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Still waiting

World War II veteran Harley Parker (second from the right) waits to speak with someone at a healthcare crisis center set up by the American Legion in Phoenix. (File photo/The Associated Press)

Andy Tullis/The Bulletin

Ken Miller holds his Veterans Choice Program card.

Mark Henle/The Arizona Republic/AP

The Veterans Day parade passes the Carl T. Hayden Veterans Affairs Medical Center in Phoenix.

Lifestyle

Still waiting

A year later, VA hospital problems are not fixed

PHOENIX—On a hot summer day here, Kelly Arrington—​a walk-in patient, because “getting an appointment is very difficult”—sat in the mostly empty waiting room of the Turquoise Clinic at the Phoenix VA Hospital. The hospital’s high-ceilinged hallways open into a series of cramped, clone-like outpatient clinics, each named for a different precious stone. Each clinic has its own staff of primary care doctors and nurse practitioners.

Last August, President Barack Obama signed into law the Choice Act, meant to solve the problem of veterans having to wait longer than 30 days for appointments in the Veterans Affairs healthcare system. Almost a year later, the problem has worsened: Veteran wait times have increased by 50 percent, according to The New York Times. I spoke with veterans who say the VA continues to use bureaucratic strategies to disguise the size of the problem. 

Arrington is one of them. She says each time she calls, hospital staffers tell her they’ll call her back. In November, while suffering from a sinus infection, she left 10 to 12 messages requesting an appointment before the clinic finally scheduled her. (Even then, she maintains she only got a call back because her OB-GYN pulled some strings with a primary care doctor.)

Other disappointed vets have joined an advocacy group, Concerned Veterans for America. Some say VA staffers tell patients “we’ll have somebody call you back,” and others say they receive appointments within 30 days only to be told, “canceled.” The result is the same—waiting months for appointments—but the second way allows the VA to say it had scheduled appointments in a timely manner. 

Glen Grippen, interim director of the Phoenix VA, said he hoped dishonest scheduling practices were not occurring in Phoenix, but said the hospital has a very large staff so he couldn’t say the practice didn’t happen. The Choice Act’s solution, Choice Cards, hasn’t worked. The cards are supposed to allow veterans to receive VA-subsidized care from outside doctors if they have to wait longer than 30 days for an appointment. But VA officials barely speak of the cards, and VA Secretary Robert McDonald tried unsuccessfully to persuade the Obama administration to defund the program in its 2016 VA budget. 

To qualify for a Choice Card, veterans need VA approval, which depends on showing they are unable to get an appointment within 30 days. They also need private doctors willing both to accept the card and to communicate with the VA about the patient throughout the process. If a doctor then recommends the vet see a specialist, there’s no guarantee the Choice Card will cover that. 

The Phoenix VA’s Grippen says Congress needs to make the Choice Card process more user-friendly, but he doesn’t think it would change much in Phoenix because he says vets love their VA doctors too much to switch. That’s true for patients like Dann Murray, who sat in gym shorts in the mostly empty waiting room of the Emerald Clinic, waiting to see a doctor for a nasty cold. 

A hoarse Murray said the Phoenix VA medical staff is exceptional. He particularly likes the nurse practitioner who has satisfied his outpatient needs for years. The hospital has only canceled on him once, he said, when his doctor was sick, and the most he’s ever waited for an appointment is three to four weeks. But others, like Harold Bolieu, have a different story. He has nerve damage in his arm, walks with a cane, and recently waited hours in the Phoenix VA Emergency Room with pneumonia. Twice.

Bolieu and his wife, Irma, sat in the Emerald Clinic waiting for an appointment they hoped would result in permission for Harold to receive care from a neurosurgeon outside the VA. The couple said the only tangible change they noticed in the VA after last year’s scandal was wait times in the emergency room shortened dramatically for a few months, but soon they crept back up. Now the Bolieus are desperate. They worry that after months of waiting for the right type of neurological consult for Harold, his condition might deteriorate beyond repair.

Harold said Irma is his secretary when it comes to scheduling VA appointments: “She stays on the phone for me for a long time.” Irma has become aggressive in trying to set up appointments for her husband. “I’m not angry,” she said with an embarrassed smile. “I’m just a little more firm.” 

Choice Act funding is allowing the Phoenix VA to hire more staff members, and through June it had added 165 medical professionals. But for the Bolieus, fixes to the broken system might be too little, too late. “We’re here on our last-ditch effort,” Irma said. If the doctor doesn’t approve their petition to go elsewhere, they’ll do it anyway, she said. “Our sons offered to lend us the money.”

—Maria Baer is a graduate of the World Journalism Institute’s mid-career course

Comments

  • Elaine
    Posted: Mon, 04/11/2016 11:52 am

    The weeping and wailing taking place over long wait times at the VA only highlights how much of a wasteful behemoth it really is.  The vast majority of the men and women who demand to be treated at the VA only served in the military for only a few years and have the same options as the rest of Americans have.  They SHOULD be doing what the rest of us do: get their insurance at work, through Medicare if of age, Tricare if they are a military retiree, or if all else fails, use Medicaid.  The reason they don't is because they don't want to pay co-pays or deductibles.  That the VA exists in its current form at all is a travesty.  It is purely socialized medicine at its worst.  Instead of building more VA facilities, we should shut all of them down and require the vets to use the civilian medicine which IS available to them.  For those who suffered war injuries, there should be special insurance to see civilian doctors for all their care needs.  The vets DO have access to other care, they simply choose not to use it.

  • Anonymous (not verified)
    Posted: Mon, 04/11/2016 11:52 am

    I'm a vision-impaired vet who gets 100% of my health care from the VA and am (this week) attending the Blinded Veterans Association annual convention in Louisville. We just had the new head of the VA medical system speak to us about this problem. One statistic that this article "doesn't know" is that the number of vets receiving care has dramatically INCREASED since the scandal. Thus, the statistics as reported here don't mean a thing. Second, ALL of us convention attendees and most VA patients in general are VERY satisfied with our medical care. Yet I've also talked to vets who report less than wonderful experiences; but even they are very happy overall and they would never want to tar the VA system as a bad system. "The staff and doctors are fantastic" is what all of the vets I've talked to over the years usually say about the system.

  • William Peck 1958's picture
    William Peck 1958
    Posted: Mon, 04/11/2016 11:52 am

    I have a question which just bugs me because I'm a veteran, 1981-986, honorably discharged and healthy (at the time anyway). Yet I have no VA medical benefits. So I don't get who are all the vets that are clamoring for care . . . If someone retired from the military, then they have health care through that, TriCare I believe.So I'm asking what is the criteria in which someone qualifies for the VA Medical benefits ? Is it pro-rated based on percentage of disability ? And do those with mental illness get full medical care.This has always confused me because as a healthy Vet, I get nuthin' . . .