15 July 2014

Fort Collins VA Clinic Experience

Fort Collins (CO) VA Outpatient Clinic
Today I related to the American Legion Crisis Action meeting here in Fort Collins my most recent
appointment experience. Previously, I'd been disappointed only with the long delay arranging an initial primary care appointment (I'm 100% service connected) after we moved to Colorado. I didn't think much about it and subsequent experiences, both with health care and appointments, were perfect; nice folks, superb care, attractive facility, short waiting time...everything great. Good reason to move to Fort Collins!

But a real problem hit in June. I'd been in the Palo Alto (CA) VA War Injury & Illness Study Center for several days of extensive tests, with more problems identified. I was discharged with instructions to seek an appointment with my primary care within two weeks. Doing so, I left a message with the Fort Collins VA Clinic recorder - no live person free to answer the phone, I guess. Gave the details of the request and waited.

Eight days later, not having heard anything, I called again, only to have to leave a message on their machine again. The next day I was called (June 26) and we discussed my request to see my primary care.

I related my recent VA hospitalization in California, mentioned I'd also just had shoulder surgery three days earlier, repeated my issues with heart disease, cancer, spinal cord injury, diabetes, 100% service connected and other stuff. The scheduler explained that I saw my primary care twice a year and so the next appointment should be in September.

Just in case he didn't understand or I'd not been clear, I repeated everything, especially the Palo
Alto VA orders to see my local VA primary care in two weeks (which would be late June into early July.) Just in case I didn't understand, the scheduler then repeated that my next appointment should be in September.

"Okay," I said. I certainly didn't want to "bump" anyone needing care more urgently, and the next available appointment offered me was again, September. I told the clerk that because I felt I needed care more promptly than that, I'd seek it through non-VA means. I repeated I didn't want to bump anybody from ahead of me at the VA. We finished our call.

Three months. A long time for a vet already rated "catastrophically disabled" and 100% service connected by the VA to wait for an appointment to see his primary care provider. An especially long time given the VA Palo Alto discharge instructions to see the primary care provider within a couple weeks. An especially long time given the twice-repeated summary of the reasons behind the appointment request, and also because the primary care had referred me to Palo Alto's War Injury and Illness Study Center and follow-up with him was necessary.

Admittedly, I was passive, unassertive, letting the appointment clerk make his decisions without my pushing, but carefully waiting to see what the outcome would be. How quickly would I be seen or how long would my appointment be put off? I was already alarmed because my first call to their appointments recorder had been eight days earlier. Eight days passed and I heard nothing until I called a second time, and then a day passed before we connected. Nine days, with the first request left on their answering machine apparently lost and never acted on.

Today, relating my situation to the team of VA specialists helping the American Legion conduct their Veterans Crisis meeting, the VA gentleman from Cheyenne typed my info into his laptop (on line with the VA) and offered me three choices for appointments next week. No big deal – when did I want to come in? What time of day was most convenient?

Wonderful! But I don't understand why I was tossed a 90-day delay with my earlier request, but today, before relating my situation in detail but simply saying I wanted to have an appointment,  was offered numerous possibilities anytime next week.

I do know the ninety day delay was bad enough that it could have left some vet dead. No non-vet would ever tolerate such a delay elsewhere in the medical community. Discussing it with VA managers today was unburdening but nobody took notes, nobody said it was something that wouldn't happen again, nobody said it was something to fix, everybody was polite.

I was told to mention it to my primary care when I see him next week. That's all.

I see no reason situations like this won't repeat, especially with confused, depressed, stoic or passive veterans who quietly accept whatever's offered in terms of appointments, scope of care, ancillary services, things which can be quite important to life and limb! The patient's role is to ask for help from the VA and explain the need.

In its ninety-day response, VA proved dangerously inadequate in my most recent experience. At least in this instance and in this place, VA's process depended on a patient to push past an appointment clerk for proper telephone triage appropriate for the urgency to be acted upon. VA cannot count on patients to push the system, and doesn't take well to them doing it, either.

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