Dayton VA needs an intervention

Back around 2000, I took a giant leap of faith and switched my health care to the Dayton VA. As a veteran with a disability, I was entitled to care. My earlier experiences with the VA dating back before they built the new hospital were pretty horrible. I was lucky, and got a wonderful doc- an Air Force veteran from my home town. His nurse is still one of my buddies. But, both of them left the VA, and it was the beginning of the writing on the wall.

The Dayton VA has had its ups and downs, but there was a time when the Director we had was considered a regional troubleshooter. His name was Glenn Costie, and to this day, I consider him a friend. He had been sent to other facilities, including Cincinnati and Phoenix, to straighten out bureaucracy gone south. He’s been gone from the Dayton VA for at least 5 years now, and the stitching is coming out of the seams.

My regularly scheduled ophthalmology exam was postponed by over a month, because 5 providers had left. When I needed to get my regular colonoscopy- something the VA should be doing like an assembly line, my appointment was sent out to “community care.” Now, I’m fine with community care for specialties like rotator cuff repairs, of which the VA probably doesn’t need to do as often, but colonoscopies for the veteran population should keep a team fully staffed.

But, there were other things that have made me wonder lately. My left hip is pretty much bone on bone- and I’m heading for a replacement. I have a pretty high tolerance for pain, and am trying to put it off as long as possible. I’ve been getting excellent chiropractic care, which has kept the pain levels pretty tolerable, but a few months ago, I had to miss an appointment due to food poisoning, and had to go 2 months between adjustments- and I was in serious pain. Only to be told, that the “new guidelines” said because I wasn’t getting better, they were going to “cut my access to treatment for 3 months to see what happens.”

The Dayton VA only has 3 chiropractors on staff. And one of them, mine, who is the only one certified to do acupuncture, is going to go to the Columbus VA, where they have 9- because he’d prefer to treat his patients, and also because, he’s getting paid less than his co-worker who treats half as many patients. It’s simple disrespect. He doesn’t want to move to Columbus, but, it’s being made clear that he’s not wanted here.

I’ve heard and seen this in other departments as well,. A wonderful urology PA who wasn’t stupid about prescribing an antibiotic for recurring prostatitis left the main hospital to work at a CBOC (branch office)- doing general med. A psychiatrist who did an excellent job of managing a difficult case, left to run a regional mental health practice. The list goes on.

When I went to leadership about an incompetent psychiatrist who allowed the veteran I was Power of Attorney for, dissolve the legal agreements while he was pink slipped (forcibly taken into the hospital- and not of sound mind and body) and change his medication routine without consulting with his caregiver (me)- I knew things had gone wrong. The shrink was playing lawyer, demanding that I had to be his guardian for her to discuss his treatment despite an 8 year track record of managing his care. The administration couldn’t be bothered.

That was last November, and all I’ll say is my life is way less tumultuous without caring for him- and from everything I’ve gathered from all the people who know him- he’s been pretty miserable and has more health problems since the probate court thought a lawyer in Centerville would do a better job of being his “Guardian” than me, who lives 2 doors away- and had been taking care of him for 8 years.

The reality is, veterans have more complicated health issues than the general public, and the VA is the best place to manage them. However, since the Trump administration pushed hard for outsourcing health care options, the cost of veterans care has gone up, and the quality hasn’t.

In 2014, community care for veterans accounted for $7.9 billion, or about 12 percent of VHA’s budget. By 2021, the cost of community care programs had more than doubled to $17.6 billion and accounted for about 20 percent of VHA’s budget, CBO estimates.
Source: The Veterans Community Care Program: Background and Early Effects

The Trump administration also pushed for the VA to abandon it’s own industry leading electronic medical records system for a proprietary system that the taxpayers wouldn’t own. It was a $5B decision- whereas if we’d invested in updating and upgrading the VA system- we’d own it- and could use it for the military branches as well.

Veterans I know who have moved to Florida, Mississippi and other places far away from Dayton have all said that the Dayton VA of old- ala 2015 or so- was a much better operation than what they encountered elsewhere.

The sad part now, is providers, the doctors who believe in the VA and who love taking care of our veterans, aren’t feeling the love in Dayton and are going elsewhere at a ridiculous rate. Morale is low, and the quality of care is suffering. It’s time for an intervention, before too much more damage is done.

The Dayton VA Blues by David Esrati