I cannot believe the VA healthcare system is as
bad as illustrated by the following examples.
However, perception is
I believe if the government completely takes
over the healthcare systems and creates a single party payer system, Americans
will have the same perceptions that these veterans have had about the VA
"The purpose of this
inspection was to determine the validity of the allegations. We did not
substantiate that a facility emergency department physician misdiagnosed a
stroke as vertigo (a feeling of motion while one is stationary) in September
2010. We determined that the facility emergency department physician’s evaluation
and management of the patient’s complaints and hyperglycemia were appropriate."
Major with a combat brain injury felt he had never been treated so poorly in
his life. A VA physician reviewing his condition did not even look at his
record. The physicians showed no compassion when the patient needed compassion the
relate to that feeling. When I was in training at a charity hospital I was
never able to form a relationship with patients. I did not even see the
patients I admitted to and discharged from the hospital.
little continuation of care or follow-up by me.
When I went
into practice the patient was my patient and I was his doctor. The positive
patient physician relationship made the visit more satisfying to me and more
therapeutic for the patient.
didn’t relate to my patient while in private practice, my patient had the
option of leaving my practice and finding another physician.
other physicians in private practice, made it my business to relate to my patients.
My incentive was to build my practice and reputation. I was a consultant to
other physicians as a clinical endocrinologist.
words, I had incentive to treat my patients well and my patients and referring
physicians had freedom of choice of any other physician.
experience patients have at the VA is reflected in the following comment,
want to know about their disease. They want to learn the reasoning for their
treatment. They are not stupid. They want to know what to expect from their
disease and their treatment.
to have a caring and comforting physician because they are frightened about
education and a positive patient physician relationship are essential for good
weeks ago at medical grand rounds I sat next to a fellow physician and good
friend who was cured of testicular cancer 30 years ago at age 32.
time he was frightened out of his mind because he had no experience with
testicular cancer. He was sent to a radiation oncologist who explained his
disease, his prognosis and what to expect throughout the course of therapy.
This relationship was a total comfort to him.
mentioned this to me during our conversation. He said that he felt very bad
because he had not appropriately thanked the radiation oncologist for the
fantastic physician patient relationship. The relationship permitted him to
tolerate his therapy well. He said he been given hope of surviving and a
positive feeling about his outcome.
this physician I was going to have lunch with that radiation oncologist the next
week. He asked me to be sure to tell the oncologist that he thinks of him all
been so thankful for his help. He added that post testicular cancer therapy he
enjoyed a fantastic marriage and has been blessed with two wonderful sons.
Now that defines a wonderful physician patient relationship!
Another complaint of
VA system patients is the long wait time for appointments and the mountain of
paper work that has to be completed in order to make each appointment.
If a patient misses
an appointment because of bad weather or unforeseen circumstances you have to
start the process all over again.
It must be maddening
for VA patients. A Veterans’ study committee has reported an average wait time
has been quoted as 50 day to 273 days.
Recently an older
veteran told me that he had a cataract that was progressing yearly. He was at
the point that he needed cataract surgery to be able to see.
He was told that the
wait and backup was one year.
He made enough of a
stink about the delay in his surgery that the VA healthcare system sent him to
a private practicing ophthalmologist. The private ophthalmologist did the cataract
surgery in one week.
He was thrilled
because he could see clearly again.
I am compelled to
tell some of these stories not to point out the solutions to the problems with
the VA system.
The VA system is run by
long term employees entrenched in their jobs without a threat of either losing
their patients or their jobs.
These employees have
little accountability; they create reports and publish meaningless evaluations.
These reports are of little value in fixing a healthcare system that works
poorly for patients but looks good on paper.
“Even Jon Stewartis blasting the
handling of Veterans’ benefits, “That is f---- criminal. The VA has a backlog
of 900,000 people. McDonalds handles ten times that many customers in an hour,
and may I remind you they are run by a clown.”
The point is that Obamacare with its ever increasing
bureaucracy, agencies, and regulations is going to lead the entire population
into this trap by decreasing incentives and limiting choice.