected.]””

        for more with Video,

        “http://www.infowars.com/fbi-at-clintonlynch-meeting-tells-reporters-no-photos-no-video/”

      • Nam, it was not that long ago when the Air Force prosecuted a female officer for adultery. I believe she was at Minot, AFB.
        I think most services still have that in the UCMJ.
        Now, if you were Stan but want to be Stacy, they’ll not only ignore UCMJ, but pay for it.

    • @namnibor
      Now Lynch is trying to get it where Hit-LIAR-y’s emails won’t be released until sometime in 2018.
      And IF anyone believes that “Secret Meeting” was about “Grandchildren and Golf”, they need a mental health screening!
      I read an opinion piece last night, where the author says, that “meeting” said LOUD AND CLEAR to any and all investigators ——–
      The Clinton’s are my friends! You better think twice, and know your facts, before you approach me on getting an indictment!
      (I’m paraphrasing ), but y’all get the point.

      Where did you get it that Lynch is going to recuse herself? I’ve not read anything on that. Only, I do believe that would remedy this situation!

      • National News…it’s all over, and the BBC. Speculation is brewing…and there’s probably yet a large steaming pile of warm VA Poo to be released around close of business day before long July 4th weekend…or maybe this AG Lynch now officially recusing herself IS that Poo?
        How *convenient*…and sorry folks, as long as Air Traffic Controllers and Homeland Security were involved with this meeting, which they were, it WAS an official ‘down low blow’ meeting.

        Meanwhile in USA, people are more concerned about the new pimple on a Kardashian hide. 🙂 Sad, but true.

        OH…just when will the VA be demanding BILLION$ to combat the Zeka Virus? You KNOW it’s in the VA pipes!!!

        You all try to have a good and safe July 4th Holiday Weekend and take the time to reread the reason WHY we continue to celebrate our Independence and WHY we are NOT quite done yet as the tyrants are on the mainland.

  5. My response was too long and dropped. Okay. We don’t live under the Constitution. We have no freedoms or choices in our health care or against all the vast amounts and levels of corruption, fascist rule, state medical board idiots and others who don’t care about us as tax payers, clients or patients. All that is done is more restrictive and oppressive laws from the tyrants. It’s all about control, globalism, big bucks for the elite and professionals.

    I left the VA only to find civilian care is not much better here, and has to follow the same socialist styled guidelines and agendas. Files and records difficult to obtain through their fancy high tech junk. What a joke American health care has become. I guess the VA pain orientation presenter was correct. The VA, the state, to Homeland Suckerty controls everything and all our states medical services. He said if we left the VA and refuse to sign the new VA contracts for care…”we would never find the health care we desire in this state again, if we find care at all.” “They” control it all. Nice huh.

    Obummer is cutting Medicare (now) but making gender reassignments a priority and more needful? Get real. Chronic pain is good for us and the establishment and state feels it good to make us suffer more and suffer more stupid fascist blood testing by the vampires. Remember what that piece of trash said about health care for all? Depends on who and what we are and what we need. Oh but is we need a joint replacement Obummer says no?

    We live under and controlled by tyrant pigs. Law enforcement, established medical liars and professionals, phony lying statistics/reports, politicians, foreigners like the United Nations and other globalist and agendas should have zero influence or totalitarian controls over my life and health care, or needs. Period. We are not supposed to be treated by corporal punishments or thought of as “all the same, one size fits all” care, not as individuals, oh no.

    We older people/vets are just “Bed Blockers.” Google that and the coming changes to Medicare while illegals can get whatever they want for free. No Constitution, we just live on a conveyor belt of taxation, serfdom, ill treatment, pain, social engineering, land of the sheepsters, and death. If we keep our ears open at various places and hang-outs we can hear some juicy sickening conversations.

    We need to drop the “Democracy” crap and go back to our well intended “Constitutional Republic” with individual freedoms and rights. Not majority rule, or what some activist or commie says or what Hollywood demands or some other group or globalist country wants us to be.

    Time and media is on the side of the corrupt, not ours. Media and trash can fill stadiums and theaters but not fill the streets for our freedoms and care? We haven’t had the real big C since the 1800s and too much corruption and too many anti-American laws have been passed and protected.

    More people will gripe about a doggie or kitty story than they will stand up for veterans or us old folks who Oprah says “should just die off.” And her millions of fans must agree, along with Hollywood and Washington DC.

    Heck, Google people like Anna Von Reitz about this new ‘merica.’ Living in Indiana or the USA today is akin to the old Soviet Union, North Korea, Gaza Strip or South Africa. This country and us are up the creek without a paddle or for me, having zero hopes or trust for change at all. It all just gets worse and worse by the day. Pathetic.

    • this is the best reply of all.
      someone who thinks critically.
      good for you, and thank you for taking the time to write this down for us.

      all of “health care” has been usurped by tyrants.
      VA, non-VA, doesn’t matter.

      we the people better read this writing on the wall.

      our health care is up to us, each of us.
      not a “doctor”.
      not a “nurse”.

      yes, in the midwest, especially rural areas, it is like living in the soviet union.

  6. That is a clear violation of sovereignty. State Education Departments have control of the licensing and monitoring of the medical profession. Any violation of that also removes the only viable recourse we have in the event of medical malpractice or complaints. This would clear be a clear threat and removal of what few rights we have left in the midst of official government genocide of the veteran community – AO and GWI being only the latest examples.

    • Please do me a favor Craig and call your states licensing department. Tell them you have a complaint against a VA provider, see what they say and report back here.

      • Respectfully your reply about calling the State and imolying it is pointless is only partly true. I called the State licensing board about the VHA pharmacists entering a pain contract into my record that I never saw, signed, or agreed to, the doctor prescribed 180 mg a day morphine, 40 mg per day hydrocodone and other drugs that I never met, and a social worker who supplied a portion of those drugs to me on the sidewalk outside the clinic in an envelope.

        The State Licensing board for the doc who refused to actually see me would not talk. The State Pharmacy Board said ey could only act against a State Pharmacists and not VHA but confirmed a felony crime by falsifying a pain comtract. Oddly, it was the Pharmacy Board who informed me, “…while we cannot act against Dr. #####, the State licensing agency responsible for LCSW (the social worker who passed me the drugs on the corner) does regulate the social workers who work at VHA, and we have forwarded your full complaint to them for action.”

        So far in this scandal VHA denies everythhing but at least seven people have “…retired from government service…” The kind social worker who passed out drugs to me that almost matched my prescription signed a written confession for VHA police. The process worked somewhat but as reported the VHA retaliated in brutal fashion for me telling on them and to this day continue to deny service, but you can indeed rat out an LCSW in Oregon State and they seem eager to pursue VHA social workers here.

      • RT, I am thinking this has to be a state by state issue. I know CO has said anyone at the VA is exempt from state oversight, after first telling me they were regulated. I have called other states, and the ones I called told me the same thing.
        I was shocked when CO told me they don’t oversee any VA provider.

      • Oregon law is extremely sympathetic to disabled. For instance we have a statute that makes it a crime to call a disabled person on the telephone and inform them that their medical care is in jeopardy. When the clinic manager called me at home and informed me that he was placing a flag on me and that my local health care were terminated, he broke that law. The Circuit Court agreed and issued a Reatraining Order against that clinic manager namining him as a “molester”, and myself the “abused”. It forbade him from contacting me or taking action.

        Four days later VHA issued a letter banning me from local care and cited the Restraining Order that the Circuit Court Judge created and issued on my behalf as a Chief reason. They also concocted a fake murder threat which their own VHA police determined was fraud. This has been reported in the paper but VHA to is day continues to deny care.

        And so my long painful journey began and three trips to the psychiatric ward later I am now stabilized again. So there are horrific consequences to the vet, but even the Oregon Circuit Court is sympathetic against VHA people, and that gives me hope.

      • No state can oversee the VA.

        The ignorant and sheer stupidity from Ben and all the commenters is amazing.

        I am going back to VBN where they are rational and know the laws and regulations.

      • Mister “Sheesh” is clearly uneducated about what the issue is here. States oversee the licensure of all clinicians licensed in their states. We oppose VA’s desire to interfere with a state’s ability to police the health care provided within its borders. In states that mandate physician-led health care, the new VA law would override a state’s right to require a certain higher level of health care.

        Don’t veterans deserve the highest level of care? Further, the Federalism executive order created by Clinton may be unconstitutional if challenged. That is the executive order under which VA claims it has the authority to lower the standard of care nationwide regardless of any state mandate.

        Anyway, Mister Sheesh spammed my entire site on Sunday under multiple emails like “[email protected]” “[email protected]gmail.com” and “[email protected]”. Spamming is prohibited, so he is now banned.

      • You know Sheeshstain, you say you are going back to VBN because we veterans are just too stupid for you to put up with, yet you comment several more times.
        Why not flush yourself back to whatever sewer you crawled out of.

    • I have signed those narcotic drug compliance contracts years ago. Then they wanted a newer updated version last year which include us NOT using civilian care for anything, emergency or not. We were “ordered” to drive the hundreds of miles to the Indy VA for everything from broken bones, heart attacks, crashes, etc. If they called in the middle of the night we were to drive non-stop to Indy for pill counts and tests. Regardless of our conditions or time of day. The new contract would take total control over our lives including keeping journals that the VA demanded and open to read at any time. Are we living in freaking Korea or Gaza Strip???

      Now go and try to get a copy of one of those ‘other’ ‘side’ contracts with the VA. It won’t happen. But we will constantly hear..’prove it.” (!?)

      We were informed that if we did not sign the papers, new contracts, that the VA would not treat us. If, when I told them about leaving the VA, “I would never see decent health care if any at all in the state of Indiana because the VA, state boards, the governor “PENCE”, ALL two party elected, Universities (filled with activist and left wingers/foreigners), the DoD, Homeland Suckerity, the CDC, Commander and chief, ad infinitum, were on board and supported this fascist threat and the “FORCED” taking of anti-depressants on us, regardless of past negative severe side effects. Just like old military days…corporal punishments to “forced” volunteering with no other options to be had.

      It must be true because I have had to wait and play games over getting records and reports from the VA. Civilian MDs and others here think it’s a big lie or a joke, While not giving a damn about our daily struggles.

      The other contracts we signed about the E-record sharing crap is just that. The only thing that all that high tech junk is good for is keeping track our us and our buying habits. They could call and tell me how much and what I have purchased for local pharmacies and other goods used with those stupid purchasing discount cards, or tell me they found I have not been convicted of any felonies or drug charges, but they cannot get my files from the VA or simply carry on with needed meds I have been on for years.

      What happened at the civilian MD? More stupid testing with emphasis on sneaky drug testing. They don’t care about the number of Xrays I have had or other scans. They all claim to need and want their own, period. Then to be told by this new MD that there is just many issues to be dealt with. Meanwhile all my meds have NOT been re-prescribed by the locals, none. No gout meds to emergency inhalers, none. So I am led to believe again the typical Indiana corruption and special interest group are running as rampant as ever on all levels. One sneaky person did say to me in the parking lot… “I see your a vet and veterans are getting a raw deal around here and expect to be toyed with.” Oh, I have to prove this type of stuff. We vets are incapable of telling our stories, or truth or pretending we have rights and freedoms or say over our health care.

      I have contacted, or tried to, media- local and national, the governors office, both elected political party scum, vet groups, Washington DC, State licensing boards, the AMA and a whole slew of abbreviated professional groups. The state’s attorney general, etc. Did no good but seems to have put me on more updated attack lists. With their expectations that I walk around and video/audio record every minute of my life seemingly is just dumb and irrational. I should not have to entertain hours and hours of interrogations over my health care, the game playing, multiple tests for a complaint and on and on it goes. Or argue with idiots over why I didn’t continue on with a phony pain pill script called Tramadol that about gave me a damned heart attack and severe side effects. But they want to know why I threw them out and didn’t get the the re-fills? Christ on a crutch I am so pissed off I can’t see straight. Health care is NOT what if was years ago and far from what we could get in the eighties before all the grand changes and labeling PC crap like “primaries” when doctors used to be able and trained to do it all or most of it. Not today, they got to spread the misery and money around.

      I want to see Trump and especially scum bucket lying pro illegal masses flooding into Indiana PENCE explain some reality and facts. Trump made a bad choice in my book and experience with the grey haired two faced typical Hoosier politician. Sorry, rant off.

      I am really fed up to the hilt.

      • It is hard when you are on narcotic pain killers. I was up to 180 mg/day morphine and 40 mg/day hydrocodone for pain from VHA, When My bhavioural flag was placed all narcotic was teminated overnight. I had three doses left when it was terminted from an illegal behavioral flag.

        The withdrawls were horrible and I ended up in the mental ward again. My anger over this was considerable. I realized as the withdrawls had receeded and my life went on withhout those narcotics in me that the word “life” began to mean something again. I live with pain now. I do not simply exist in comfort. Morphine will never release its grasp on your soul my friend. As long as it is an option, you know, I know, and every single other person who was also made dependant upon morphine through the dispensing machine known as VHA knows that until that supply is terminated by others we will fight to death to keep getting it.

        Moreover, ALL of us that are now ependant upon morphine are ALWAYS angling for more and more and more. Morphine gave me permission to skip the hard parts of life. It gave me permission to exist in beautiful comfort on my couch. When VHA terminated my morphine (we all call it “my morphine” too) I hated them as I have hated nobody else.

        Now free of that horrible curse, I realize that the most collosal mistake I EVER made (and I hav made some whoppers), he biggest mistake I ever made was to allow myself to become dependent upon government to feed my addiction. When I did that theynhad me by the short and curly hairs and my hands were tied.

        As a patient now dependant upon and free of morphine from the VHA, I am going to say something you will hate; whoever is making it hard for you to get morphine is gifting you life. If a VHA doctor is making it tough, then maybe for once you have a good one. My friend, I know what real pain is

        Walk way from morphine and live.

      • Thanks for the reply and info. Along with my most sincere well wishes for you and your plight with pain and VA issues.

        I know all about addictions, etc. I was a corporate trained counselor since I refused the PC garbage and affiliations/demands from the college crowd and others. I also helped run Sober Club and volunteer work for over eighteen years. But that isn’t good enough the VA since they told us in class that we are too stupid to know what is best for our own bodies, too forget everything we have been trained to do, and to forget ‘everything’ any clinic, doctor, whomever, specialist, has ever told us about our care, treatment plans.. for anything, to forget it all. Anything I knew, worked, trained for, did, etc., was to all be forgotten, relearned, since it’s all garbage unless it comes from VA staff. And I’m in my sixties and supposed to just forget “everything.” (??) That I don’t know my own body or what’s good for me? And that only the VA and scum suckers in the government and VA trained knows what is best for me, and how to live my daily life. No way. They tell me to run three miles a day and would be required when I can’t even walk that well or long enough, but tell me to run?

        I have NAFL disease. Non-alcoholic fatty liver. So I was told supposedly by the best, and visiting liver specialist and world class surgeon to never take anything but narcs for pain. Nothing over the counter, no NSAIDS, no tylenol that the VA had been bombarding me with. Even when my liver enzymes come back down to normal. But the Liver clinic at the VA must know it all and simply dismissed what he told me, just like my primary at the time did.

        So there is more conflict between VA staff and others;
        Oh yes you can take over the counter meds and stuff. Vs., Oh no you can’t or shouldn’t. Then have another MD call me and tell me to get off of stomach meds, arthritis meds and more pills for cholesterol that is killing people off, raising my enzymes, but seems good to push that stuff on us. Then over and over it goes, the conflict, contradictions, malpractice to intentional neglect continued on with every change in care and MDs or who ever.

        I don’t need large doses of morph. Normally and works fine is Hydro 10 twice a day with increases only on bad nights of cramps and joints or spine being out. The pain issues I have are from head to toe. Migraines to artificial joints that so-called experts and professionals put in wrong and maladjusted to function properly. The only increase i need is for the migraines since I went broke going to emergency rooms for help and having to pay their budget busting bills.Osteo-arth etc., really sucks to deal with in the raw let alone bone deterioration and joints with raw nerves seemingly. Higher doses are reserved for the most severe of pain.

        Knees and hips both sides are about ready for artificial but won’t happen now since leaving the VA and they have to get much worse, they claim. Really I’m falling apart and can’t do much at all for enjoyment or even walk. So to do something in the slightest fashion I could pop a few pills in 24hrs, no big deal to me. I didn’t have withdrawals in between getting them before and not when they cut us off for not signing the special contracts of tyrannical Draconian rules for the new VA care for us with pain issues.

        The addiction part would be them ordering us to take higher doses every day, every four hours during the night and day both and never stop. That is total non-sense, un-needed, foolish, and stupid, just begging for vets to become addicted or dead. And to never show a clean pain med free drug screen. It’s nuts. Personally if I don’t need a pill for the day I won’t take one. Who are they to tell me now I have to or else?

        I can control my self and I know full well what happens if I don’t. Unlike what we were told all veterans and our ills are not alike and we are all not alike. But according to the VA we are, We were told if one veterans robs or kills to get pain meds we all will sooner or later. Which is total degrading socialist, fascist pig, BS from the government. And from scum unionized stupid VA trained staff that would kill their mothers for a cushy VA position.

        The only withdrawals I have dealt with is the head meds the VA told me I had to do or try. Sometimes several at a time that did nothing for pain, but the withdrawals were worse than anything I have ever experienced.

        The VA and this stinking over-reaching government and it’s agencies need to get out of our lives and health care. They are soft and hard killing Americans and veterans by mass but few care as long as they get that free care, even if it kills them. Then when Pence, state boards and others start threatening MDs about losing their license for signing a pain med script, when MD fear, then something is wrong. The same goes when the media reports they are going after emergency room doctors for giving pain relieving medications. I guess it’s like I have been told before by foreign doctors. “Americans are weak and can’t take pain.” How much pain? I have sit by many many people and watched them expire or wait days for life ending pain meds to be approved. Would Pence, Bush, King Obummer have to wait until they are dead to get pain meds? I don’t think so. So it’s a deep and varying subject but we the serfs and tax payers are not in control or have a say in much these days. While my local officials and unions have their own Mds and clinic to go to, unlike us regular old peons. They don’t suffer and wait like we do. Their attorney wives can get a crap load of meds for a bruised thumb. But a male vet or old dude has to suffer because we don’t count and have no group or spokespeople to riot or go to Congress and raise hell for us.

        Oh well. Have great day. and again, all the best to you and yours.

  7. Department of Veterans Affairs has already been caught falsifying doctors credintuals , and using MD’s with civilian deciniplinary actions against them . As in the case of TBI exams . Everyone with any reasoning skills at all should have No bout this will occur with even less trains nurses . I too agree the pro letters appear to be form letters written by Department of Veterans Affairs propaganda machine . I also agree VA should be held to the same or better standards than civilian practice , ie. State boards of Nursing regulations .As should the ability to let gate wrong doing by VA . I am an ex medic , orderly and LPN , Almost thirty years experience. As long as VA does not punish wrong doers to the full extent of the Law for veterans deaths and punish whistle blowers NOTHING will change ! As long as it is cost effective to stall claim and let veterans die IT WILL CONTINUE .Also my recent hx at obtaining VA records indicates VA is now reacting our medical records we receive at ROI , hence the increased time in obtaining them and the lack of information and doctors and nurses notes in them when we do .it now takes me over 6 moths to obtain , used to leave with disc in hand . Their excuse , veteran increasing and they need more help and overtime , BS !

    • Not reacting redacting , altering medical records . These Are legal documents and it is illegal to alter them . But of course this has NEVER stopped VA . It is also evident VA doctors are disciplined if the place anything , knowingly to aid veterans in their claims with VA .IT is also evident joint replacement surgeries are frowned upon . Over thirty years and braces and pain meds that I have to constantly fight with them over . Although no abuse and Never a dirty urine and refusal of Veterans Affairs to do any further plan of care or even MRI ‘s .

      • About the same here. My best wishes/prayers for you suffering over all this.

        I have never tested dirty either. No over-use or abuse, period. My aritificial implants are a mess but too late now. All I have ever been told by a wide variety of MDs and clinics both civilian and VA was pain management and possible alternative, non VA recognized treatments and care. Which is now a un-mentionable. Like acupuncture.

        I was just told this by a new nurse at a civilian clinic about changing file entries and disappearing records, files and emails. All of which were just deleted from my Healthy E vet site by the VA and Contractors IT techs. All of my previous items on that page were gone when I went back to copy all of it for proof about what I was being told, and arguing with them over. That include lost Xrays and such too. And I have not been able to open a single package of about fifty pounds of files I requested, and know much has probably been “adjusted” to suit their agendas and purposes.

        When I was still bantering back and forth with Patient Advocates they couldn’t find a single email, complaint, crossword, or threat I was told about or threatened with. They did mention they could find everything deleted from my Evet thing and from the local CBOC, but it never happened and then they claimed “could not be found.” “Therefore never existed.”

        Nothing surprises me in the USA any longer. I had an entire federal court brief complete with original evidence go missing in my highly paid attorney’s office. That would have exposed my state and many agencies and the elite as corrupt scum they all are. So nothing the VA nor our present politicians, media, courts and others may do, can do, will shock or surprise me. Like Hillary they are all above the law and have it made compared to the rest of us.

        You guys should hear the hate and comments I’m getting for having a simple Trump sticker on my truck and another that says “I survived the VA.” “Giving veterans a second chance to die for their country.” We really do live in horrible anti-American, anti-veteran corrupt times. The VA stickers can be ordered online and money goes to vets in need.

  8. I’m not sure which would be worse, nurses acting on their own, or being under a bully VA doctor’s supervision. My PCP was a qualified nurse, but the bully doctor in the clinic, who got demoted and replaced by a nurse, made sure NO ONE got treated correctly. In my case, I was forced off a med I had been on for 20+ years and was contraindicated. She didn’t fight for me even for a moment. I believe there are nurses that are better providers than doctors, but statistically they aren’t really any better than the ‘system’ allows.

    What needs to happen in the VA, is for patients/Vets to file complaints on each nurse or doctor that has wronged them and get rid of the substandard providers.

    • Ben this is ridiculous. I must challenge you on this nonsense. There is NO constitutional law broken here, in regards to the Advanced Practice Nurses being able to work across state lines. Unless, perhaps you mean it is a violation of my rights, than I may take another look.
      The Va and the VHA have had ANPs for a long time working with the patients and the doctors.
      It is my humble opinion that many provide better care than that of the physician. This action only adds quality and accountability to the process which is still sorely lacking. As Nurses we are more likely than not, to be held accountable. It can not be said to be true of mds.
      The issue is the fact that these APNs must work under the guidance of a MD. That being said, the AMA is up in arms because, the APN while working within the VA setting is working under the direct action of the top MD. It is a wonderful change for humanity as a whole, because now we can serve more patients, at a higher quality and with a better outcome anywhere in the USA. Which brings us to the issue of licensing, each state already has their own board. A National Nursing Board would bring it to a higher level and many Doctors fear competition. As Nurses we welcome change across all state borders. .

      • Trolling disabled Veterans shame on you Kimberly. Show just how unethical you are. Go fight for Nurses instead of Doctors in your own fucking health care. Do not come here and troll disabled Veterans with your union bullshit.

      • 1. Who the hell said the QUACKS at the VA were worth keeping to begin with? There’s a reason why they are making 200K at the VA when they could be making 500K in general practice. 2. Who gets to see a REAL doctor at the VA anyway? Most of those I’ve seen are PAs 3. NURSES? Are they high? Most nurses at the VA couldn’t find their ass with both hands! Also, in the past six months I’ve been threatened with the power of the ALMIGHTY VA no less than 6 times. Once by a REAL doctor. Once by a PA and 4 (FOUR) times by 4 different nurses. Yeah. I want these “blanks” running my medical care, right! In conclusion, The VA is a lost cause. If Trump should win and we can use our ID cards to procure REAL Medical Treatment in the private sector, I’ll never see the inside of a VA hospital again!!!

      • @Kimberly

        Good and Great physicians or healthcare professionals DON’T want to work for VHA’s. And it ain’t because of the money. It’s because of the ‘criminal activities’ performed at these wonderful clinics and hospitals you praise so highly.
        Anytime VHA’s do get good or great healthcare providers, they quit after a very short period.
        If they speak up over anything, they’re usually FIRED!
        How’s that for factual information!
        So, go back down your rabbit hole. And leave the grown ups alone, PLEASE!

      • In the last two years here at Roseburg VHA at least three docs who have quit came on TV and said they quit because of fross misconduct by the senior staff and physicians. One said on tv, the turnover rate is 30% higher for doctors here than the national average – and this is with financial obligations in place; you do the math. The local vets association, thousanda strong has voted nearly unanimously a vote of no confidence in the quality of care.

      • So you will take another look if its a violation of YOUR rights, but who cares about rights of veterans.
        As for working across state lines, why do you mention that? Is that because a majority of states will not take action against a practitioner licensed in another state?
        If you do not mean that, Please explain in detail how a veteran could lodge a complaint against your state licensing board.

    • Mixed with unicorn farts and fairy dust…here they come. “My care is great, so everyone else should think exactly the same way”…rotten cabbage always a trusty alert. 🙂

      • Had to get a new phone earlier today.
        While gone, I see the smell of “Troll Shit” hit the airwaves on here.
        Although some vets might receive good care, most don’t. That’s why we’ve come on sites like this. To set the record straight. To let other vets know how we are being treated.

      • Posted this by email but don’t think it worked, again here.
        Thanks for the warning. I can save myself some time and pain by not sitting here and reading through it all.

        Update on my ‘stuff.’

        1) We don’t have a Constitution for one thing. No real freedoms or rights. That is more of that cute “fairy dust’ flying around. We have the right to be dismissed, ignored, be silent, to suffer, to be threatened, treated like criminals, blood tested to death, hurry up and wait, listen to BS, and that’s about it.

        2) Physician led care is no guarantee especially if one is living in Indiana and has to follow state guidelines and rules set by state boards, the lousy governor and his war on drugs and war against veterans and freedom. Right along with all of our lousy elected officials and others. The AMA, state’s medical advisors to the governor, led by the nose by the CDC, United Nations, WHO, police agencies, and others are in total control over our individual care. Oh but they have their own special clinics like Congress has here, so they have no worries. I was just told a local physician unless in private practice/office dares to go against the state and it’s cabal for proper treatments and health care that we need, they must follow clinic and states expectations of care, and to withhold certain meds and treatments.

        The grand governor is making the news for claiming a huge drop in prescription pain meds and his war on drugs. Of course he is and it started years ago with the VA and us. Which has now spread to civy emergency rooms and local doctors I have been waiting for months to see now too. The present MD will not prescribe anything, not even emergency inhalers until he hears back from the VA. And for pain I have to pay to see another clinic and pass the bucks around. Totally different from care we could get twenty or more years ago. The health care beast and establishment we deal with today is nothing like the ‘services’ we could get from the fifties on up till today’s huge mess. Well, that is if anyone else had to deal with family/friends/our own illnesses and or deaths from a young age. If not they may think we live in great times with great progress and cheaper. Wrong. I was told here to get pain meds I’d have to be on my death bed. Wrong again. The last several people I have been around didn’t get that well of end of life care. Some with DNRs like mine were just shoved in rooms by themselves to die in their own filth. That is until I walked in when told to sit for hours with the family in the waiting room. While those highly paid nurses were eating B-day cake, filling out cards to doing their fancy nails.

        Now I get to wait another month to see the pain clinic after waiting longer for a “referral.” Kinda like the VA’s “consults” that may never happen for various reasons, or get lost.. So I guess the scum at the VA, purple team, the MDs that treated me, barked orders, their counselors said if I left the VA I’d never find health care in Indiana again, because they, the state, university hospitals/colleges, with the others have total control of it all. Oh forgot one main one mentioned. “Homeland Security.”

        Now a few others around here have been ‘cut off’ and must play the new pain game. It was all okay when it was me, but now it hit too close to their home and now they are without and suffering. What goes around…

        I am still working on my dentures and chewing since the VA broke my jaw pulling a tooth. There is so much scar tissue and damage I don’t think I will be able to chew correctly or with pressure much at all. How nice and an appropriate going away gift, plus them missing a aneuyrism. But docs here think it’s no big thing yet like my passing blood hasn’t raised any eyebrow but told it’s normal for guys my age. (?!!) And much more like two torn rotator cuffs, bone spurs, artificial joints put in wrong, etc. alot more but told it will take time to get through all my issues. So more sitting and suffering, and going through hell just to type or chew, get up, get down, etc., oh what fun What joke everything is today, every damn thing is a money game and we all lose while some have it good or have all that ‘special care.’

  9. Gee, all of the comments are negative about the VA. Wonder if these people are using the VA themselves or just people who what to tell the world how bad the VA is.

    Been going to the VA full time since 1992. Previously I used the VA starting back in 1969. I’ve had the greatest care and I’ve had doctors and Nurse Practitioners both who provided great health care.

    Every Nurse Practitioner I had worked with a doctor and made sure that what they were doing was best for me. And, I used my Choice Card last week and could have used it to see a lung doctor because my VA doc was not able to see me until August.

    I’ve been going to the same group of doctors at the VA for many years now. They know me, they know what works and what won’t and why in heck would I want to go find a doctor out in private practice who does not even know me and does not have my records either.

    And, for all of those who think that getting rid of the VA is the best…you’re full of crap…in the end you will be unable to pay the bill that will be your responsibility after the insurance pays their portion.

    Lets get real about what we say!

    • I know we will all go and toll Kimberly Bolen’s twitter account with some real informative troll excrement.

    • So, you got good care, so everyone who hasn’t shared your experience isn’t keeping it real?

      Ben may ban me for this, but go fuck yourself. My experience is every bit as valid as yours, and I bought and paid for my right to share it with my service to my country.

    • Darrell, is the AFGE giving you a little reach around to post your comments?
      Seems your comments are more on System Worth Saving or union related than what a typical vet would experience.

    • I had to come back here to question you, joker. ” The same group of doctors for years?” You fail to mention which VA or CBOC that is and in what state. Afraid to show your location or which VA you work at? I lost count on the revolving doors of PCPs, students, interns, others, I have had over the years. Some secretaries yeah, but that is about all besides a few nurses that quickly changed positions to lessen their aggravation and stress.

      I stick out like a sore thumb in Indiana because I am the only one in my town, Terre Haute, that has the balls to confront all the local corruption, and have fought it on many levels, for many many years. Tarnish the facade of this town or corrupt scum sucking Indiana (VA – whatever) you become a target, well known, gossiped about, not welcome in council meetings, etc., for life. And I know some local rats know about this board and other forums present and past, then to try and censor me or began some form of attack or retribution. Or letting me know somehow they know what I am doing and reporting. Some on the local political scene and on councils always point to me, by name and address, whenever a negative post or mention is made about this area and state. Is that real enough for you??? That is also a clue about what kind of environment and corrupt state/area I have to endure for not being part of the herd or a corrupt commie like the rest.

      Break time. Have to make a move. I will come back to this post to report my adventure to the new civilian pain clinic/MD and the treatment there and the rules, legalese/state laws I had to deal with.

      • Small town’s are very bad. At Retalation. Your attacking the whole town. You speak about one. Then their uncle’s. Cousin’s. Friend’s go after you. !

        They don’t like change and if your s loner or try and do the right thing they will try anything to try and shut you up. !

        That’s a small town mentality. Like they say push. Push the status que. !
        Hell. Sue them. Take their money. Then they will stop. !

  10. If I as an American am stained enough by the label “veteran” that the rules that apply to other Americans do not apply to me or vice versa, then that does indeed cast me into the elite aming America known as felons and inmates.

    As an American my neighbor can sue his doctor for malpractice. He is not stained with the vet label. As an American my neighbor ccan expect all of his health care pros to anide by the law, or he can expect action and compensation should they fail in that duty. Because I am an American Veteran my doctor has no legal obligation to me and chooses his own set of standards.

    My neighbor can expect to go to his doctor without armed guards escorting them through the halls. Americans so stained as a veteran often cannot. My neighbor can expect a fair trial of an impartial jury when the taking of his Life, Liberty, or Properrty are at stake. I am a stained American. I am a veteran. I have no such right at VA. My neighbor can expect the police to intervene if somebody threatens or hurts them. Stained Americans often cannot.

    Why should I expect the same healthcare standard or equal protection under the law when I admittedly have placed my hands on the implements of war. Why should one so shamed with the title “veteran” expect their rights. It is madness.

      • I have been in civilian ER’s and asked for assistance after waiting multiple hours – when my meds wear off and I get pissed then I am the bad guy despite telling them, pleading with them, to give the little I need to be able to wait longer. They all suck outside. My wife works for a doctor – they schedule appointments 60 days out. It took me almost 30 years but once I was in the VA system they have, for the most part, done well for me. It is essential to find a medical person who will work with you – that makes all the difference in the world. But I have also accused those who needed it of medical malpractice. What are they going to do, draft me?

    • Apologies for the delay. My body tells me what I can do and when the majority of the time.

      My adventures in switching from VA to civy care has not been pleasant in Indiana, rather eye opening to deeper issues we many face with modern medical care. I thought I was escaping long waits, lack of communication, contradictions, Stupidity, fascist rules/demands, etc. Wow.

      My “PCP” family doctor we used to call them is a fifty fifty thing. At least he did find an aneurism and other things, but said there was just too much to cover with me in one visit. I was told before to find a geriatric specialist with all my old age issues however I can’t find one here or heard of any. So it’s just more farting around, game playing, and waiting. He did give me a script for “Gabapentin” for pain even after telling him the VA forced me on it along with head meds and none of it worked but rather made things worse. I simply cannot function on the stuff. Then referring me to another MD for pain clinic. One doctor is not allowed to do it all today, they must spread the money around, go by prohibitive clinic/hospital/association rules, even though they are trained to do a variety of things. Plus having to return to sign more release of VA records this new office seems to have lost or misplaced. (?!) Crap, again????

      I won’t get into the file thing again or how the VA inserted crap and stuff from their medical staff I never even heard of or seen. What a freaking mess.

      Pain clinic was majority of a joke of course. No head to toe physical, couldn’t complete a sentence or answer questions without rude interruption with how he/the state thinks I should feel according to their reports and studies. Had to sign and fill out a stack of paper work, legal releases, contracts, agreements with state and federal laws I never heard of before, “BitterPill law,” etc. About fifty or so pages, I stopped counting. Told the visit would take two hours, try more like – seven – and his waiting room was full when I left at 3:30pm. Others said it is like that with every visit, even established patients. Nice to see foreigners/illegals coming in and straight to back offices for immediate care, unseen disabilities or pain issues, with a few interpreters too. (sarcasm) Oh no we aren’t a sanctuary town or state. Another office there (secretary) reported that the long wait, forms, etc., such can be blamed on the VA, all state legislators, state and federal medical advisors/boards, the CDC, DoD, Pentacons, military high command, to the higher offices in DC. And it’s all a pity I’m not fully covered by state’s medicaid, an illegal, or cannot have supplemental coverage through Medicare in this state until age of 65. A bit short there. So all my so-called rights, privacy, freedoms, beliefs, decent expectations, are all thrown to the side apparently. It all started with socialist styled, tyrannical VA care and can be now found thoroughly in civy care.

      Looking at the dope I took to his office and what records I had he used the F word a few times griping about the VA and how dangerous they have treated me, and the types of dope they mixed together. Dropped the Gaba again claiming I should never be on it, and did get some low level HydroCo.with Tylenol. Then wanted to send me back to them for more intensive care, I said no-way, why?? Especially after what you just said? Then he wanted to send me out to several other specialist, again I said, no way. I am not getting financially ruined more than I am for care. Period. And then the contradictions of care and meds continued ad nauseum. Yeah, it’s all freaking totally madness and having sign a contract stating that medical care is “a practice” by trial and error is more of a joke. Big letters pointed to the fact that medial care is only “practicing care.” Of course with all care here for me has had to be paid up-front and immediately. Unlike the care we get here. I am about ready to just sit home and say to hell with all of it. It just gets worse and worse and more pathetic all the way around.

      Among those papers there were no guarantees of my privacy rights when file sharing to whomever they passed them along to, the Feds, Cops, Homeland. Plus the stupid agreement for on-call pee and blood testing, pill counts, and giving them any unused meds for the month back…that I paid high prices for. Another (??!!) So no emergency stashing or for first aid kit. Plus the clinic and others having the ability to ‘sue me’ for law breaking or violating any agreements. So they were all signed V. C. as a friend (paralegal) told me to do years back.

      Kicker: I just sent a oral surgeon here registered mail to try and force them to give me a copy of my file, damage found, what they tried to correct and so-on. They have been ignoring my request and refuse to say the damage was done at the VA dental. At least they should report a broken jaw and large slivers to grind down as far back into my jaw muscles they conldn’t do anything about. This is the shit we, or I, and others I have heard about, have known, have to deal with. But gee, it will all go away when I die too, just like many others I know of.

      • Just a side note. I never knew about this and don’t have any drug insurance or part D on Medicare. A local pharmacy tech told me about the “GoodRx” website to compare costs and get coupons for cheaper meds. She reported they could not give out that information freely since the local pharmacies lost money over it, and techs can lose their job passing along certain information. She said just to see how bad the American people and veterans like me are getting screwed and ripped-off.

        Lovely living in the new America of censorship, propaganda, corrupt unions, not much real media, obvious corruption, tyranny, serving the bankers and professionals laughing all the way to the bank at our expence and life. Forgot….and fascism.

        Take care folks.

      • Out of curiosity I searched the choice link : http://www.va.gov/opa/apps/locator/index.html for CA. The choice program uses the term “Gerontology” =the study of the social, psychological, cognitive, and biological aspects of aging & I found no providers, it only searches up to 100 miles & won’t search at all if you don’t put your zip code in the address search box. Its not exciting how few Dr’s there are in the Provider type that participate. I did find a place to get Eye Glasses just down the road from me.

        I have no faith in the Pain Clinic, seems to me the VA is sending patients out side the VA for the sole purpose of showing congress that “they” have decreased prescribing medication especially the opioids. The first Pain Clinic appt I had was a 4mos wait time with local clinic. Because of that choice made me an appt for ‘anesthesiology’ that was 44.6 miles, I cxl it. The next time Choice called me to make an appt, she wouldn’t tell me where I was being sent so I clx it too & she wouldn’t disconnect from the phone until I agreed to follow up at the local clinic. Not!

        My approval came for TMJ treatment & I’m glad for that. DDS office told me TMJ is a medical condition, that’s how its billed anyway yet my PC did not want to see the CT Scan which shows nasal cavity, skull, neck, cervical regions aside from just the teeth & jaw bones. It indicated other areas that need clinical evaluation but she said No to this. That’s not the way I expect any Dr to act.

        Thankx for sharing your experience. It was how I assumed these appts would go. Be Well.

  11. No! VA can’t do it right or legally with doctors, why allow them to further pervert and then destroy nurses credibility as well? DEMAND VA abide by existing law! Prosecute VA criminals under the same laws that apply to all of us! VA is NOT an authority, it is a property fiduciary and SERVANT – always!

  12. Good lord,
    Most every disabled veteran was once treated (on the battlefield) by someone with no more than a high school education. I am unique here in my experiences with VA care with only 1-single exception my care through the VA has been exceptional in every way. The argument over AP nurse’s vs physicians will continue without end.
    However, in the daily care of hospitalized veterans all care is provided by registered nurses. The physicians direct the care and the nurses (RN’s) provide the care, do testing make on the spot diagnosis to keep us alive etc. AP Nurses have significantly more education in a specialization that provides knowledge in specific areas esp. in the area of anesthesia. The specialization these nurses undergo in their field of interest is to the benefit of the patient. The specialized field of study as it applies to a patient is occasionally superior to a physicians because of the focused specialization. Consider a nurse with an advanced degree as opposed to a GP physician who might be tasked with providing oversight to a certified registered nurse anesthetist (CRNA). We’re talking about areas of specialization, and if you think that supervision of a qualified AP nurse by a physician is a minute by minute situation you are uninformed.
    For those of you who think physicians walk on water I caution you against going into any hospital setting in June when the most recent class of ‘doctors’ has graduated, if you do seek out a nurse they spend much more time learning how to provide care in order to earn their license.

    • Fricken VA AFGE Union Troll. If you want nurses to act like doctors in your health care go for it. Veterans do not want it and it is clear the ethics and morals of you Fricken Trolls show how bad Veterans need a choice between real health care outside the VA system or Troll city health care at the VA.

      • Dear seemore clueless,
        You couldn’t be further from the truth or facts. Facts are those are the troubling little things in life that motivates us or make us uncomfortable. You appear to be without motivation.
        Point out exactly what it is I said that was incorrect or ‘trolling’ the go find something else besides confirmed high quality healthcare providers to be upset about.

      • @ s. clueless
        You seem to be without any intelligent or informed responses.
        You should first take your own advice as offered to me in your last post!

    • Callmebob
      Your hypothetical of a GP physician supervising a CRNA is in medical practice totally fallacious and misleading because it would never happen. Even the surgeon defers to the Anesthesiologist.

      A GP physician is not the Physician who would be performing the Anesthesiology in Surgery or Procedures , (MRI, Radiation Therapy treatment etc) where the patient is under general anesthesia.

      An Anesthesiologist is the only type of physician certified to prescribe the doses in relation to the patient’s risk factors,( cardiac, pulmonary, hepatic statuses etc) present disease conditions, length of surgical time etc.
      This is where medical school training is absolutely critical. A CRNA may specialize in the field of Anesthesia administration but most certainly , in no way, qualified by education, employment, and experience as to what type of anesthetic agent and dosing should be delivered.

      • Agreed, It was a hypothetical (GP supervision) up to the point of supervision. Who would be qualified in the hypothetical of supervision for a CRNA? In this hypothetical only another anesthesiologist. In the modern world of medicine there is precious little time available for any of the care givers to devote much time at all to individual patients ergo my position on minute to minute supervision. Whether an anesthesiologist or neurologist or cardio’ no one has the time available for hands on minute to minute supervision.
        I agree with you entirely on the critical nature of and regarding the degree of training/knowledge.
        I vehemently disagree with your position on qualification by education, employment relative to the type of anesthetic agent and dosing to be delivered. There were more than a few patients along side of me in the neurosurgery ward that would never regain consciousness as a result of the errors made by anesthesiologists during surgery, after all, were mere humans- all of us. I do agree with you absolutely on the experience side of the argument. With regards to the experience side of your argument remember to avoid the physician specific side of healthcare in June.

    • IF nurse’s want to play doctor ? Go back to medical school. !

      They call them doctor’s for s reason. ! More education. !

    • I don’t disagree with you cmBob…if you are talking those outside the VA.
      My concern is the VA watering down the training requirements called for to a 10 minute online video.
      Given that, and VA history, I might as well go to YouTube for my medical care.

  13. Hey Namnibor,

    Here is some of that Government Holiday weekend poo that is about to hit the fan.
    ~
    “Exclusive: Hillary Clinton Scheduled to Meet With FBI On Saturday”

    By Chuck Ross July 01, 2016; The Daily Caller

    “http://dailycaller.com/2016/07/01/exclusive-hillary-clinton-scheduled-to-meet-with-fbi-on-saturday/”

    Hey Elf,

    I know in my response to your comment yesterday about the Puerto Rico bailout. I said it had to do with Vulture Hedge Funds and congress, the senate, Clinton Foundation and the President were just giving themselves a bonus. Mainly because they are all invested in the Hedge Funds. Also I pointed out it is just like the way the Clintons and their son-in-law’s Hedge Fund was operating on the Greece debt crisis.

    Fox new did a story today on the Greece debt crisis and Hillary providing secret information to her son-in-law and his Hedge Fund. Yes it is very illegal and yes she did do it. Actually the Hedge Fund was funded by and the accounts were managed by Goldman Sachs. So basically Hillary was working not only for the Clinton Foundation she was also working for Goldman Sachs.

    Judge Napolitano explains it in the video, but reading the article provides a deeper understanding.

    “Clinton sought secret info on EU bailout plans as son-in-law’s doomed hedge fund gambled on Greece”

    By Peter Byrne, Published July 01, 2016; “Foxnews.com”
    “http://www.foxnews.com/politics/2016/07/01/clinton-sought-secret-info-on-eu-bailout-plans-as-son-in-laws-doomed-hedge-fund-gambled-on-greece.html”

    ~
    ~
    ~

      • @Seymore Klearly

        Watcha wanna bet she bows out of that meeting?

        Unless, Billie Boy made a deal with Lynch on Monday past!

    • @Seymore
      Well, I lost that bet. Hillary met with the FBI for 3 1/2 hours on Saturday.
      CNN the reports, (paraphrase), “IF” nothing is amiss, “NO charges” will be brought. CNN also said that would come out in about two weeks.
      CNN must have a crystal ball. Or, they know the “fix is in for Hillary Clinton!”

  14. @namnibor and anyone else interested.

    “Full Speech: Donald Trump Speaks at Western Conservative Summit in Denver (7-1-16)”

    *************************

    Today, at the phone store, I ran across a person
    “claiming” to be “101st Airborne” and a “Vietnam Veteran”! Yet, when I asked his age – he said, “…52”!
    I wish posers would quit lying! It only makes it bad on us real Vietnam Veterans, or any other real “combat veteran”! We get enough lies from people at VA. We don’t need it from punks out in public!

    When you see and hear crap like this, it makes me wish I were 25 years younger. If y’all get my drift!

    • I am 57 and I was in 11th grade on 5/1975. So I was to young at that time to be in Vietnam. So was he. He would’ve had to of been 59 at very youngest.
      He was trying to snow you.
      People like that need to be bit©h slapped into reality.

  15. Lawsuits against the VA have skyrocketed in the last decade. This is not something that would move that pendulum the opposite direction, but instead, it would make it worse.

  16. I just returned from Cuba. Cuba has trained a surplus of qualified medical doctors that is hired out to other countries. Some of these medical doctors trained in Cuba are from the United States, and plan to return back to the US after medical school in Cuba. Since President Obama has lifted the embargo on Cuba, some of these medical doctors from Cuba should be hired at the VA Hospital. This is a temporary solutions until enough medical doctors are trained in the US.

    • Sure why not? Cuban doctors would for right in with the rest of the third world doctors hired by the VA.
      Can anyone tell me how a country that primarily runs on 1950s cars has imported 21st century medical equipment to train these doctors?

  17. First, I think part of the premise of your post Ben that states will lose regulatory authority over professionals practicing in their states is utter bullshit.
    Please tell me you have contacted at least one state licensing board in a state other than Minnesota and asked what they would do if they received a complaint from a veteran against a doctor, nurse, APRN or any other VA practitioner in their state.
    I garaun-damn-tee you that they will tell you that the VA is considered federal property, and the state will not take action against them. They will likely tell you to submit your complaint to the state in which the provider is licensed in, who will not take action because the provider is not practicing in that state.
    I have contacted my states licensing board and was told exactly that.
    So what the hell rights are states giving up If they have already ceded those rights to the VA claim that they operate on federal property and are exempt from state regulations?
    Seriously. Nobody gives a shit that states regulate hairstylists more tightly than a doctor or any other provider at the VA. I know. I have tried for the past year to interest media in that fiasco, and nobody cares.
    Nobody gives a shit if you can document a VA nurse or doctor who has been sued for malpractice, even if they have been sued more than once and still work for the VA.
    As for VA assurances that nurses would receive extra training, that does not give me confidence at all when that extra training would likely be a video they watch online, and get credit for 8 hours of training.
    Since the state’s have already ceded their oversight authority of VA providers practicing in their state, they don’t give a damn if the VA says a 10 minute video qualified them to be equivalent to a doctor.
    Sorry Ben. You’re off the mark if you’re arguing a states rights issue here in regulating professionals operating in those states if you are talking about the VA. That ship has sailed, and every state waved at the veterans saying “good luck, sucks to be you”.

  18. Y’all are an lawyer so I shouldn’t have to point out the BS factor in your argument. The VA is FEDERAL and as such and inspite of it’s common practice DOES NOT FALL UNDER STATE LAW. VA buildings/centers/clinics are by law and definition FEDERAL PROPERTY and are not BOUND BY STATE LAW. PERIOD. There is NO Constitutional issue here. As a lawyer you should know that very basic differentiation. That FACT is why we have to play games with them such as the FTCA and FOI and hope that we have a “prior knowledge/blood or marriage” relation that is a lawyer that has taken and been accepted by the federal bar to fight them.
    As to the issue of using nurses instead of Doctors. I would prefer a Nurse to what the INS/AMA has insisted that we credit as Doctors coming out of Asia with the MBBS and similar degrees. Due to getting stuck teaching pre-med course in my salad days I do know what the requirements for various Pre-Md/DO et al are. The requirements for those degrees (which are even called a BACHELORS, and NOT a Doctorate) would not have been sufficient to even earn the “Pre-Med” designation on the diplomas we issued to our student’s, leave alone allow them to practice as DOCTORS! And yes, the VA does hire these people and uses them as PCP.

  19. Is a PR firm putting in the comments? What about the union?

    Seems to me a Form letter has been sent throughout the VA’s. I caught it when I read: I am a physician at the VA hospital. I support America’s veterans: they put their lives on the line in service to our country….same wording as the majority of Pro comments. Also Pro’s from: supporters of midwifery. I found reference to Robert Wood Johnson Foundation. Example: Comments 44100-44125 of those 25, 13 were duplicates. So yes some philanthropic activity going on probably to increase investment portfolios.

    I started out reading them one by one but 47,970 comments on 960 pages is too many for one person to read through. I skipped by 50, then 100 by sorting Posted Older to Newer. I only found individuals’ against this commented in ordinary language. I saw a pattern & surely 6,000 of those who commented came from VHA Union nurses as that is a number a poster said the VA had. Pages 959/960 This comment was there: Then Current VA employee WITHDRAWN | ID: # & a few other reasons for withdrawn. I counted 47 withdrawn comments.

    I picked up from a commenter that VA’s Quality Enhancement Research Initiative (QUERI) reported that VA does not have sufficient scientific data to support that more complex surgeries can be safely managed by CRNAs. So I went to QUERI to read the finding of complaints: “We did not substantiate the allegations that inexperienced residents in the Anesthesiology Service were improperly supervised”

    I am against this. & learned that in a number of VHA facilities CRNAs are the sole anesthesia providers. Hush my dear, just sleep now soon it will all be over.

  20. Here’s a 2 July 2016 video, showing a ‘distinct comparison’ between how people in the U.S. think about our incumbents!
    In a way, I understand why this kind of “public display” takes place. It’s because our educational system, partially, is to blame. And, also, patially because our “family structure” is failing! There are additional reasons for this kind of “SHAMEFUL Public Display”! Yet, I believe y’all know how this makes America look in countries around the world!

    The following is from;
    “Clash Daily” with Doug Giles.
    Title:

    “Watch: Compare This Young Trump Supporter to the Anti-Trump @ss-Clowns”

    “HUFFPOST POLITICS”

    Quote: “Who do you think will be more successful in life down the line?”

    “Shameful” doesn’t fully describe what some people will do to others just to get attention!

  21. Although some seem to believe that this isn’t a Constitutional issue. VA facilities management is governed by the Code of Federal Regulations and not by State Laws were they are located. The fact remains that the proposed change to allow some Nurses to prescribe, diagnose, and treat patients without physician oversight does raise a number of Constitutional questions.

    Several Constitutional question that stands out:

    In a states where nurse’s licenses are “restricted” to requiring a physician’s oversight to prescribe, diagnose, and treat patients.

    1.) Will that nurse be in violation of that state’s statutes by working without the required oversight of a physician at a VA Facility either in that same state or any VA Facility in another state?
    ___

    If a nurse licensed in a state where their license is restricted but is working at a VA facility in another state where some nurses can operate without physician oversight.

    2.) Will the nurse be required to meet that’s states requirements to be eligible to work without Physician oversight or will the VA just consider education and over-ride the states requirements?
    ___

    Say a nurse is able to meet the educational and training requirements in the state where they are employed by the VA, but would not be able to obtain an advanced nursing license in that state due to failing a criminal background check.

    Due to convictions like DUI, Armed Robbery, manslaughter, sexual offences, drug diversion, drug sales, fraud, or neglect … given the VA does and continues to employ nurses that have been convicted of these crimes.

    But the nurse has a license from another state where the license requires the oversight of a physician. But the licensing state does not require passing a Criminal Background check.

    3.) Will the VA be able to over ride the states requirements and allow the nurse to work without the supervision of a Physician due to the restricted license in one state and meeting the educational requirements?

    ~~~~

    In closing a little bit of disinfecting “Sunshine” for the Trolls. There is plenty of Sunshine just say anything and I will supply a big burst of Sunlight.

    A link to a data base of articles from a series of ProPublica investigation titled “When Caregivers Harm America’s Unwatched Nurses”. It contains 40 articles on 10s’ of thousands nurses that are guilty of egregious misconduct but still getting away with continuing to work as nurses.

    “https://www.propublica.org/series/nurses”

    • Regarding the pro Vs Neg examples. All but one of the pro examples uses the term Our Veterans. It is like they think we are property that is owned by them.

      Definitely done by a team effort on the part of the Pro nurses to replace doctors.

      • Have it so all our elected officials only can be treated by nurse’s for everything. !

        Nothing wrong with nurse’s. But they need to stay in that field. !

        If they want the role of a certified medical doctor. Then go back to school. A real school. Not one day seminar. !

        Veternarian’s. Will be next to treat veterans. !

    • Well c more,

      What about those states where AP Nurses already practice legally as primary care providers, any angst there? “Our veterans” deserve timely professional care. Yes I am one of “our veterans” just speaking out for the benefit of all U.S. Veterans who deserve the best America has to offer.

      callmeBob
      USA -Ret
      90%

      • They had nurse’s doing c&p examinations. Nope not qualified and all those veterans got screwed. !

        Nothing wrong with nurse’s doing nurse jobs if they want to play doctor don’t do it on veterans. !

        Why not let them do everything. Nope won’t work. Enough employees have the God syndrome !

    • Hey CMB,

      You honestly are not fooling any one here. You are just a fucked in the head troll that is trolling disabled Veterans trying to promote using nurses instead of Doctors in their health care through the VA. Clearly you are showing just how unethical and immorally you truly are by trolling disabled Veterans.

      Given I don’t like your chosen name of CMB, I am just going to call you Kimberly. Also Kimberly in my prior post I did make a promise stating “There is plenty of Sunshine just say anything and I will supply a big burst of Sunlight.”. I just want to assure you that I am a man of my word and will provide that big burst of disinfecting Sunlight sometime today, but first since you were foolish enough to take the bait I do have a question for you.

      Don’t worry I am not going to ask anything about that bogus charity Kimberly Bolen is collecting donations for. The one claiming to help pay Veterans Medical Expenses for health care services that Veterans receive at the VA. I am sure it is quite profitable and Kimberly Bolen’s trolling of disabled Veterans shows her total lack of ethics and morals. We also know someone who lacks ethics and morals is getting rich. So we will save that for another time.

      Kimberly, given Kimberly Bolen is a member of the Atlantic County Mental Health Advisory Board and Northfield Veteran’s Clinic is located in Atlantic County. The Northfield Veteran’s Clinic is where Charles R. Ingram III had been receiving Mental Health care via Tele-Med connected to the Wilmington VA Medical Center system when he set himself on fire outside of the Clinic.

      Now Kimberly VAMC Wilmington is located in the State of Delaware where not only can APNs in the Mental Health field prescribe, diagnose, and treat patients without physician oversight. But Student APNs in the Mental Health field can be temporally licensed to do the same while they are attending school in the state of Delaware.

      A review of the training program for APNs in Mental Health at VAMC Wilmington show that the students enrolled in certain courses are required to man the Tele-Med system a minimum of 4 hours per week. Also that the school affiliated with the system is on a quarter basis and not semester biased.

      Charles Ingram set himself on fire outside of the Northfield Veteran’s Clinic where he had been receiving treatment Via Tele-Med with VAMC Wilmington and the Clinic is located in New Jersey a state that requires APNs to have oversight of a physician.

      Unfortunately for Charles his mental Health Crisis also occurred during spring break a period where students are focused on their breaks. When students return from spring break no doubt new students would have been assigned to the Tele-Med system to assist Veterans like Charles, but clearly he was not receiving proper care.

      Personally Kimberly I feel that Charles would be alive today enjoying his life with his wife his two-year-old daughter and his eight-year-old son If he had received proper care. Instead he received care from a system designed to circumvent the Code of Federal Regulations requiring that he receive care from a qualified professional Not an unqualified student APN via Tele-Med.
      ~~
      ~
      Kimberly I have to go right now but will be back later today to finish up and ask that question and also provide that big burst of disinfecting Sun Shine as promised.

      • Hi c more,
        …Trolling Veterans? Nothing could possibly be further from the truth! Calling me Kimberly will do if it makes you more comfortable. While you do raise some valid points I sometimes find it difficult to communicate with all knowing bitter ‘experts’ of which there is no shortage in this world. Every one of us deserves the best (and most timely) care available at any price. Whether bitter or otherwise, quality professional medical care for disabled veterans in the VA system is my primary interest.

      • One question. How many veterans have you reported to the disruptive committee. Because they questioned you about their care. !

        Or rubbed you the wrong way. !

      • @ redturtle984

        Secondary interest? Its somewhere between hoping that my current marriage lasts and that the doc’s at the VA stop describing me as having anger issues. I work hard at communicating politely because I’m aware of the problems I have had (and caused) in the past.

        @ James

        Perhaps you have me confused with being employed by the VA. I am unemployed and have never heard of the ‘disruptive committee’; furthermore, I have never, and would never, report a veteran for their behavior (I’ve had my ‘behavioral’ moments). Maybe I have been referred myself and simply forgot about it. The only care I have ever provided (at the VA) was to a wheelchair bound veteran who couldn’t get into the bathroom by himself at Audie Murphy VA Hosp. He questioned me, asking “Don’t you think I can do it!”? Well I had no opinion on the immediate matter at hand, I was just offering help.
        Apparently (according to the doc’s) most everybody rubs me the wrong way.!

        Best of luck to you both.

      • Just. So many employees have their own agenda on here and it’s not to benefit the veterans!

        It’s all about what they can get from the VA and really don’t care About the veterans. !
        Have a good day. !

      • Kimberly unfortunately I have been unable to complete the premise before the question and also unable to provide that disinfecting Sun Burst of light on the subject due to my limited use of my hands on my bad days.

        Although I should be able to provide it today.

      • Hey c more,

        You have finally bored me to death, thank you for your service.
        I wish you well.

    • As I said before in other comments, sometimes it takes a few days for my brain to get working.
      This time it took a little longer.
      I can see your points now in this being a Constitutional issue. I see it as Constitutional from a state point of view. Once again the federal gorilla is going to states and dictating, and completely ignoring states rights.
      Or as in my state, willingly rolling over with whatever the gorilla wants.

  22. Guys, please don’t read this and do nothing. Please sign the petition to stop this here, and take the extra 30 second step at the end to notify your lawmakers:
    http://www.safevacare.org/

    And here’s another article explaining the issue, if you want more information:
    http://www.kevinmd.com/blog/2016/07/physician-led-anesthesia-safe-anesthesia.html

    I would encourage everyone that reads this to post these links on their Facebook page, as I just did. Good luck to us!

  23. Never ending! But is the statement I made about the VA or these replies that I see. I begin to wonder how many are written by those who are veterans, veterans who actually use the VA, veterans who actually have had a problem with the VA or those who think that the know and are able to talk about it.

    Hell, I’ve been going to the VA since 1992. The VA is my primary source of medical care…and I have had some problems, yes but no worst than when I had to use private medical care from my family physician and form for profit hospitals.

    Some of the best care I have received is by that RN who has had extended education and is able to work in the same capacity that our Army PAs did. I have never had my Nurse Practitioner do anything to me that was without supervision from a doctor.

    So as I read these well written replies, testimony to the fact that they were not written by your average person, I begin to wonder if the problems with the VA are not being created by those who might, receive some type of reward if the can bring down the giant lion known as the VA.

    • How. Many veterans must be hurt before something is done. We don’t want to tear down anything we want to build it to work for every veteran.

      All of us can’t be wrong or the VA Would not be in the news so much.

      Have you seen how many veterans are committing suicide. How many are being reported as being disruptive and the VA does not require proof of this disruptive behavior.

      One. Veteran getting good care does not take away from all the veterans whom HAVE been mistreated.

      Look at the candy man. Look at Rubins and Graves. Look at Bob McDonald stating be was special forces.

      Look at the employees who go in front of congress and plead the 5th. !

      Look at the patient who died because an employee hit him in the head.

      Look at the patient where the employee pushed and pushed and then tried to blame the veteran and it was recorded and proved the employee lied about the veteran starting it. The employee tryed to accuse the veteran if disruptive behavior.

      Yes. The VA Is doing a bang up job. !

      NOT. !

      We all agree that their are good employees. But management control is out of control. How many good employees are being retaliated against after they speak out about wrongdoings. !

      If the VA did not need reform. Why are millions of Americans mad at the VA for lieing and lieing.

      They lie so much. They start believing their own lies. But others can see right though their deceptions. !

      Do. You suffer from ptsd or TBI !

    • You are right. These replies are not written by the average person. The average person in America has not taken an oath to uphold and defend the Constituion, nor has the aberage person been injured in the line of duty serving to protect American freedoms.

      Your hunch is correct. Veterans are not average people.

      • Veterans are not average people. Most average people would run from gun fire. Veterans ran to the gun fire and never came home. !

        Without veterans Their would be no United State’s. !

        Veterans are above average. !

        They are the back bone. !

  24. This sad article & short video from a Vet in Seattle suffering from botched VA surgery’s for a rare bone break, was told by his nurse “ Your pain is only neuropathic”, then he finds out from outside the VA that a screw had been drilled through a nerve bundle, ends up having to amputate the area.

    http://www.seattletimes.com/seattle-news/health/vet-loses-faith-in-va-care-after-surgeries-amputation/

    And the establishment wants to give nurses more “power” more “authority” more “influence” that will affect us all!

    I’d also bet he was offered Gabapentin when VA stopped giving him any pain meds.

    • The medication your talking about was given to me for back pain. I took it a couple of times and it made me feel like I was going to pass out. Dizzy and I had to lay down.

      I told the doctor. Thank you. But no thank you.

Comments are closed.