Thursday, May 29, 2014

Maybe I can be of Assistance [UPDATED]

I have been closely following the VA situation - I cannot call it a scandal, for reasons I will explain - and wish to offer some much needed assistance. This is of interest to me for two reasons:

First, my husband served 8 years in the Air Force and as such is eligible for the VA Healthcare. However, even when he was in (1985-1992) we knew then that the VA did not deliver either on-time care or good quality care and we always planned on using the civilian system.

Second, of course, I am interested since I am in Medical Practice Management. As a previously certified medical manager with my MBA and over 15 years of management experience, I think I can help them solve the problem very quickly and easily.

So let’s break this down. How can the VA see and treat 1,700 veterans? In the civilian world, primary care appointments are approximately 15 minutes. So, 1,700 veterans seen at 15 minute intervals are 425 hours. When my husband was in the military he routinely worked 12 hour days. So, since this is an emergency, let’s set the workday for 10 hours, with staggered lunches so patients can continue to be seen. So, at 425 hours broken down in 10 hour days, that would be 42.5 days. So in a little over one month, every patient can be seen and this is based on one provider seeing all 1,700 patients. In the civilian world a primary care doctor normally sees 30 patients a day, so that doctor would see 1,700 patients in 56 days. At 20 business days a month, 12 months a year, a primary doctor sees a minimum of 7,200 patients a year; any primary doctor will tell you that they probably see double that number in a year.

This would solve two issues; 1) it would remove the need for wait lists, simply schedule the patient for their next appointment at the time of service (how many times has your primary care doctor put you on a wait list instead of scheduling your next appointment?) and 2) the veterans would have the care they deserve.

I did not call this a scandal because this is business as usual in the world of military medicine, or socialized healthcare in America. When my husband was in the Air Force we used the military healthcare system, which while it was not difficult, it was also not a pleasant experience. The issues revolved around lack of timely appointments, physicians unable to quickly treat a condition without first a lab test, x-ray, etc. (I once waited 5 hours in a wait room for the test results of a UTI so I could get medication. After 5 hours, the doctor gave me a prescription while he waited for the results), not willing to remedy a medical situation, (After driving 3 hours to the nearest base with an ENT, the doctor refused to remove my daughter’s ear tubes, which had been in over a year. Once we were civilian, she needed surgery to close a hole in her ear caused by the tube being in for over 2 years), and general attitude by the medical community that we, their patients, were a bother. Sound familiar?

This is not a new development, but instead an ingrained culture in the Military Medical Community. Now this is, of course, not true for every individual in the Military Medical Community, but being in the system and working in the civilian medical world this is the rule rather than the exception. If the government is serious about correcting this situation, then may I suggest that they pattern themselves after the civilian model, which has worked very well for decades or they can keep doing what they have been doing and getting the same results.

ADDENDUM [HGS]: Well, this guy certainly seems promising:

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