Nurse Practioner Are Seeing Patients Instead Of Doctors

[tmoe]

The previous post was closed.was told to start over,anyway I ask the question about NP as being my primary doctor. Is this going on at all

VA medical center or just in Augusta Ga.Carlie says its been going on but in my seven years as seeing VA doctors this is my first with a

NP.She is doing good so far even givin some pain meds. I think it maybe a good ideal stay on her good side,because they are the one

that does C&P exams mostly. I guess you see the doctor when dying only.I know a lot of MH doctors quit at Charlie-Norwood but looks

like regular doctor also

[VADDS]

In san Antonio... they are sending some veterans to private practices for C/P exams.. I was sent to one two years ago....

Yes, in addition to QTC, a provider can have a personal services contract with VHA. 4 years ago, one of my San Antonio C&P exams was by a QTC doc, off of Fredericksburg Road, if I recall, near the Medical Center. The audiology was done by an ENT in a private office, northeast part of town. Not sure if he was affiliated with QTC, or had a separate contract.

[Chuck75]

I got a horrible staff infection from a private podiatrist's handiwork. I attempted to sue the bastard doctor, but here in Florida these "doctors" are almost bullet proof unless they cut off the wrong leg or kill someone while removing a ingrown toenail. Since I have an option I don't let the VA operate on me.

I did have a private orthopedist look at MRI of my neck and say surgery was my only hope. I got a second opinion from a neurosurgeon and he was astonished at what the orthopod was going to do. Doctor's are not Gods or even saints. They are businessmen who we hope are better than the mechanic that fixes our cars. I always get second opinions these days. I have had at least three surgeries that failed under workers compensation while I was trying to cling to my postal job. I trust none of these guys.

"I got a horrible staff infection from a private podiatrist's handiwork" An infection of one kind or another is a fairly common problem with foot surgery of almost any kind.

The original surgery, good or not, creates an opening for infection to occur. The foot's environment is a big part of the problem. In the "old days", one of the preventive measures was to use an iodine solution to soak the foot before and after surgery. If the residuals wore off before there was at least a surface healing, infection was a real concern. Antibiotics have lost effectiveness for many things, and staff infections happen to be one.

[Stretch]

http://www.va.gov/health/rights/patientrights.asp

Rights and Responsibilities of VA Patients and Residents of Community Living Centers

The Veterans Health Administration (VHA) is pleased you have selected us to provide your health care. We will provide you with personalized, patient-driven, compassionate, state-of-the-art care. Our goal is to make your experience as positive and pleasant as we can. As part of our service to you, to other Veterans and to the Nation, we are committed to improving health care quality. We also train future health care professionals, conduct research, and support our country in times of national emergency. In all of these activities, our employees will respect and support your rights as a patient or resident of a community living center (CLC). Your basic rights and responsibilities are outlined in this document. You will receive this information in your preferred language. Please talk with the VA treatment team members who are providing your care or to a patient advocate if you have any questions or would like more information about your rights and responsibilities.

1. Nondiscrimination and Respect

• You will be treated with dignity, compassion, and respect as an individual. Consistent with Federal law, VA policy, and accreditation standards of The Joint Commission, you will not be subject to discrimination for any reason, including for reasons of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, or gender identity or expression.
• You will receive care in a safe environment free from excess noise, and with sufficient light to ensure comfort and safety.
• You have a right to have access to the outdoors.
• We will seek to honor your cultural and personal values, beliefs, and preferences. We ask that you identify any cultural, religious, or spiritual beliefs or practices that influence your care.
• You or someone you choose has the right to keep and spend your money. You have the right to receive an accounting of any funds that VA is holding for you.
• We will respect your personal freedoms in the care and treatment we provide you. This includes trying to accommodate your normal sleep and wake cycles, food likes and dislikes, and other personal preferences.
• In the Community Living Center, you have the right to be free from chemical and physical restraints. In the inpatient acute care setting, and only in rare cases, the use of chemical and physical restraints may be used if all other efforts to keep you or others free from harm have not worked.
• In the Community Living Center, you may keep personal items and are expected to wear your own clothes. As an inpatient, you may wear your own clothes depending on your medical condition.
• You have the right to keep and use personal items as long as they are safe and legal.
• You have the right to social interaction and regular exercise. You will have the opportunity for religious worship and spiritual support. You may decide whether to participate in these activities. You may decide whether or not to perform tasks in or for the Medical Center or in the Community Living Center.
• You have the right to communicate freely and privately. You will have access to public telephones and VA will assist you in sending and receiving mail. You may participate in civic rights, such as voting and free speech.
• When a loved one is involved in support and care of a VA patient or CLC resident, VA considers a patient or CLC resident's family to include anyone related to the patient or CLC resident in any way (for example, biologically or legally) and anyone whom the patient or CLC resident considers to be family. If you are an inpatient, any persons you choose can be with you to support you during your stay. Medical staff may restrict visitors for inpatients if medical or safety concerns require it. You will be told promptly about any visitor restriction and the reason for it.
• In order to provide a safe treatment environment for all patients or CLC residents and staff, you and your visitors are expected to avoid unsafe acts that place others at risk for accidents or injuries. Please immediately report any condition you believe to be unsafe.

2. Information Disclosure and Confidentiality

• Your privacy will be protected.
• You will be given information about the health benefits you can receive. The information will be provided in a way you can understand.
• You will receive information about the costs of your care (for example, co-payments), if any, before you are treated. You are responsible for paying your portion of any costs associated with your care.
• Your health record will be kept confidential. Information about you will not be released without your authorization unless permitted by law (an example of this is State public health reporting). You have the right to have access to or request a copy of your own health records.
• Please respect the privacy of other patients and CLC residents and do not reveal their health information that you may overhear or otherwise become aware of.

3. Participation in Treatment Decisions

• You have a right to express your preferences concerning future medical care in an advance directive, including designating a health care agent to make health care decisions on your behalf when you can no longer do so.
• You, and any person(s) you choose, will be involved in all decisions about your care. You will be given information you can understand about the benefits and risks of treatment in your preferred language. You will be given other options. You can agree to or refuse any treatment. You will be told what is likely to happen to you if you refuse a treatment. Refusing a treatment will not affect your rights to future care but you take responsibility for the impact this decision may have on your health.
• Tell your provider about your current condition, medicines (including over-the-counter and herbals), and medical history. Also, share any other information that affects your health. You should ask questions when you do not understand something about your care. This will help us provide you the best care possible.
• You will be given, in writing, the name and title of the provider in charge of your care. You have the right to be involved in choosing your provider. You also have the right to know the names and titles of those who provide you care. This includes students and other trainees. Providers will properly introduce themselves when they take part in your care.
• You will be educated about your role and responsibilities as a patient or CLC resident. This includes your participation in decision making and care at the end of life.
• If you believe you cannot follow the treatment plan, you have a responsibility to tell your provider or treatment team.
• You will be informed of all outcomes of your care, including any possible injuries associated with your care. You will be informed about how to request compensation and other remedies for any serious injuries.
• You have the right to have your pain assessed and to receive treatment to manage your pain. You and your treatment team will develop a pain management plan together. You are expected to help the treatment team by telling them if you have pain and if the treatment is working.
• As an inpatient or CLC resident, you will be provided any transportation necessary for your treatment plan.
• You have the right to choose whether or not you will participate in any research project. Any research will be clearly identified. Potential risks of the research will be identified and there will be no pressure on you to participate.
• You will be included in resolving any ethical issues about your care. If you have ethical issues or concerns, you may speak with the Medical Center's Ethics Consultation Service for help.

4. Concerns or Complaints

• You are encouraged and expected to seek help from your treatment team or a patient advocate if you have problems or complaints. Any privacy complaints will be addressed by the facility Privacy Officer. You will be given understandable information about the complaint process in your preferred language. You may complain verbally or in writing, without fear of retaliation.
• If you believe that you or your family member has been neglected, abused or exploited by VA staff, please report this promptly to the treatment team or patient advocate. You will receive help immediately.
• If you believe the organization has failed to address or satisfy your concerns about health care quality and safety, you may contact the Joint Commission's Office of Quality Monitoring at 1-800-994-6610. If you believe that the organization has failed to address your concerns about suspected criminal activities, fraud, waste, abuse, or mismanagement, you may contact the VA Office of the Inspector General at 1-800-488-8244 or email vaoighotline@va.gov.

5. Additional Rights and Responsibilities of Community Living Center Residents

Because the CLC serves as your home for short or long-stay services, you have the following additional rights and responsibilities as a CLC resident:

• Staff will knock on your bedroom door prior to entry.
• You have the right to receive care from the same staff member every day to the extent that consistent assignment is possible.
• You may have visitors at any time of the day or night provided visitors are respectful of you, your need for privacy and the privacy of others. You may refuse visitors at any time.
• You have a right to conjugal visits and you have a right to privacy during those visits.
• Your care will be delivered in a setting that resembles home. Therefore, you will be invited to have your meals in a designated dining area and you will have access to those activities that contribute to meaningful use of time.
• In preparation for being discharged to your own home, you and or your care giver may be invited to participate in activities that prepare you to go home such as self administration of medications and treatments.
• You and your care givers have a right to attend treatment planning meetings and participate in household or resident council.

Edited April 10, 2013 by Stretch

[Pete53]

For years I saw the same MD Doc at VAMC in Dallas. I liked her and my family did also. She always took the time I needed and she would go to great lengths to make the consults I needed and explain my medications. She would order VA to give me some of the more expensive meds also. I felt like I had a perfect Doc Patient relationship but as word spread through the Veterans more and more asked for her. I also ended up in the program where the VA Doc and others come to my home. It was the last consult she made for me as it became to hard to make the trip to VA and I had lost the availability of three actually four who would go with me.

My main care person now is a nurse practitioner and a hard core nurse. I am actually much happier. Things change. I also have a backup Doc using Medicare HMO Advantage Plan. I was glad that 32 million now will have coverage.

My personal opinion is all Americans should have Medicare as a minimum and also pay for supplements or advantage plans on their own.

The things that most Veterans have in common with poor people is we go to the VA and they go to County Hospitals often staffed with the same Doctors.

[iceturkee]

the only person I am seeing for my afib is a PA. He is very good but he is prescribing my medication, which I thought was not supposed to happen. I never see a cardiologist. I think this is a trend in medicine, not just the VA..

physician assistants and nurse practioners can prescribe most medicines. they complete 2 additional years of college beyond undergraduate school.

[harleyman]

When a person graduates from Medical School at the top of their class they give them a special name. Does anyone know what they call the person who graduates dead last at the BOTTOM of the class??

answer, "DOCTOR"

Your treatment is only as good as the person providing it. Check out who you let treat you whenever it is possible. We have doctors at our VA, who couldn't make in it private practice, and now they work for VA and they are not good there either. It is sad the government seems to get mostly the bottom of the class, unless they are being paid for research (thats a different story).

Edited July 28, 2013 by harleyman