Shinseki gone. It’s time for the VA to heal itself.

My high hopes for Gen. Eric Shinseki taking an already overburdened and poorly-managed Department of Veterans Affairs were dashed early. Oh, I suppose I gave him more time than was warranted. But just because I continued to see the VA healthcare system imploding from the ground up didn’t mean that a total collapse had yet made it to the top of the food chain. Regardless of my poor vision of the cluster f**k of a bureaucracy that is the VA, the situation has progressed even beyond that state expressed in the old military acronym SNFAU. For those of you unfamiliar with the term — for those of you returning visitors from Zimbawe — it means “Situation Normal All F**ked Up.” Shinseki resigned today and many talking heads were a bit too timid to bury the retired four-star in their disgust. The general did, after all, have half of his foot blown off in the Vietnam War. And from the political and pundit class who might call their target of opportunity a “sonofabitch” they are sure to add “But we thank him for his service.” Such is similar to the way veterans are treated by the VA these days. Oh, not all of them, for sure. Not even the majority of them. One may be certain, though, when more than a thousand, who knows for certain even how many, maybe tens of thousands, are used in a numerical shell game when all they seek is medical treatment there remains a certainty that these veterans are not treated in the respectful manner in which even an injured dog would receive. I had erroneously believed the hiding of veterans seeking appointments was for specialty treatment. Specialists have, for at least the past 20 years I have used the VA for health care, been the scarcest of medical commodity. It is not uncommon to see residents, physician assistants or even nurse practitioners when attending specialty clinic appointments. It’s the luck of the draw. Oh, if you are sick enough or suffering from a critical injury, you’ll likely be attended to or at least overseen by a board certified specialist. It seems though, the veterans in the news are those that were seeking primary care however. That boggles my mind as bureaucratic insanity at its worst.

The Michael E. DeBakey Veterans Medical Center in Houston.
The Michael E. DeBakey Veterans Medical Center in Houston.

The VA bureaucracy is like this: Washington–>three separate administrations for Health, Benefits and Cemeteries–>Regions–>Regional benefit offices–>Regional-to-extra-regional systems called “VISNs” for Veterans Integrated Service Networks–>Health care networks based on a large VA hospital system (mine is the Michael E. DeBakey Veterans Medical Center in Houston)–>Community-based outpatient centers–>Vet Centers–>The veterans. That’s not even including the National Cemeteries the VA oversees.

Now don’t you think at least one level somewhere in this wicked matrix could be eliminated? I had two dealings with the VA this week. One was concerning an appointment. The other relating to a complaint from an appointment last week. I had scheduled an appointment for a clinic for which I went almost 15 years without a follow-up. I will not say which one. I can understand long wait times because of the particular clinic and will say part of the reason for the failure was situational. Nevertheless, my appointment was Wednesday, 80 miles away in Houston. There is a toll-free phone number on which patients may hear their appointments as well as manage their prescriptions. I called the night before to make sure the time was what I was last told. The clinics usually send letters with appointment information at least a few weeks before. They also give automated calls within a week of the appointment during which one can confirm, cancel or reschedule. I did not receive a letter for this clinic. I do not remember receiving a call. This month I had an unusually high number of appointments in Houston. It was just how they happened to fall. When I called to check on this clinic, it was not listed. I called the “Telecare” staff in Houston and the notation they had on their computer indicated that I had cancelled the appointment. They didn’t know when or why. I had taken a day of leave, which have become scarce lately because of various medical and other problems. I was livid and wrote a very scathing letter to the department that oversees customer complaints. I didn’t hesitate to drop a few names either. I hate when I do that, but unfortunately one can only receive relatively quick response unless some kind of “enhancement” is employed. I received a call early the next morning saying the clinic responsible would be contacted. They were and I was called by the clinic. The person who called told me once again that I had cancelled the appointment by phone. I have seen some of these specialty clinic top people in Houston go directly into their best “Cover Your Ass” mode when such a problem happens. I told the person who called that what she said sounded like someone who was trying to “cover their rear ends.” I’m so nice. Well, I came away with a rescheduled appointment in two weeks. Later, I received a call from the VA Police Department in Houston. I thought, “OMG, they think I’m a nut and are going to give me the third degree!” Instead the officer was following up a complaint I left in a “suggestion box” regarding parking. I mentioned quite succinctly that the medical center had incessantly bragged as to how they have eased the parking problems at the hospital. Steps have been made including a free valet service. However, I am not comfortable with someone else driving my pickup, at least someone I don’t know. Parking lots have supposedly been expanded for patients and employees. But during my last visit I spent some 30 minutes trying to find a place where I would not have to walk too far to the hospital. I continue to have knee problems, especially when walking for a distance. Well, the officer was quite thorough explaining where parking has been increased and it was mostly on the side that I didn’t want to park. However, she said there now are shuttle vans that drive through the parking lots which will pick up patients and take them to the lobby. Apparently, these vans aren’t well advertised but if I can indeed flag one down to get it to drive me to a close entrance then this entire exercise will have been worth it. This is just one small example of how the VA can fix things when they put their minds to it. It looks as if now is the time for great minds to converge and not at just one medical center. The whole system has needed help for years. It is time to fix the VA.

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