Military Medical Madness.

[ka5piu]

Hello.

At around 330am I decided to visit a friend who works at the local hospitals.
His primary job is ER and support MD for a for profit hospital.
He also works both the local military and the VA joints.
He is a civilian.
We decided to take a spin and see some people near the VA.
A patient was brought into the VA with respiratory failure.
We look at each other and ask what next.
The hospital staff call 911.
So, we grab a gurney and I put him on a ventilator.
The ambulance arrives and is ready to take him to the local community hospital, most local hospitals no longer take VA cases.
So, one of the vets who seems to be POed over the lack of medical care starts to scream at the 2 of us.
The MD gets less than 1/4 the pay of a regular hospital at the VA, so he limits his hours.
I do not work for any hospital, so I get no pay, this was a medical emergency.
And we have somebody POed.
I am not saying that things are not bad, just that the vets need to look at the facts.
The guy works something like 12 to 16 VA cases in 5 hours with a 4 day rotation.
This pays 90k a year.
He works the same rotation at the other hospital and gets nearly 500k with half the workload and nicer people.
So, what to do?
If he does not renew his contract with the VA, not only will he be in better working conditions but will get paid quite a bit more.

[ka5s]

"Pain is inevitable, suffering optional."
-- Mohandas Ghandi

I'm an old soldier. Soldiers have the medical care, benefits, pay and (yes) weapons and armor Congress wants us to have. Congress is the voice of the American people. If Congress (they) wanted soldiers to have superb medical care, it (they) would better fund the institutions that deliver it, but it (they) won't. Don't think I am assigning blame; I'm not. I am not only one of "them" but (as Mark Twain said) I am leading the parade.

FWIW, the Pentagon's 2008 budget estimate assumes it will save $1.8 billion by raising the fees retired military personnel under 65 must pay for medical care.

Over 65, old soldiers are Medicare's problem. Or vice-versa!



Cortland
KA5S

[ka5piu]

Hello.

I guess the point was lost.
The staff that was there did not deal with a medical emergency.
It turns out that there are quite a few VA hospitals that have limited hours and or will not take ER cases.
Yes, the person transporting should have called the hospital in advance, but.
And, now that I have time to look things over, almost all AP's at the VA are PA's.
http://www.bls.gov/oco/ocos081.htm
That is correct, the ONLY MD that was in the building at that time showed up totally uncheduled.
The PA works under a MD, and what the vets were POed about.
Without a MD present, limited treatment.
The really odd thing?
Except for field medic and advanced first aid, I have no formal medical training, that is going to change, I have added it to my training roster.

[ka5piu]

Hello.

I have decided on a career track extension.
What do I need to do to get PA certification?
http://www.nccpa.net/
Not a whole lot.
The MD I am friends with has decided to take the plunge.
http://www.usphs.gov/
Together, we work as an excellent team, have for over 10 years.
Why the change?
No more vets to deal with, not that it is the vets fault.
After this change it will be active duty military and Civil service.
No dependendents, no retirees, no vets.
I will undergo 6 months of refresher training, this will complete my PA requirements.
an MD need do nothing, just sign on the dotted line.
The bottom line is that the good Dr and I were reprimanded.
We were to follow written policy, and that means wait for the ambulance.
It was the Vietnam era vet who raised a stink about the incident, HE did not get medical attention.
So, 2 less whipping boys.

[n1ydx]

As a 30 year Army Vet, I would not go into a VA Hospital with an escort.

The complete staff intelligence level in a VA Hospital is equaled by a single ER Nurse with less than 1 year experience.

Most VA staff cannot speak english.

VA forms want to know your entire financial status prior to giving you a rating.

It ain't what it used to be, medical support for the veterans.

N1YDX - Lee

[KI4PEQ]

Quote[/b] (ka5s @ Feb. 27 2007,05:47)]FWIW, the Pentagon's 2008 budget estimate assumes it will save $1.8 billion by raising the fees retired military personnel under 65 must pay for medical care. #

Over 65, old soldiers are Medicare's problem. Or vice-versa!



Cortland
KA5S
Cortland,

You touched on one of the things that really ticks me off. I am a 100 percent service connected disabled veteran. I still have to pay for Tricare to cover my wife and children. The reasoning behind raising the costs for veterans under the age of 65 is that those veterans frequently leave the military and go on to a second career with medical benefits from their employer. I have no such option, yet because I am under 65 the health care fees that I will have to pay are about to double, then double again. Where does that extra money come from? I can't work anymore, and I have no means of additional income.

I live in a state where the property insurance market is shrinking and insurance costs are tripling and quadrupling every year. When I bought my home, I could get insurance from anyone, for about $300 a year for my home. Now I pay $1500 a year for a home 40 miles inland, and the coverage sucks. No liability coverage for my dogs. No coverage if someone drowns in my pool (an above ground pool, I'm not rich enough to afford an in ground one).

I love my home, but I fear that in the next two or three years I will be priced out of it, and have to sell. I will then have to move out of state, a hard thing for a native Floridian.

The presumption that all military retirees are double dipping and can easily afford a rate hike for coverage we were told would be free when we first signed up for the service is galling. But as one of the other posters in this thread pointed out, we get the coverage the American public feels we deserve. It sad to know that we have been held in such low esteem.

Have you seen those pictures from Walter Reed Army Hospital on the news? Those places were palaces compared to the dumps I lived in when I was assigned to Army units. I figured that such standards must be par for the course. Even at the worst remote assignment I was stationed at with the Air Force, it was never as bad as the barracks I was assigned to in Germany. And the married enlisted had it far worse facility wise than the folks who have to endure that cesspool that is Building 18 at Walter Reed.

[KW4MW]

I could tell you some horror stories about VA hospitals, one of which concerned my father in law but it would take too much bandwidth. #I will say this, I wouldn't take a sick mangy cur to a VA hospital, let alone any human being. #

Alas, military hospitals seem to be following the same trend. #Here in NE Florida we are reading about people sueing the Navy because of poor medical attention. #In one case a man died of infection after surgery because the operating instruments had not been sterilized after being previously used. #A second case involved the delivery of twins. #The first twin was delivered normally but complications arose and the second twin was not delivered until almost an hour later. #Needless to say the poor kid has brain damage and will require medical attention for the rest of his life. #

The problem at the VA and military medical:
- cushy assignments for lazy docs who get a paycheck whether they work or not and are protected by the gov't against being sued for malpractice. # I'm guessing that this attracts the low end of the med grads.

Despite the fact that I am eligible to participate in either program I obtain my medical services in the private sector where I have a right to choose my own Doc and switch if I don't like him. #With the military and the VA you get whoever is available at the time.

[ka5piu]

Quote[/b] (n1ydx @ Mar. 02 2007,03:13)]As a 30 year Army Vet, I would not go into a VA Hospital with an escort.

The complete staff intelligence level in a VA Hospital is equaled by a single ER Nurse with less than 1 year experience.

Most VA staff cannot speak english.

VA forms want to know your entire financial status prior to giving you a rating.

It ain't what it used to be, medical support for the veterans.

N1YDX - Lee
Hello.

YES!
A VA hospital is where the people who can not get a job at a regular military hospital go.
And the regular military hospitals are nothing short of bad.
To give you an example of how bad it really is, they count all time I spend in an air ambulance as medical time.
Nothing wrong with that, I can learn quite a bit about medical practice, while flying the aircraft.
The same is true of any ambulance, but a ground ambulance driver has a better chance of learning.
I am something of an exception, if I have time, I am at the equipment repair lab, learning the ins and outs of everything, or in training.
And, that is one thing that I live for, I am a professional student.
If I need a new pair of glasses I order the blanks and grind, polish and edge them myself.
I do everything but a self eye exam.
That is just the way I do things, everything is a chance to learn new skills.

[ka5s]

Quote[/b] (KI4PEQ @ Mar. 02 2007,07:31)]Have you seen those pictures from Walter Reed Army Hospital on the news? Those places were palaces compared to the dumps I lived in when I was assigned to Army units.
When El Toro Marine Corp Air Station was closed, talk about making government housing there into low-rent homes for civilians ended after home inspectors got a look at it. #It's not that peoplecan't live there, but civilian health and safety codes won't let them.

This is, most of the time, where the military is in American society. #Let's enjoy what change we can while it lasts.


Cortland
KA5S

[K3XR]

And the LIBS want to give us government run health care.

[ka5piu]

Quote[/b] (K3XR @ Mar. 08 2007,15:32)]And the LIBS want to give us government run health care.
Hello.

Part of the trouble is that in todays society we limit the number of MD's by this system where an intern works a zillion hours, after completing med school.
Or, one can work at a government hospital at limited wages.
Or, private practice, and make a huge amount of money.
So, if you were a medical graduate with really good grades, what would you take?
If you are a medical student with poor grades you end up at a government or public hospital.

[KC0NBW]

the medical treatment at the v.a. in minneapolis is probably the best in the system due to the fact that
it is a teaching hospital connected to the u of m and the mayo system, as well as other college nursing and related programs.

dealing with the petty bureaucracy there is really quite irritating most of the time, trying to get past them to the medical treatment can be nearly impossible at times.

i am a service connected vet, and therefore qualify for 100% treatment at the v.a. facilties, yet i have to fight it out with the petty clerks and bean counters before i get to see the medical types.

i do not have a primary care doctor, i have a certified nurse practitioner who i see regularly for the majority of my requirements. #it seems that the doctors that actually work for the v.a. are far too important to be bothered with seeing patients !

the only #major problem i have with the medical treatment there is the orthopedic clinic.

i have been trying to get in to see the orthopedics gang due to the fact that i am still having a lot of pain from my knee operations.

they are only there a few days a week and they seem to be able to come and go as they please, every time i go in there, i never get to see any of the real ortho docs, i just get to see a different resident every time and they have no idea about what i have been through already.

there is one staff doctor that wants me to go through #experimental botox injections in my knee.

i have told him ''no'' several times because if i do go through with it they will not do anything else for my problem for at least a year after the final injection.

i am not willing to go through another year of pain and not being able to walk very far if it does not work and they freely admit that they have no idea if it will work or not.

i keep telling them that i need some long term relief from the problems without having to take painkillers for the rest of my life.

i can't straighten the left leg out and i can only walk a hundred feet or so and only with canes or crutches.

i spend a good portion of every day that i am away from the house in a wheelchair.

i am getting very depressed trying to deal with the pain and limited mobility and the seeming lack of care by the ortho clinic. http://www.qrz.com/iB_html/non-cgi/emoticons/mad.gif

[ka5piu]

Hello.

It is not that the doctors come and go as they please.\
It is the government has a set number of hours that they get, and want to use them to the maximum advantage.
A senior military officer always gets priority.
Next are the grunts.
After that are the high ranking retirees.
At some point they get to the grunt retirees.
Just like in the military, RHP.

[W5IEI]

Quote[/b] (ka5piu @ Mar. 08 2007,15:52)]Quote[/b] (K3XR @ Mar. 08 2007,15:32)]And the LIBS want to give us government run health care.
Hello.

Part of the trouble is that in todays society we limit the number of MD's by this system where an intern works a zillion hours, after completing med school.
Or, one can work at a government hospital at limited wages.
Or, private practice, and make a huge amount of money.
So, if you were a medical graduate with really good grades, what would you take?
If you are a medical student with poor grades you end up at a government or public hospital.
Yesss!!!!
What he said?
Where's AD4MG's opinion on this,I'd hate to screw up america http://www.qrz.com/iB_html/non-cgi/emoticons/tounge.gif

[ad4mg]

Quote[/b] (W5IEI @ Mar. 08 2007,20:59)]Quote[/b] (ka5piu @ Mar. 08 2007,15:52)]Quote[/b] (K3XR @ Mar. 08 2007,15:32)]And the LIBS want to give us government run health care.
Hello.

Part of the trouble is that in todays society we limit the number of MD's by this system where an intern works a zillion hours, after completing med school.
Or, one can work at a government hospital at limited wages.
Or, private practice, and make a huge amount of money.
So, if you were a medical graduate with really good grades, what would you take?
If you are a medical student with poor grades you end up at a government or public hospital.
Yesss!!!!
What he said?
Where's AD4MG's opinion on this,I'd hate to screw up america http://www.qrz.com/iB_html/non-cgi/emoticons/tounge.gif
Mike,

You really want to take this to a personal level. Let's do it elsewhere. These honorable folks are having a nice, productive discussion, and don't want to hear you spew your garbage.

I'll not entertain you here. Sorry.

My apologies to everyone else in the thread.

[ka5s]

Quote[/b] (ka5piu @ Mar. 08 2007,21:04)]A senior military officer always gets priority.
Next are the grunts.
After that are the high ranking retirees.
At some point they get to the grunt retirees.
Just like in the military, RHP.
Because I had a really good job and no disability, I didn't qualify for VA care after income limits came into play. I'm not complaining; PLENTY of folks deserve to get ahead of me, and need it more, too. But rank and commissioned or ranking enlisted status should have no room in who gets seen. Blood, IMO, trumps rank.



Cortland
KA5S

[ka5piu]

Hello.

The reality of it all is that there is a given allotment for every group.
If you are active duty military you are of more use to the government and so the doctors are being shifted to that area.
If you are a guy who has been out and out and the future looks grim not a whole lot of effort is going into your case.
Micky Mantle was a classic example.
The guy had very little chance of any real recovery, but the fact that he was a very famous baseball player and the money, he was given transplants ahead of just about everybody.
Be a guy who served his 3 years in and nothing else and see what kind of treatment the medical community gives you.
Be indigent and you are really screwed.

[KC0NBW]

Quote[/b] (ka5piu @ Mar. 08 2007,18:04)]Hello.

It is not that the doctors come and go as they please.\
It is the government has a set number of hours that they get, and want to use them to the maximum advantage.
A senior military officer always gets priority.
Next are the grunts.
After that are the high ranking retirees.
At some point they get to the grunt retirees.
Just like in the military, RHP.


the ortho staff doctors act like a bunch of spoiled brats, they treat you like they are doing you some enormous favor by being willing to see you.

i have not seen much of that kind of attitude from most of the other doctors in the v.a. system



in the v.a. system, service connection gets top priority, rank does not have any bearing on order of treatment. #i have been in the same room with former officers, even a few full colonels!

one time i was put into a room with a former bird colonel and they moved him to another bed so i could be closer to the bathroom !

he was not overly happy with it but he admitted that i needed to be closer #to the facilities than he did !

i imagine that there are a few instances where officers try to ''pull rank'' but i personally have not seen it in a v.a.hospital.

i have seen the army hospitals where they even have separate wards for officers and enlisted however.

the officers wards were far better staffed and maintained than the enlisted wards were.

[n1ydx]

Most of what folks have posted is true. I know that when I needed new hearing aids for a service connected disability and contacted VA, the answer I got made me seek a civilian source for the hearing aids.

Forms up the ying yang, even though I have a VA Disability coming in for wounds which included ear damage.

Complete military history, DD214, and to top it off, they wanted my financial history, home ownership status and more.

They didn't ask for that stuff when I served my 30 years.

The system is screwed up in a royal manner and mismanaged to the hilt.

I feel sorry for the veterans that depend on the VA for treatment. I'd rather use up my savings than go to VA.

N1YDX - Lee

[ka5piu]

Hello.

The trouble is that for some things the VA has to do the outside vendor thing.
Hearing aids can cost $3G a pop.
That is a lot of pocket change.
And, anybody who thinks rank has no bearing is nuts.
I know of 5 MD's who set aside 4 hours just for commissioned officers.
Also, they will see retired commissioned officers at the regular post hospital.
NCO and down can not do this.
And, yes, service connected disability does count for medial care, but up to a point.

[KC0NBW]

Quote[/b] (ka5piu @ Mar. 09 2007,10:55)]Hello.

The trouble is that for some things the VA has to do the outside vendor thing.
Hearing aids can cost $3G a pop.
That is a lot of pocket change.
And, anybody who thinks rank has no bearing is nuts.
I know of 5 MD's who set aside 4 hours just for commissioned officers.
Also, they will see retired commissioned officers at the regular post hospital.
NCO and down can not do this.
And, yes, service connected disability does count for medial care, but up to a point.
military hospitals treat the officers first,then senior ncos, then the rank and file.

the v.a. hospital system treats service connected first, regardless of whatever rank the person held.

if i go in at the same time a non service connected ex officer comes in, i will get admitted before the ex officer would.

and there are no special wards for the brass and senior ncos as there are in military hospitals.

at this time, there have been 6 generations of my family have been in service during periods of armed conflict.

my great great grandfather in the civil war, my great grandfather in the ''indian'' wars, my grandfather and great uncle during ww1(my grandfather was 100%service connected from ww1, my great uncle died from the flu epidemic while he was in the army ), my dad (my dad just missed going to korea a a lt2)and my uncle were in ww2, i was in during vietnam and my oldest son was in desert storm.

my grandfather,my dad,myself and my oldest son have all been rated as having service connection for injuries and disabilities. my grandfather and my dad are gone now, just my son and i are left at this point.

[ka5piu]

Hello.

If an officer has not resigned his commission his rank is still current.
And, as far as service connected goes, officers look out for officers, usually.
The old paging system, supplied by the army, operated on 149.775 MHz nationwide.
There were codes for officer and everybody else.
An officer might end up at a VA hospital, but once this was known and he was a friendly, a transfer order was sent.
Now everybody uses cellphones so this is simply said over the air.
I should know, I fly air ambulance and have NEVER transferred anything but officers from a VA facility.
When the VA hospital in Waco Texas closed I trasferred 28 patients.
All had current commissions.
It is this "play ball" attitude that has helped me get ahead.
Read the current American Legion mag, there is an almost identical story of what I went thru, except there they let the guy die.

[n6hcm]

Quote[/b] (KC0NBW @ Mar. 08 2007,16:59)]the medical treatment at the v.a. in minneapolis is probably the best in the system due to the fact that
it is a teaching hospital connected to the u of m and the mayo system, as well as other college nursing and related programs.
we have a similar situation in san francisco: the local v.a. is a teaching hospital with many top-notch folks from ucsf (http://www.ucsf.edu), and other local med schools (places like stanford (although most of these folks are at v.a.p.a.) (http://med.stanford.edu/)) ...

getting care at a teaching hospital has its own risks ... students are students for a reason, and doctors assigned there (from the local med school) still have to publish or perish ... and this is all in addition to the usual large government bureaucracy.