Tuesday, December 31, 2013


So, I am going over a thoracic cat scan looking for a finding to send to the Chief of Staff at the VA San Antonio to prove to him that the attending radiologists are just signing off on the work of the students without reviewing the scans. In a thoracic cat scan it will catch part of the abdominal area. I noticed it says I have a diseased gallbladder.   A most interesting finding, since I do not have a gallbladder.

My original interest was to highlight wherein the report says I was referred for shortness of breath.  The radiologist report says nothing found to explain the shortness of breath.  But the report also says they found something with a primary symptom of shortness of breath upon exertion which is the problem.  My doctor only reads the summary and is unaware that there was a positive finding.  Again, why was this not caught?

Oh yes, there is a third.  In the read for the pituitary the student finds that something is unusual for my age.  I have known about this since my TIA in 1986.  Several brain scans have been done since, and to a radiologist and neurologist,  the finding is considered within normal limits.  There is no such thing as a normal brain in the context of they all look the same.  Again the student did not know this and made a finding of unusual for my age. 

And here in lies the problem with VA hospitals.  I should first note that some radiology reports are now being down in Harlingen while others are still being done in San Antonio.  I was told by San Antonio officials they were redoing their reports while they have asked that Harlingen redo their reports.

All VA hospitals and now the Harlingen VA clinic are teaching facilities.  Students are to be supervised by the licensed attending.  Unfortunately, the attending who is more often than not tied to the medical schools refuse to leave their office to go to the clinics and oversee the students.  I remember the chief of cardiology in SA having a meltdown with me because I forced him to leave his office at University hospital to see me across the street at the VA.  I invoked my right to not be seen by a student.  By law he was to be in the clinic overseeing the students.  He was not.

The veterans demanding a hospital are an example of people hanging themselves.  The VA, because they do not want problems with the medical schools, will never enforce the rule that the attending must be overseeing the students at all times.  A VA hospital in the LRGV will only mean a lower quality of care - but then these veterans will be able to say see- "we may be dying, but we have a building."

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