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    Monday, March 05, 2007

    The Good, The Bad, and The VA: How does this:

    Most private hospitals can only dream of the futuristic medicine Dr. Divya Shroff practices today. Outside an elderly patient's room, the attending physician gathers her residents around a wireless laptop propped on a mobile cart. Shroff accesses the patient's entire medical history--a stack of paper in most private hospitals. And instead of trekking to the radiology lab to view the latest X-ray, she brings it up on her computer screen. While Shroff is visiting the patient, a resident types in a request for pain medication, then punches the SEND button. Seconds later, the printer in the hospital pharmacy spits out the order. The druggist stuffs a plastic bag of pills into what looks like a tiny space capsule, then shoots it up to the ward in a vacuum tube. By the time Shroff wheels away her computer, a nurse walks up with the drugs....

    square with this:

    Ray Oliva went into the spare bedroom in his home in Kelseyville, Calif., to wrestle with his feelings. He didn't know a single soldier at Walter Reed, but he felt he knew them all. He worried about the wounded who were entering the world of military health care, which he knew all too well. His own VA hospital in Livermore was a mess. The gown he wore was torn. The wheelchairs were old and broken.

    "It is just not Walter Reed," Oliva slowly tapped out on his keyboard at 4:23 in the afternoon on Friday. "The VA hospitals are not good either except for the staff who work so hard. It brings tears to my eyes when I see my brothers and sisters having to deal with these conditions. I am 70 years old, some say older than dirt but when I am with my brothers and sisters we become one and are made whole again."

    Oliva is but one quaking voice in a vast outpouring of accounts filled with emotion and anger about the mistreatment of wounded outpatients at Walter Reed Army Medical Center. Stories of neglect and substandard care have flooded in from soldiers, their family members, veterans, doctors and nurses working inside the system.
    ?

    How did the VA system go from being the most vaunted, sterling example of how well government-run healthcare can work to being a decrepit not-fit-for-dogs system in just a few short months? It didn't. The Washington Post did an investigative piece on Walter Reed, but the complaints about the VA are from emails. Uncomfirmed emails.

    I haven't been inside a VA hospital for nearly twenty years, but I have patients who go there for routine care in order to get their medications inexpensively. I haven't heard one patient complain about the facilities or the staff. And believe me, they wouldn't be shy about it. Most of the horror stories in the Post article focus on hospitals at military bases, not the VA. The VA complaints are vague and focused on entitlements:

    Among the most aggrieved are veterans who have lived with the open secret of substandard, underfunded care in the 154 VA hospitals and hundreds of community health centers around the country. They vented their fury in thousands of e-mails and phone calls and in chat rooms.

    "I have been trying to get someone, ANYBODY, to look into my allegations" at the Dayton VA, pleaded Darrell Hampton.

    "I'm calling from Summerville, South Carolina, and I have a story to tell," began Horace Williams, 62. "I'm a Marine from the Vietnam era, and it took me 20 years to get the benefits I was entitled to."

    .....Sgt. William A. Jones had recently written to his Arizona senators complaining about abuse at the VA hospital in Phoenix. He had written to the president before that. "Not one person has taken the time to respond in any manner," Jones said in an e-mail.

    From Ray Oliva, the distraught 70-year-old vet from Kelseyville, Calif., came this: "I wrote a letter to Senators Feinstein and Boxer a few years ago asking why I had to wear Hospital gowns that had holes in them and torn and why some of the Vets had to ask for beds that had good mattress instead of broken and old. Wheel chairs old and tired and the list goes on and on. I never did get a response."

    Oliva lives in a house on a tranquil lake. His hearing is shot from working on fighter jets on the flight line. "Gun plumbers," as they called themselves, didn't get earplugs in the late 1950s, when Oliva served with the Air Force. His hands had been burned from touching the skin of the aircraft. All is minor compared with what he later saw at the VA hospital where he received care.

    "I sat with guys who'd served in 'Nam," Oliva said. "We had terrible problems with the VA. But we were all so powerless to do anything about them. Just like Walter Reed."


    It's not clear how long ago Mr. Oliva and the others had to wear torn gowns and use broken wheelchairs. Was this in today's VA or yesterday's VA? Shouldn't a distinguishd paper like the Washington Post investigate those allegations before publishing them? Why, they're acting like a blog!
     

    posted by Sydney on 3/05/2007 08:39:00 PM 6 comments

    6 Comments:

    I haven't been in a VA hospital since my wife finished her internship, but that was only a couple of years ago. She always said that they had the best computer system of any hospital she has ever worked in, and probably still to this day. (dont get me as an IT guy started on the absolute silly exercise of developing a HUGE browser based app to have all your records in and then force it to run only inside of a Citrix session. Talk about overcomplicating for the sake of growing your IT department, but I digress...) But the rest is run like any other bureaucratic exercise. Which means that the hospitals, and even the individual wards on the floors run the gamut from the absolute best to what it might be like if the DMV ran health care.

    By Anonymous Anonymous, at 8:00 AM  

    We need to be careful to differentitate between the Active Service Hospitals and the Veteran’s Administration. There are major differences.

    I am currently a resident in a Veteran’s Home after having undergone treatment through the VA for PTSD and Depression, long overdue some 40 years after the Tet Offensive that cap stoned my military 2nd tour in Vietnam with a lifetime of illness.

    My blog has attracted the stories of many veterans such as myself and other sufferers from PTSD who were victimized by elements of society other than the VA system of medical and mental treatment. I, for one, became trapped in the Military Industrial Complex for 36 years working on weapons systems that are saving lives today but with such high security clearances that I dared not get treated for fear of losing my career:

    http://rosecoveredglasses.blogspot.com/2006/11/odyssey-of-armaments.html

    When my disorders became life threatening I was entered into the VA System for treatment in Minneapolis. It saved my life and I am now in complete recovery and functioning as a volunteer for SCORE, as well as authoring books and blogging the world.

    When I was in the VA system I was amazed at how well it functioned and how state of the art it is for its massive mission. Below is a feature article from Time Magazine which does a good job of explaining why it is a class act:

    http://www.time.com/time/magazine/article/0,9171,1376238,00.html

    I had state of the art medical and mental care, met some of the most dedicated professionals I have ever seen and was cared for by a handful of very special nurses among the 60,000 + nursing population that make up that mammoth system. While I was resident at the VA Hospital in Minneapolis I observed many returnees from Iraq getting excellent care.

    I do not say the VA system is perfect but it is certainly being run better on a $39B budget than the Pentagon is running on $494B.

    We have bought into the Military Industrial Complex (MIC). If you would like to read this happens please see:

    http://www.vanityfair.com/politics/features/2007/03/spyagency200703

    Through a combination of public apathy and threats by the MIC we have let the SYSTEM get too large. It is now a SYSTEMIC problem and the SYSTEM is out of control. Government and industry are merging and that is very dangerous.

    There is no conspiracy. The SYSTEM has gotten so big that those who make it up and run it day to day in industry and government simply are perpetuating their existance.
    The politicians rely on them for details and recommendations because they cannot possibly grasp the nuances of the environment and the BIG SYSTEM.

    So, the system has to go bust and then be re-scaled, fixed and re-designed to run efficiently and prudently, just like any other big machine that runs poorly or becomes obsolete or dangerous.

    This situation will right itself through trauma. I see a government ENRON on the horizon, with an associated house cleaning.

    The next president will come and go along with his appointees and politicos. The event to watch is the collapse of the MIC.
    For more details see:

    http://www.rosecoveredglasses.blogspot.com

    By Blogger RoseCovered Glasses, at 11:29 AM  

    it's like the IHS (Indian Health service). The building is old and ugly, the beds etc old fashioned, but it treats poor people, and they are treated well because the doctors try their best.
    Every couple of years, a bigshot reporter "investigates" the IHS and finds a mess.
    And tell you the truth it is a mess, compared to the hotel suites of rich hospitals.
    As for WRAMC: it was scheduled to be closed. Probably things just didn't get fixed.
    As for the "waits": yup. In the IHS if you need cancer treatment, you get treatment. If you have a torn meniscus and see our clinic in Oklahoma, you may get seen in six months when we get funding. Many of those waiting for care at WRAMC I suspect had similar "elective" problems.

    By Blogger boinky, at 1:28 AM  

    My father is a VA patient and is treated very well. If he waits more than 20 min. he has been told to speak to someone so that he will not wait any longer. This is compared to the hour plus wait my wife and I see when we go to a physician.

    Testing is done on an outpatient basis by people who know what they are doing, not in a doctor's office in a rush. Test are explained and results are discussed. He had a private physician testing on a cash basis with no explanation of why or what the results indicated.

    Our experience with the VA has been very positive.

    Steve Lucas

    By Anonymous Anonymous, at 5:23 AM  

    I recently was treated for AIDS at the MPLS, VA, and have two tales:

    I wass diagnosed with HIV in 1993, I was told that I could go to VA to recieve treatment, and given the fact that I was completely devastated, anf feeling isolated. I contacted VAMC Minneapolis, and was told by the screener that if I was a reservist with AIDS that I was probably gay. He told me I should go elsewhere for care.

    That one conversation left me feeling even more isolated.

    Granted it was a biased jerk who discouraged me, but, really, how would you feel if someone said something like that to you when you really need help, and the lie to you about your benefits??????

    fast forward to thanksgiving 2006, I caught pneumonia, went in to VA for a checkup......was admitted, and fast tracked into critical care, they got me free medical care for a year (via means test) all the meds I wanted, and got me a social worker who is in the process of getting me disability.

    My doctors were amazing Dr. Felice, Dr. Allison Bormann, Dr. Thurn SAVED MY LIFE!

    They were kind, dedicated people, and the nurses too were outgoing and empathic.

    My only complaint was about a nurses aid who kept checking my vitals every hour for a week as I attempted to sleep.

    Yet given how overwhelming my illness was and how much I have suffered at having no immune system....this hospital makes me feel grateful that my country is trying to do good.

    By Anonymous Anonymous, at 9:55 PM  

    I recently was treated for AIDS at the MPLS, VA, and have two tales:

    I wass diagnosed with HIV in 1993, I was told that I could go to VA to recieve treatment, and given the fact that I was completely devastated, anf feeling isolated. I contacted VAMC Minneapolis, and was told by the screener that if I was a reservist with AIDS that I was probably gay. He told me I should go elsewhere for care.

    That one conversation left me feeling even more isolated.

    Granted it was a biased jerk who discouraged me, but, really, how would you feel if someone said something like that to you when you really need help, and the lie to you about your benefits??????

    fast forward to thanksgiving 2006, I caught pneumonia, went in to VA for a checkup......was admitted, and fast tracked into critical care, they got me free medical care for a year (via means test) all the meds I wanted, and got me a social worker who is in the process of getting me disability.

    My doctors were amazing Dr. Felice, Dr. Allison Bormann, Dr. Thurn SAVED MY LIFE!

    They were kind, dedicated people, and the nurses too were outgoing and empathic.

    My only complaint was about a nurses aid who kept checking my vitals every hour for a week as I attempted to sleep.

    Yet given how overwhelming my illness was and how much I have suffered at having no immune system....this hospital makes me feel grateful that my country is trying to do good.

    By Anonymous Anonymous, at 9:56 PM  

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