VA hospitals: excellent models for integrated treatment

[eridani]

http://www.washingtonpost.com/opinions/in-the-va-system-the-future-of-primary-health-care/2012/11/30/c10d5cf0-3b2e-11e2-8a97-363b0f9a0ab3_print.html

My first patient in medical school was a 25-year-old Iraq war vet from a small farming town in Idaho. A star high school football player, he had enlisted in the Army on his 18th birthday so he could see the world and afford college. Within his first month in Iraq, a satellite pole fell on him during a brutal sandstorm. Multiple leg surgeries later, he was sent back to America battling chronic pain and dependent on narcotics. Using a cane to walk, my patient grew depressed, gained 30 pounds and became a diabetic.

I had 30 minutes with him, and my attending physician had just 15. We were already running late. But my attending calmly introduced our team’s social worker and psychologist. They booked visits for the patient with the VA pain-management clinic, the mental health clinic for post-traumatic stress disorder and a physical rehabilitation specialist. And we saw the patient the very next day to begin treating his diabetes.

This multifaceted and coordinated approach to treatment — all of it at minimal or no cost for veterans at the VA — is rarely practiced in other American hospitals and clinics. If this patient had hobbled in and found me at a private clinic outside the VA system, his lack of insurance and a job would have put him in the Medicaid ranks. Specialists might have refused to accept Medicaid, and he might have had to pay out of his own pocket — or not see them at all.

Moreover, like nearly all private patients, he would have needed to coordinate these visits on his own, carry his medical chart with him and later ensure that I received the specialists’ recommendations. To see me again, he might have needed to wait weeks for an opening.

The VA system could be a model of how to change all that. Indeed, it’s a model of changing itself.

[bakpakr]

1. Totally Agree

Several years ago now. I had a medical issue. My employer does not offer health insurance and I do not qualify for medicaid.
Being a vet I was able to access the VA Medical system. I had heard all the negatives about the system, long waits for appointments, substandard care to name a few.

To my surprise and delight I found ALL the negatives I had been hearing to be false. My condition was not life threatening just painful. Once I entered the system I was seen within days of my initial contact with the system. I was referred to a surgeon and issued meds to manage the pain. I left the clinic for that initial visit with only an appointment card and my meds all other aspects such as making the appointment with the surgeon were handled painlessly with the scheduling clerk. the only thing they asked me what day and time were convenient for me.

At the surgeon my records were readily available by way of the computer no paper records were needed. Within weeks of that appointment I had my surgery and they actually apologized to me for the wait to have the surgery. I knew going in that due to my condition that I would have to wait for the surgery so that was not a big problem for me. So only having to wait a few weeks was in my opinion no wait at all. I was expecting to wait several months.

The care I received before, during and after the surgery was by far above and beyond the best I have received in the civilian medical system.

Now remember I had no insurance at all prior and during the case. My final bill for everything came to a whopping $697.00.

I was also offered transportation to all my appointments.

Will I utilize the VA system again. Dern tootin I will. I now consider the VA system as my primary medical provider.

[Victor_c3]

2. I'm on the PTSD side of the VA system and I have nothing bad to say about it either

I kept hearing how bad everything supposedly was, but I never saw it. I've been through the VA hospital in Wilmington, DE and the one at Castle Point, NY. Both are excellent facilities as far as I've seen.

Even the claims process that I keep hearing is supposed to be very messed up went nice and smoothly for me.

I have nothing bad to say about the VA and I personally haven't met anyone who has either. I'm guessing a lot of the horror stories we hear are isolated events or from a previous time.