s DD789

[DD789]

I don't have a real question per se, but more of an observation.  I noticed that the VA accepts medical decisions from Nurse Practitioners on C&P exams, but I wonder if they give the same weight to Nurse Practitioners who may write nexus letters?

[brokensoldier244th]

Good point. Yeah, thats a good process to do, though take the "rate my doctor" sites sometimes with a grain of salt. 

Its like "rate my professor". 65% junk and pissed off students that weren't coddled. 

[broncovet]

Its not "that" unusual for a VA examiner to not be qualified or competent to do the exam, unfortunately.  Many times we Vets simply dont know what the "doctor" (the guy in a white coat at VA with a stethoscope) qualifications are.  We have not seen his CV.  

We dont even know if he is a doctor, NP, nurse or something else much of the time.  Sometimes we dont even know the examiner name.  

As Berta pointed out, contractors for VA are generally not held liable in 1151/malpractice claims.  Vets sometimes go to VA, get treated by a guy in a white coat "we assume" to be a VA doc, and dont find out he was a contractor, not an employee, AFTER we filed a suit against VA (for malpractice) and find out (after the statue of limitiations expired) that this doc was not a VA employee after all.  

In a similar manner, Vets going to a C and P exam often dont get the examiner name or credentials.  Then, if those credentials are not up to snuff, its sometimes too late to challenge the competency of an examiner. 

https://cck-law.com/blog/how-to-challenge-va-cp-exam/

Because of the presumption of regularity, the VA gets away with exams by non competent examiners all too frequently.  

It happened to ME.  I was sent to an exam for sleep apnea.  The examiner was not competent.  Yes, she had an MD, but no experience or training in treatment or diagnosis of sleep apnea.  (A degree alone does not make one competent, they must demonstrate expertise in that field to be an expert witness).  

In other words a guy who has a PHd (doctor degree) in basket ball, is probably not competent to opine whether I have Osteo arthritis, RA, or something else, as he knows nothing about arthritis or joints..no training or expertise.  

My MD examiner had "0" experience or training in sleep medicine.  VA sent me there anyway because she was the best they had, they did not have a sleep medicine doc available to do c and p exams.  

Edited February 18, 2021 by broncovet

[brokensoldier244th]

You don't ask? I do, every time. I figure they HAVE to tell me at least their name. I make small talk about what they do the rest of the time, so then I know what their area of practice it. 

[broncovet]

Many Vets do not ask the guy in the white coat examining them what are their qualifications.  We just get sent in there, see the white coat and stethoscope and assume they are doctors.  They could be a nurses aid.  They dont even always wear name tags with their medical degree on them.  Sometimes a name only, sometimes a badge (that is hard to read), we often just dont know.  

Its okay to ask, BUT, most of the time we get maybe 2 minutes with the "doctor".  So he does not have time to explain where he went to college, where he went to med school, and what type of medicine he practices.  Or if he is a nurses aid in training.

[brokensoldier244th]

You don't need to get that in depth, but come on, I find it difficult to assume that someone just goes to a white coat and assumes everything without even asking. Thats not a VA problem. 

[broncovet]

I have a family member who is a military doc.  Altho she is a supervisor now (medical), they schedule them for, sometimes, 90 appointments a day.  

Generally, a nurse handles "triage".  Depending on what the nurse decides, you may/may not get to see the doc when you come in.  You could see a physician, nurse, NP, medical assistant, nursing assistant, or one or more of the specialty areas such as xray techs, phlebotomists, lab techs, "program assistants", medical people, non medical etc.  If you go to the VA you mostly see "many" of these not just a single doctor, and, most often I see different ones each time.  If I were to remember each time I saw each "medical person's" name, I would have a photographic memory.  I am lucky if I can remember the date and time of the appointment, and show up in the right room, since my VA rather frequently changes the floor, location, or even building of where I am supposed to go.  My VAMC has

In my years of going to the VA, I rarely have the person identify their medical degree.  They have to herd patients in like cattle, and my visits to the doc typically are "under" 2 minutes and rarely over 5 minutes.  There is not time..these people are busy and just dont tell me what their degree is, and only a small part wear a name tag identifying their name and medical degree or lack thereof.  

My VA has 51 buildings on 266 acres, and each building has multiple rooms.  Vets can be sent to almost any of these.   And there are 266,000 va employees, not counting trainees (such as students) and contrators, too.  

Im glad you have no problem knowing the identity of every person you came into contact with Va, but I think I know maybe 4 or 5 by sight (and by medical degree) , even tho I have seen literally hundreds over the years.   They just dont have time to explain their degree.  Exception:  MY prime care doc will take a little more time to tell me who he is, and he says, "Im Dr. Garber".  That is it.  He could have a Phd in ping pong for all I know.  Oh, yea..Im supposed to trust that Im being seen by a qualified doc, that each and every VA employee is fully accredited and qualified, and that it dont rain in Indanapolis in the summer time.  

On the attorney websites, especially Chris Attig, he calls many of the c and p exams "junk science", and he often challenges the competency of the examiner and wins.  When the VA is signing the docs check, the doc owes his loyalty to them.  As Berta has pointed out, many times the "doc" you think is a VA doc is not a doc at all, they are often PA's, nurses, or trainees.  (no degree at all..in training), or contractors, not even va employees.  

Often I dont get to see a doc AT ALL, especially if the nurse (triage) thinks my case is too uniportant to trouble a busy, overworked doctor.

 

Edited February 18, 2021 by broncovet