Wednesday, May 7, 2014


Click for Herald Article

In typical fashion for Mark Reagan he never got the full story.  A key problem is with vouchers to see outside doctors.  It is a problem but the blame goes equally to the private doctors, veterans and VA.  The good news is, the VA's response is the typical governmental response. They have decided they cannot hire competent people to run the voucher program so they have just outsourced it to TriWest Provider.

The new company will make the appointments for the veterans with approved doctors while insuring the doctors they will get paid.  The Herald completely left out this reality from the article.  Mark Reagan has an extraordinary flair for leaving out essential facts.

The private doctors contribute to the problem because they hire minimum wage clerks to handle the vouchers and they lack the requisite skills to understand how to submit the billing and where to submit the medical records.  It does not help you need a magnified glass to read the voucher.

The VA Harlingen does have a lot of in house specialists.  Many are top of the line, but unfortunately some failed in private practice and are now failing the veterans.  The end result is the VA is sending veterans to outside specialists even though they are already paying an arm and a leg to in house specialists.

A big problem no one wants to talk about is how UT messed up the surgery unit on the third floor of the new building.  Day surgeries and procedures were delayed for a year because the design did not meet health codes for disinfecting.  To add insult to injury when UT designed the surgery procedure wing they failed to provide for procedure rooms. 

On Thursday I will have my second caudal on my sciatic nerve.  My check in time is 8:30.  I am the third patient.  This means he will get to me about 12:30 to 1 p.m..  Why?  Because they failed to create procedure rooms.  The protocol for turning around a surgery room and procedure room is different.  The pain management doctor estimates on any given day he is doing half the procedures he can do because of the delay in turning the surgery room around.  He does not need a surgery room  - only a procedure room.  With a procedure room he can do twice as many procedures.  This mistake by UT is delaying procedures for veterans.  It is also a cause for having to refer so many veterans out to specialists.

The voucher problem is a nightmare.  A key part is the VA staff refuses to educate the veterans in how it works.  On Tuesday I took my lab requests from my endocrinologist to my doctor's nurse.  She entered the lab requests.  They will be performed with me getting the results in time before my appointment.  The problem is no one tells the veteran they have to retrieve the results and bring them to the doctor.  The VA is not set up for faxing over the results to all of the doctors.  Because I am enrolled in myhealthyvet, three business days after the lab work is done I can print out the results from home.  The other option is to  go back to Harlingen to retrieve the results.

The veterans need to be proactive in their own care.  I know enough to know medical records faxed to the VA by the private doctors disappear.  I hand carry all notes to my nurse who has them entered into the system for review by my doctor.  If you do not know to do this nothing will come of the recommendations made by the specialist.

Tuesday I took my brother in law for the same purpose.  The pharmacy filled his prescription written by the private doctor, the nurse entered the request for his lab work and did his EKG and scheduled him for a walk in on Thursday for a check x-ray.  This is all for a procedure to be done in two weeks at Valley Baptist.  On Thursday when he takes me for my back procedure he will do his lab work and then go get his x-ray.  By Wednesday I will go to his myhealthyvet account and print out all of the results for delivery to Valley Baptist.

The problem is - no one at the VA is willing to train the veterans in how to manage their care. So the veterans complain.

From the Herald:

"Jimenez said that when he arrived at the specialist with the voucher, the doctor gave him another form to fill out and take back to the VA before he could have surgery on the ear.
“I gave it to them a couple of months ago and never heard back from them,” Jimenez said. “And I went there and asked about the form and they sent me from one place to another. And finally, I went over there again and they said they lost it.”

I cannot speak for this veteran, but if he gave the request to the clerk that was his mistake.  You must ask to see your assigned nurse who then enters the information.  You must then follow up with the voucher department.  The voucher department is as worthless as a tit on a boar hog, which is why they are bringing in TriWest, because a private company is an easier solution than hiring competent people.

The voucher department ignored every written request made by my doctor for three months. I have the documentation.  I eventually filed a complaint with the Regional Office in Arlington.  That afternoon I had the voucher but with the wrong date.  They refused to change it.  So now the VA has a multitude of people working on the problem.  I had already been to the specialist and paid for it out of pocket.  I could not wait any longer.  The VA is refusing to issue a denial of payment so I can appeal.  It will take an order from their lawyers in Washington to force them to issue a letter of denial of the claim so I can appeal it.  Everyone in the voucher department needs to be fired.


"The nation's largest veteran organization, The American Legion, and one other veterans group, Concerned Veterans for America, on Monday called for the resignation of Veterans Affairs Secretary Eric K. Shinseki"

Click for CNN story

I have filed endless complaints in Washington against Eric K. Shinseki.  He is you consummate bureaucrat.  He turns a blind eye to the incompetence of his underlings. 

Think about it, all the VA has to do is authorize the funds to convert several of the operating rooms in Harlingen to procedure rooms and the doctors  can double the number or procedures they are doing.  This would be a major benefit to veterans.  The local administrators are worthless and never will act because it will anger UT who is the responsible party for the mess.

A local team of specialists are now seeing veterans for free or at a discounted price because they are well aware of the incompetence of a specialist hired by the VA to work in Harlingen..  The veterans will not go back for a second appointment.  He is that bad.  But the local administrators will not fire him.  They simply tell veterans to accept his incompetence or go without care.  So a local team of specialists in Brownsville are now donating their services so veterans do not go without care.

The entire administrative staff in Harlingen needs to be fired.  Until this happens, no matter how hard the good doctors work, nothing will change.  The problem with rare exception is with the non-medical staff.  Far too many are incompetent and have zero training in how to deal with seniors.


Anonymous said...

Last week I was in Vegas and read an interesting newspaper article. An estimated 40..40 veterans died awaiting treatment at the VA hospital in Phoenix, Arizona.

BobbyWC said...

A primary source of the problem is Republicans and Democrats alike lie when they say they care. Billions are spent every year subsidizing state medical schools. The money should be used for veterans, but instead is used to subsidize the medical schools at the expense of the veterans.

Veteran's hospitals over rely on medical students who have no clue as to medicine. Fellow are not allow to see me - a Fellow is a specialist in training.

The attendings at the medical school are too busy playing golf to supervise the Fellows and in the end the veterans suffer.

It is a joke - and the Republicans are as at fault as the Democrats - Rick Perry will never turn down all of the federal money used to subsidize Texas medical schools at the expense of veterans

bobby WC