Monday, March 5, 2007

Guest Post: Wisconsin Vietnam Vet Speaks Up About The VA

A Vietnam veteran from Wisconsin, reacting to the horror stories flooding the news about deficient medical care at Walter Reed and other Veterans Administration facilities nationally, sends along this thoughtful guest posting. I'm happy to run it.

It's clearly an invitation to media to take a look at Wisconsin's VA presence.

The vet is a credible person. We agree that the posting should run anonymously:

Guest Post:

By way of local angles, there is a story at the Milwaukee and Madison VA hospitals, a direct spin off of Walter Reed.

The staffs are vocal in apologizing for the long delays on needed surgeries and treatments due to the lack of resources and increased demands due to the wars as well as Bush pandering to the non-needy, but huge pool of vets made newly eligible for various care programs.

The VA is the minor leagues for new medical personnel to attempt their first ops, treatments and case loads.

Some needed ops work OK. Some simply get lost in the shuffle. Some are misdiagnosed, and some are delayed for months.

There are staff who probably would be willing to talk if asked. The problem with patient sources is that so many of them are extremely vulnerable, and fearful of jeopardizing the care that they get.

And many more don't know what any other care looks like, and feel that what they get is the best available, so grateful are they for any medical attention at all.

There is the expected old boys network, where second opinions amount to little more than MD's scratching each other's back.

Can be frustrating. For me, the 'every nickel' strategy seems to work best. I am comfortable, as comfortable as the "owies" allow. And there is the certainty of shekels for all pleasures great and small. As long as one isn't too greedy.

So it is reasonable for me to see a future without the horrors of poverty and old age and isolation. And I do. I'm lucky.

But for a lot of these guys, life is just going to get worse. And despite the near-heroic efforts of some of the people I was fortunate enough to have as care-givers and guardian angels, the rewards for them aren't sufficient to buy the regular relief from the demands that just don't end.

They can't be everybody's hero and angel.

Would that it were so, though.


Anonymous said...

I believe the Wisconsin VA hospitals are above average in most respects, though they have problems related to the problems in other military and VA health care facilities.

My first job after Vietnam was as a Nursing Assistant on the Ortho ward of the Madison VA Hospital. I was there about 2 years.

I also receive my primary health care from the Milwaukee VA.

Though delivery of health care has changed in the last 30 years, both hospitals work similarly. There are fewer hospital beds. Most care is done on an out-patient basis. There is an increasing demand (thousands of out-patients as opposed to hundreds of beds) and an increasingly understaffed clerical and nursing staff forced to handle the overload.

There's likely a thousand- fold difference, depending on how you do your statistics. Many more out-patients can be seen in a given time, but they still need their blood pressure, temps, and other supporting tests, before they see a doctor.

The MDs who do the heavy lifting are medical students, interns, or residents. They're overseen by a "real" doctor who makes sure that nothing too outrageous happens.

This is good training for future doctors, and while I don't mind being a teaching instrument, I tend to object to being an experiment.

Still, my wife is a nurse, and I'm knowledgable and competent, so I've been able to use the system, and make sure I get the care I need.

I believe changes that have been made recently will cause older, and less able patients to be dropped from the system. If they aren't competent enough to ask the right questions, they can't get the correct answers, and they're less likely to get necessary care.

In short, I generally believe the Milwaukee VA Hospital is doing as well as it can with the resources supplied. Is that good enough? No.

In Milwaukee, my biggest problem is trying to "commercialize" the grounds.

So, what is the 110th Congress (the guys who divvy up the money) going to do about it?

My best guess - not much other than talk a lot.

James Rowen said...

Thoughtful comment. Appreciated it.