Medical evidence Community Care

[jjrbus]

For the last 30+ years I have used the VA exclusively and on occasion they send me to Community Care.  I love the VA and their care,  community care always turns into a cluster    !  

When the VA asks me for medical records I assume the VA has everything and will supply them to claims.   What about Community Care am I responsible for obtaining those records and supplying them to the VA for disability claims??  I recently had a sleep study done by Community Care, they sent their findings to the VA and gave me a copy to hand deliver to my primary care provider because they are a bit skeptical of the VA's record keeping.   

I was diagnosed with mild sleep apnea and prescribed C PAP.   It took about 7 weeks and several phone calls and messages to get the C PAP.  My primary care providers nurse finally got it straightened out.  It always seems like they have never done anything before. 

So am I responsible for gathering  up Community Care records and submitting to claims? 

[relatively happy camper]

I prefer Community Care (CC).  The VAMC would schedule me for every 6 months (and very often cancel an appt extending it to a year) whereas my CC Dr would see me every 3 months and if needed I could be seen same day, if emergency, or a few days if needed.  I've continued paying my Medicare, just in case I need it.  About 30+yrs ago the VA started having their Dr's see more patients and I believe at that time they tripled their patient load (roughly 500 patients to over 1400 patients).  You have to remember that all VAMC are in some way affiliated with a medical school.  It's always going to be for the cheapest price.  I'm kinda glad I'm nearing my expiration date (one of these days)

[Tbird]

@relatively happy camperI agree. I've had terrible trouble with what the VA diagnosed as IBS. It got severe again in Jan I went to the ER, I was bleeding rectally and they admitted me. Doc came to see me and he suspected that it was not IBS, so he did a colonoscopy and took biopsies. 

Turns out I had microscopic colitis he put me on meds and I haven't had any bad attacks.. i was getting severe attacks a couple times a week and mild attacks everyday. This has been going on for over a decade. 

I don't think the VA would have diagnosed if. I've had plenty of colonoscopy and they just kept saying IBS. The new medicines are working well for me.

I can finally go out and eat. Its amazing.

[Tbird]

Here is a post I wrote in 2012

The 15 minute visit and 1 issue visit at the VA Medical Center

My primary care doc is a PA, I'm not complaining about her. What I am complaining about today is policy. There is policy from what I understand from my PA, that appointments shouldn't go over about 15 minutes and you can only discuss 1 issue at a time. If you have another issue, you have to make another appointment.

I realize there aren't enough docs to take care of all the veterans, not my problem. I realize that they can't spend much time with you because of their caseload, again, not my problem.

What I find most frustrating is the 1 issue visit, where I sit in the waiting room trying to triage myself, so I can ask about what I think is the most important issue.

I am blessed in that I don't have many physical problems. I worry about our brothers and sisters who have a lot going on with their health and I am wondering if this 1 issue visit is happening at more than my VA.

Is there a shortage of doctors in the country? Or is there just a shortage of doctors in the VA? I am not a psychic, but even I could see at the beginning of the Afghanistan war that we were going to have a lot more veterans come into the system. Then the Iraq war and so I knew we would have even more.

So why at the beginning of the war did they not start hiring more doctors and training them up? Why didn't they hire more raters so by the time the war was over they would have the experience and training they needed to handle the caseload, which is so backlogged, it makes the news at least once a week lately.

**The VA motto "To Care For Him Who Shall Have Borne The Battle And For His Widow, And His Orphan" Abraham Lincoln**

Those are powerful words, of course they lose some of the power if you add 1 issue and 15 minutes at a time.

Perhaps this 1 issue 15 minute visit is just my VA, it's damn frustrating for many of our brothers and sisters.

I get that many that work at the VA think it's a thankless job and it is a difficult job, I'm onboard with that. But hey we are veterans we know all about thankless difficult jobs. So there ladies and gents is my two-cents.

[broncovet]

I agree with TBIRD, above.  Veterans are forced to "triage themselves" and only speak to the doctor about THE MOST URGENT ISSUE (because we are mostly only allowed to discuss with our doc the most pressing issue, not ALL our health issues.  Well, for people with no medical training, to be forced to "triage themselves" is a terrible idea.  

How would you like to be in an emergency room, where you had to evaluate people and decide which persons problem could likely kill them, and which person can wait 2 hours, "if you had no medical training".  You could easily make a mistake and not promply care for a heart attack victom, and instead treat someone for a broken arm, because you did not know the symptoms of a heart attack.  Worse, what if the problem was with you?  

How are we supposed to know if that "spot on our back" that itches is cancer, or maybe just a non malignant mole?  How are we supposed to know if that spot on our back is more important than our cold and maybe neededing a covid test without some serious medical training?  

As far as VA "not having enough doctors" this, too, is often a management problem.  My example should suffice:

     I have a good friend who is a Psychiatrist.  He applied for the position at VA, and it took VA at least 3 years to decide whether or not to hire him.  He was a good doc, competent and qualified, and willing to work for VA.  But, he could not do without income for 3 years while VA does all the red tape to make up their mind.  As a rusult, he was not hired by VA...not because he was not qualified, but because he could not wait 3 years for VA to make up their mind.  So, there is a "shortage" of VA doctors at VA "in no small part" due to VA mis management.  A private firm hired him, and he does a good job for them, as he gave up waiting on VA's massive red tape.  I guess someone at VA got confused, thought he was a Veteran and they should delay and deny him until he dies, not a doctor who many Veterans need desperately.  

     Worse, VA saves money by not hiring enough docs.  They blame a doctor shortage, when its often a VA management problem, not a doctor shortage as my example shows.  

     ONE Veteran, some years ago, went to my VA for treatment. (mental health).  So, the VA naturally says, "Ok, what are you doing in November..we have a spot open to see you then?"  He did not need a doc "in November", because he was dead 3 days later, after killing himself in front of the VA when he could not promptly get the mental health treatment he so badly needed.   Probably, in no small part because of mismanagement, when the VA could have hired a doctor, but instead delayed his application at least 3 years.  

I did not make this up, at least one Veteran killed himself basically becuse of VA health care mismanagent.  Im sure it has happened other times, too:

https://www.daytondailynews.com/news/local/staff-treated-soldier-before-killed-himself/axkF8GVcCzDqfyicECdNEL/