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‘Do It Yourself, White Boy!’ Life at the VA
Another lifetime ago, those five words were spoken to me in a VA hospital in New Orleans. Another typical civil service, morbidly obese nurse biding her time until retirement. The patient was a WW1 vet (who’d been gassed, etc.) and he needed to have his bladder catheterized. I wrote the order that was countersigned by a resident but it didn’t happen.
A few hours later I returned. I asked about it and was told,”Do it yourself, white boy!” So I did, although I fumbled my way through the procedure since his 90-year-old prostate was the size of Delaware. He’d been hurting for hours while this lady did her very minimal job as well as her nails.
Now let’s go to an actual VA doc who, when he resigned after a couple of years, was told by his boss that he was the worst employee ever. Funny thing, that doc was as bright, compassionate and motivated as any I’ve ever met. But being the “worst” actually meant he busted his bottom and refused to give in to the slothy culture which permeates ALL civil service life. Holding a meeting and resolving to eventually do something positive but never doing it was the norm. This “worst employee ever” could not deal with the rampant laziness and dysfunction. Having spent plenty of time in four VA hospitals, I can say this is epidemic.
In the private world we bust our buns. Time is money and we have promises to keep, with miles to go before we sleep.
In the civil service world, you kill your work time until the shift is over, doing the minimum and never rocking the boat. The patient life units are all just statistics anyway, right? They fought for our freedom but the basketball playoffs are on tonight, so just wait in line, buddy, and shut up.
We are headed to a single-payer system eventually, albeit run through cronyist insurance agents who are in bed with bribed politicians. As Obamacare fails, this eventual system will emerge, populated by clock-punching robots without compassion or motivation. Does anybody even remotely think civil service hospitals for ALL will be anything better than our VA’s?
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And that’s what the Left wants for us here, because it means control.
Yep Rosie, we are headed to an ever increasing cheapening of human life.
Yes Arahant, of course, the worse it is the more big brother. What a world we have coming our way.
When my brother left the Air Force in 1973, he hoped he could get a job with good medical benefits. I said “Well, you’ve always got the VA…” He said “I’m planning my life so I never – ever – have to darken the doors of a VA hospital.”
This is not a recent phenomenon.
This can’t be blamed on Obama. I remember horrifying stories of VA healthcare from the 70’s. I think it was Keven Williamson who recently wrote something to the effect that it’s not the VA, it’s socialized medicine. Welcome to Obamacare. This is the healthcare we’re all in for.
No, but his reactions to what’s happening under his administration are certainly worthy of criticism, positive or negative, especially when Barry was making a career out of claiming he would do something about it.
It’s a pretty direct line from the VA to Barrycare. Single-payer. Everyone in the same “pool”. Equal access. To a system that’s getting lots of dollars and has gotten a lot more in recent years.
Strap in for the ride. And hope you don’t need help from the system that Barry’s creating.
Frankly, in the context of this whole conversation, this comment sounds extremely creepy.
What’s in the gravy?
-E
Do we actually need VA hospitals, staffed with government employees? Would it be practical to just give the veterans an insurance card from the VA that they can use in any hospital? That way a veteran wouldn’t have to travel a couple hundred miles to a VA hospital, he could just go to one that is closer. If one hospital can’t get him in for two months, maybe another can. I’m not proposing that the existing VA hospitals be bulldozed. They could simply be sold off to companies that already run hospitals. I don’t know enough about the system to know if this is practical or unworkable. There would be political resistance of course, but are there any logical reasons why this wouldn’t work?
That was the recommendation of the WSJ article that I linked to, above.
Yes, one would not want to be starring in a documentary entitled: When Insulted Hammers Strike Back!
Lucy, thank you for posting the WSJ article link.
I’m with giving veterans vouchers for medical insurance. Since poor patient care & long wait times have lead to deaths, those responsible for devising the wait time doctoring scheme, those who carried it out & those who did not care for the patients should be hauled into criminal court. And we should do away with the union that protects these people.
My VA experience is both old and new. Old, I did my residency in the mid 70’s in a VA hospital associated with a medical school. Mostly what you found then was typical paperwork hurdles, which you learned to overcome with appropriate paperwork work-arounds. So, eg, when you admitted a GI patient, you put in for upper and lower GI on the admitting orders. You didn’t know then whether you would need it of not, but if you didn’t, you simply cancelled it.
Modern exposure is southern Indiana, where the nearest VA hospital is at least 2+ hours away, but there is a local clinic. What mostly see is abysmal follow-up. Work-ups are never anything I would consider timely, and the overall attitude seems to be that if we don’t do much, you will either get better or die. Rather sad to see a Korean vet being so mistreated. I take every opportunity to admit these to our regular hospital – for both care and evaluation.
Usually if you understand a bureuocracy you can often find ways to burn them to the ground. But it takes work, and it helps to BE a vet.
There had better be GOP political ad makers tying the VA to Obamacare. Imagine ads showing:
Ditto. After spending just 4 years in the Army and experiencing that medical care under President Carter’s budget cutting years, I said the same thing. Although for many years, I thought VA facilities were for war vets, those injured in the service and retirees only.
I do have a friend, did his 4 years and goes to the VA for every medical thing he needs–crazy.
My dad new a doctor who spent endless hours, outside of his private practice, at the VA hospital in White City, Oregon. He was a WWII vet and nearly lived there on weekends. God bless him.
I agree the VA in the 70’s was best represented by Oliver Stone’s movie Born on the Fourth of July – a hellhole. When I was just out of the military in my early twenties I tried to get care for a service connected injury; the hospital in NYC was a disgrace. But I have recently gone back to receiving care and have to say I am surprisingly happy with the service I get in Asheville, NC. Maybe this is an outlier with a culture that particularly venerates military service, but I feel I need to defend the nurses, doctors and support staff I have dealt with.
I’m guessing it’s North Carolina and probably the South in general. One of my buddies has described his sojourns to the VA here in the Detroit area, and they are much more of the “Do it yourself, White Boy” variety.
Doc, you’ll get no arguments from me. Twenty years ago that’s just how it was. Now, there’s no really diplomatic way to put this, but during your internship you may have had a few rough edges also, both in skill and in manners. You, that is, and 400 other young people per year who showed varying degrees of promise.That’s no excuse for the old VA. Thing is, I have worked elsewhere, rumors of my unemployability having been exaggerated. And I can tell you I’ve seen worse. but I can’t talk about them by name because their attorneys will be on the phone to me lickety-split. Not so the VA. Every hack journalist becomes an expert the minute they talk about the VA. Sorry to sound bitter, but I get a lot of this and it beating up VA is fun, but it’s not helpful or new. If we’re ever at the same meetup I’d love to buy you a drink and tell you the details. Suffice it to say that the Media stories are at a 90 degree angle from the truth and intersect with it only by chance
Agreed! Shinseki didn’t do this and discarding him made less sense than throwing a virgin into a volcano.
That sounds like just about everything the MSM reports on.
I think that’s a different thread by DocJay.
Ah, yes, those poor put-upon doctors. I have two words for you: double-dipping. Well, I volunteered for fours years during my teens at a VA clinic. It was revealing. See, this VA like many are affiliated with a university hospital, usually next door. And many of those VA docs are also on staff at the University hospitals. So, docs would get Veteran patients that they were treating for a certain condition at VA and send them over to the university hospital for the same treatment under their care. They’d get paid twice for treating the same patient for the same condition, but at two different places! No wonder many VA hospital employees hated doctors. Everyone knew what they were doing – probably still doing. But they acted like we were supposed to bow down to these god-like docs who lowered themselves to treat strung-out homeless Veterans. Please. I was just a kid and I saw how some of the residents treated our Veterans. Shameful. Wanna fix the VA? Start with the unscrupulous docs ripping off the taxpayers.
The single payer system is the culprit here. It leads to all manner of corruption and inefficiency. Dismantle the entire system and give veterans vouchers for private healthcare.
Problem is the VA isn’t a payer, so it’s a false assumption to compare the VA to single-payer. So this argument that “what’s happening at the VA will be our future as single-payer healthcare” is a fundamental misunderstanding of how the VA functions and what a single payer is. The VA is a system 100% capitated and has to provide care to the covered population in the direct care system or by purchase. A single payer in the ACA sense is more like Medicare/Medicaid. There are 22 million Vets, the VA takes care of 6.5 million in its globally capitated direct care system, the rest get healthcare from somewhere else. This is really an apples to oranges argument.
While Shinseki didn’t start this he certainly should have known, and made appropriate noise about it. In the end, if nothing changed, he should have resigned in protest. But he’s a flag that goes along to get along. Sorry, no compassion for him from me. Honourable men don’t act that way.
This is a case of a distinction without a difference. Whether capitated or not, the problem would be the same: there is no competition in the market, and the government can only control costs through poor service and rationing care.
Frank,
Not true, it’s a distinction and a difference because the ACA won’t be a bricks and mortar gov’t owned delivery system like the VA. It’s misinformed and distracting from the issue to keep beating this drum. VSO’s want and need the VA. They want it better managed. Veterans want services the VA offers because it offers things not available in the private healthcare sector. VSO’s will lose political leverage if the VA closes. Watch. The. Hearings. The VA already sends Veterans to the private market, so I don’t see how the voucher plan is a fixer. And with federal gov’t paying 50 cents of every healthcare dollar spent, it’s not much of free market anyway. Using the VA scandal as a dog whistle for single payer just makes people sound confused and clueless. It’s like saying, “Hey, I can count to potato!” It makes no sense. Maybe that’s by design, but I thought conservatives were supposed to be the informed voters.
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I strongly suspect that your teen self misinterpreted what was going on.
I’ve spent my life working at university hospitals with affiliated VAs. The way it works is this: the VA pays to create an expensive and inefficient smaller replica of the university hospital next door, staffed with people who may start with good intentions but end up beaten down by the system. Because there is no accountability at all, people who are lazy or stupid or mean thrive in the system. People who start out working hard become lazy and mean and see no reason to use their brains, because they get absolutely no reward. The equipment is ancient even when new, because the procurement process is so slow that, by the time a requested piece of equipment arrives, there have been three or four newer generations developed.
You cannot get a patient across the street to the university hospital without a huge paperwork hassle, during which you must prove that equivalent needed services cannot be provided at the VA. You can imagine how long this may take. And you can imagine how liberally the VA bureaucrats interpret “equivalent.”