Breaking Appointments At A Vamc

[carlie]

Someone had posted a question recently that dealt with

not showing up for a VAMC appointment and being told

VA could withhold services if it happened again.

I believe this is the reg that would address this situation.

Hope this helps a vet.

carlie

http://ecfr.gpoaccess.gov/cgi/t/text/text-...1.1.19.0.182.58

§ 17.100 Refusal of treatment by unnecessarily breaking appointments.

A patient under medical treatment who breaks an appointment without a reasonable excuse will be informed that breaking an additional appointment will be deemed to be a refusal to accept VA treatment. If such a patient fails to keep a second appointment, without at least 24 hours notice, such action will be deemed as a refusal to accept VA treatment.

Thereafter, no further treatment will be furnished until the veteran has agreed to cooperate by keeping appointments. Treatment will not be discontinued until the treating physician has reviewed the treatment files, concurred in the action and signed a statement to this effect in the record. Consideration will be given to the veteran's ability to make a rational decision concerning the need for medical care and/or examination.

The veteran will be advised of the final decision. Nothing in this section will be construed to prevent treatment for an emergent condition that may arise during or subsequent to this action. Where an appointment is broken without notice and satisfactory reasons are advanced for breaking the appointment and circumstances were such that notice could not be given, the patient will not be deemed to have refused treatment.

[allan]

I've seen several canceled appointments in my records for testing that I never canceled.

I've been called several times just minutes before making the 300+ mile trip to the VAMC & told the appointment was canceled, but never given a reason as to why.

I sometimes wasn't told it was canceled until I showed up for it. Than it was, we never made you an appointment, until I show them the printed page they sent me.

I've sometimes had to call & cancel due to the roads being to dangerous to travel on. But always tried to give some kind of notice.

[Jayg]

Oh if it were ever so plain cut. I was a no show for an appointment that I did not know that I had. I was threatened with being kicked to the curb and basically having to start over and no more prescriptions.

Some of the clinics now send out a yellow sheet warning the Veteran not to miss an appointment.

Now the question for the day. How do you expect anyone to remember an appointment when it may be months on down the road.

I have the VA Call me and not say a thing. I usually take it that I soon have an appointment and I double check calendars and scribbled notes and computer records.

What about the Docs who are no shows that happens to me also?

I keep a calendar on the wall by our computer area here and mark the appointment on it with a Sharpie. Kinda hard to miss.

But, and I guess this is a local VAMC thing, I get a letter from the VAMC about a week to 10 days before the appointment and then an automated call a few days before it. So there's really no excuse to miss one due to sheer forgetfulness.

Concerning canceling, one problem I have run into concerns some of the clinics. The worst was the foot clinic. I missed an appointment there due to a change in schedule of family coming from out of state. For some days before the appointment I tried to call but all I ever got was an answering machine. Then I was only able to leave a message once and that was never acknowledged or my call returned. Every other time I called the system was full and I couldn't even leave a message. I haven't had an appointment from there since and I'm having to have my doctor start me up again.

[john999]

I know that special clinics like podiatry are incredibly hard to get at my VAMC. If you miss an appointment it will take months if not years to get another one. I have had doctor no shows and that really gets my goat. A day wasted going out to the VA and finding out the doctor is a no show. The VA is already rationing care, so when you miss an appointment they will kick you to the curb. The dental clinic is a joke. You can't schedule dental visits in advance. I get one dental exam every two years. I end up using a private dentist sometimes. Everyone is going to have to cancell or reschedule appointments, but it is unwise to skip them if you want to continue to be in the loop. Once you are in the loop I think you can get care at any clinic, but if you fall out of the loop you cease to exist. That goes for mental health in a big way. My shrink always tells me to stay in the loop. I get only 4-5 appointments a year with my VA shrink. If I miss one then it means an extra two months to get in to see him. No matter how I might abuse the VA system I think it is important to stay in the loop for the long haul. Who knows what will happen to medicare or private insurance? Imagine a world where you actually will depend entirely on the VA for treatment. It could happen. My BC/BS is now demanding all psychiatric visits be pre-authorized. That is there response to government demanding that they treat psychiatric illness on par with physical illness. They intend to stall and chisel the shrinks so they won't accept BC. BC/BS is the largest health insurance company in the USA and supposed to be non-profit. I wonder what the CEO makes in salary.....20 million a year?

[Pete53]

Oh yeah and the main thing I forgot is try and talk to your clinic to cancel. The wait time on telephone can be over 45 minutes.

[LarryJ]

Oh yeah and the main thing I forgot is try and talk to your clinic to cancel. The wait time on telephone can be over 45 minutes.

Yup. You are right about that.

But, I've found out a way around that. Whatcha do is wait until "after hours" and call the "tele-nurse" line. It usually just takes a few minutes to let them know you can't make the appointment. Of course, you have to do it at least the night before.

[john999]

The VA dreamed up "veteran centered scheduling" at my VAMC. You can't just make an appointment when you leave the hospital. You make an appointment to make an appointment. Just more rationing of care under a new name. You have to struggle to make an appointment. The VA knows that many will just say to hell with it. I have medicare. Why do I go to the VA? Just to get pills and document my disability. You have to be motivated just to use the VA system. As the number of vets trying to access the VA increases the hoops to jump through will get higher. I think they are playing "crack the whip" with us. If they can't treat all the vets asking for care they will try to discourage us from using the system.