Tuesday, January 21, 2014


The primary care physicians at the VA Clinic in Harlingen may be some of the best doctors in the LRGV.  Nearly all of the specialists are exceptional in their skills.  Unfortunately some are lazy and just incompetent.

With doctors working 60 plus hours a week they can no longer meet the medical needs of the veterans. Months ago the VA performed a thoracic cat scan on me.  The results show why I lose my breath on exertion.  Whether there is a treatment I do not know.  There has been no follow-up.  I have tried for months to get a new voucher to go back to the specialist who ordered the scan to begin with.  Every request is just ignored.  It is not that the doctor does not care - they tell an overwhelmed nurse to work on it - the nurse sends it to fee services which is where everything goes to die. 

Now Harlingen does have a pulmonologist, but lets just say - well let's leave it at that.  Many veterans have been approved to see outside pulmonologists for reasons we shall say are - just lets leave it at that.  The VA will not get rid of any specialist regardless of how bad it gets.  They are too hard to come by - so the veterans just suffer through the bad specialists.  The VA pulmonologist a year ago wrote there is no explanation for my shortness of breath and he refused to see me again.  Funny thing is, had he not acted like a god and just ordered the thoracic cat scan he would have seen the problem.

Tomorrow I will pay a private pulmonologist to do the follow-up.  This particular doctor is aware of the specialty problem at the VA, which the Chief of Staff refuses to address, and is giving veterans discounts rather than leave us without competent care.  You can bet I will take the $90 receipt to fee services and make a big issue about it.  If they refuse to pay, I will send it through the claims process and the VA will spend thousands of dollars reviewing how it got to this point.  Doctors will be pulled from patient care to complete endless paperwork as they are blamed for the incompetence of the administrators.

I will give fee services a week to get me a voucher to see a gastroenterologist.  I am at my 5 year point for a scope.  I have a history of dysplastic changes in the polyps.  This may or may not be a problem.  The colon may or may not be the source of the problem with my sciatic nerve.  I think it is based on when the pain hits and I fall to the floor.  Today I hit my head on the tile.  I am done waiting on the VA finding time to find a doctor who can do a simple referral to one of the 2 in house gastroenterologists.  It has been months of getting no where

Here is the problem, any number of the problems with my colon including colon cancer can be causing the problem with my sciatic nerve.  The glute muscles and thigh muscles will contract into horrific pain sending me to the floor and at times hitting my head on the tile.  The pain management doctor will not do another procedure until I am seen by the gastroenterologist - which I cannot be seen because I cannot get a  referral to the gastroenterologist.

I do not blame my PCP - once you hit 60 hours a week of work you are getting diminishing returns.  The best thing which could happen to the valley veterans is if the PCPs just quit en masse.  Until they stand up to the incompetent administrators and the Regional Office in Arlington, nothing will change.  They simply are so overwhelmed with work they cannot get to what they need to do.  They have no time to check to see if anyone has actually done what they were told to do - hence referrals and vouchers are not getting done. 

When my testosterone dropped to 35 on treatment I had to print out the report and bring it to my doctor.  The doctors have no  time to review testing results.  It is up to the veteran to track down the reports and do a walk in - waiting as long as 8 hours to be seen.  This is unacceptable.

I do not care what it takes - they need to double the number of PCP's to fix the problem.  They need to offer hiring bonuses which includes relocation pay.  What will be beyond sad is if we lose some really great doctors because the inept administrators would prefer the doctors quit than the administrators actually do their job.

It is so bad some of the primadona specialists rather than write a prescription will send a note to the PCP to write the prescription.  It is beneath them to write their own prescriptions.  This gets the PCP's even further behind. while forcing the veteran to go to another building to only learn days later the prescription will be mailed to them because the PCP has no time to write the prescription at this time.  Or the veteran will have to wait hours to be seen by the PCP to get the prescription to only then have to wait up to another 2 hours to get it filled.  All because of some primadona specialist.

The new pain management doctor invented rude - he actually told me that it is not his job to know the source of my sciatic pain.  It is only for him to treat it - in the dark.  The pain management doctor I saw in San Antonio diagnosed in 10 minutes which one doctor after another for 10 years could not diagnose.  It took some 8-9 procedures to clean up the nerve endings at L4 and L 5 and repair the tear in the annulus tissue.  It was real - I have the fluoroscope x-ray where he proved it. He did not just treat, he took the time to diagnose the source of the problem.  And I can say in all of those procedures, other than when he numbed me I felt nothing as he went up into my spine through my tail bone.  With the guy in Harlington I was holding on to grips crying while the staff is telling me to stop moving because he had the needle inserted in my tail bone - he never learned how to numb the patient.  It was horrible - but he will stay because the VA is unwilling to recruit where ever it takes to get quality specialists.

Now mind you there are a lot of great specialist - the dermatologist is amazing the MD eye doctor is amazing - I have not seen any other ones - so I do not know.

With the coming of the medical school the quality of care will drop even further. 

You would not know it, but the VA has a ton of openings - but they refuse to market the job openings so they go unfilled.

So Tuesday will be busy fighting the VA - I will be declared the bad guy because I fail to under the Administrator's motto - "STFU is free."

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