Va Exam/dr Id

[deanbrt]

I had a recent neurology exam at my VAMC. I was not happy with the diagnosis and they are going to do a second exam. But my concern is this. the Dr. that examined me (a male) gave no indication he was anything other than a VA doctor. When I got the notes from the exam it was signed by a female neurologist, who is VA staff, and never saw ,me that day, like she had performed the exam. It turns out the person that saw me is a resident at the local university hospital.

I have had a resident do an initial exam before but the VA doctor always did the finish in person and the resident represented himself as such. I have complained to the case worker at the VAMC and the Patient Advocate there. Am I off base in thinking it is a serious breach of ethics, if not law?

[Chuck75]

You woud be surprised how many Docs at VA are Interns

Around here, there are few interns. Many of the exams, be they the usual or a C&P exam, are actually given by an NP or PA, then "signed off" by a doctor that hasn't seen the veteran. Another problem at the remote outpatient clinics is turnover of the more qualified staff.

The doctors seem to come and go more rapidly than I've ever seen before. Something about so much time to do an exam, and not enough time allowed to do a decent exam and write it up properly.

[deanbrt]

"At Sepulveda when I have an appointment I'm usually seen first by a medical student doing their clinicals, they check me out first then they go talk with the doctor who comes and does his own check."

That is always how it had gone for mu until this last check. I think the thing that got me is I am losing feeling in my extremities and was basically told it is old age.I have no feeling from the left side of my neck down to my left shoulder and no feeling in my feet, which I did not realize until the exam.

[Hoppy]

Some of these doctors talk just to make conversation. What is important is what they put in the reports. When I had an EMG they told me it was normal. When I got the report of findings, The report stated that it was an abmormal result showing nerve function slowing due to a herniated C-4. They ruled out shoulder, elbow and carpul tunnel as the cause of the numbness and loss of flexibility in my hand and fingers. Old age is not a diagnosis and normal aging does not result in your symptoms. There is a specific disease etiology that will be diagnosed. It took the VAMC three years of listening to my complaints of head, neck, shoulder, arm, hand and finger pain and numbness to schedule the mri's and emg's.

[chr49]

Some of these doctors talk just to make conversation. What is important is what they put in the reports. When I had an EMG they told me it was normal. When I got the report of findings, The report stated that it was an abmormal result showing nerve function slowing due to a herniated C-4. They ruled out shoulder, elbow and carpul tunnel as the cause of the numbness and loss of flexibility in my hand and fingers. Old age is not a diagnosis and normal aging does not result in your symptoms. There is a specific disease etiology that will be diagnosed. It took the VAMC three years of listening to my complaints of head, neck, shoulder, arm, hand and finger pain and numbness to schedule the mri's and emg's.

I've gone thru the same Hoppy. Most recently I got a phone call from the Vascular Clinic stating they had "reviewed my chart" and everything looked "fine" so they would like to cancel my annual appointment and schedule me for testing in 1 yr. as a follow up. You always get the "How are you doing?" but never get, "Have you noticed any changes" or "Have you been having any problems?" On my last visit I was told by an intern that the fact that I had lower leg pain at rest was not PAD!

It all makes me wonder.

Edited March 2, 2012 by chr49

[deanbrt]

Because of my emergency room experience in August I had an MRI in September and was already diagnosed with disc degeneration and bone spurs around C5-6.. Seeing that I had lost feeling in my feet really bothered me. He brought up peripheral neuropathy at the exam but never put it down. He asked if I had been in an accident and I said yes, I had been run over by a 105 Howitzer in the service. He never put that down. I have dizzy spells that they have written off to vertigo but I am concerned there is a common health tie. I asked for a second opinion and an appointment is scheduled for March 12.

[john999]

I think the overall quality of VA health care is quite poor, but since many vets who use the VA have no other insurance what do they have to compare? The area where the VA really falls down is being proactive about following medical leads with testing and preventive treatment. If you want good care at the VA you really have to work at it. The private health care system is not a system. It is just a bunch of hospitals and small businesses that provide treatment for profit.