Wednesday, March 6, 2013


I was one of 8 veterans invited to discuss the issue of quality of care at the Harlingen clinic with the top administrators over the Region which oversees VA facilities from Southern Oklahoma to South Texas.

On balance I found the meeting very helpful.  I am grateful that someone referred me as an invitee.  I will begin with the good news.

NURSE PRACTITIONER HIRED FOR WALK INS:  A big problem at the clinic is your regular doctor somehow has to see you as a walk in when you do not have an appointment.  A nurse practitioner has been hired to handle the walk ins.  This means the wait time for walk in patients will be reduced big time.  If you are not familiar with nurse practitioners in many cases they are as good or better than a regular doctor.  The key is the extent of their clinical experience.  This will improve the quality of care big time at the VA

VOUCHERS AND UNPAID BILLS:  The VA is fully aware that many local doctors are no longer taking VA vouchers because of prior problems getting paid.  They are changing the system to have better  direct contact with the private doctors and to in fact help the veterans secure the appointments with the private doctors.  For now if you have an unpaid bill, just go to the specialty clinic building and ask to speak with someone in fee services.  Bring the bill with you - more often than not it is a coding problem or the doctor's staff sent the bill to the wrong address.  If you bring the matter to the attention of fee services my experience is they will take care of it right away.

VA HOSPITAL VERSUS  CURRENT CLINIC:  I was nervous about raising this issue, but every veteran and every administrator in the building agreed.  It is not about the building it is about the quality of care.  Veteran after veteran agreed a VA hospital would be a waste of money.  The money needs to go to services and not a building so the VA can incur the cost of training new doctors.  Doctors in training are not qualified to deal with geriatric patients or war wound veterans.  I was actually quite pleased with how to a veteran they opposed a VA hospital.  What they want is improvement at the current clinic - more doctors - extended hours - and more timely payment of bills  for outside services.

On this issue I will try and meet with Congressman Vela.  His support for the VA hospital while politically expedient is not in the best interests of the veterans.  He can though earn a lot of points with veterans if he pushes hard for the funding needed to hire more doctors, and more PA's or nurse practitioners to help with the walk in patients.

BEST HEALTH CARE IN VALLEY:  With the exception of one veteran, everyone agreed the VA clinic in Harlingen is delivering the best health care hands down anywhere in the Valley.  Is it perfect?  No - but on balance it is the best.  The one veteran who disagreed big complaint is he feels like the doctors are not competent because they will not overrule VA policy on treatment options.  In my opinion this is not a valid complaint.  It is true that for certain medications the doctor must seek approval from higher officials.  I cannot take statins for example.  So every time my Zetia comes up for renewal my doctor my seek a waiver to allow for Zetia, which is not approved by the VA for use except in patients who cannot take statins.

GERIATRIC CARE:  To a veteran we agreed that the clerical staff is poorly trained in how to deal with older patients.  Sometimes when you sit there waiting for your appointment you watch how the clerks are just down  right rude to older patients who clearly have health problems related to their age.  I suggested and the other veterans agreed that the administrative staff need training in sensitivity when dealing with older patients.

I DECIDED TO NOT GO WITH THE NEGATIVE:  I  will assume this one administrator was just having a bad day.

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