In one story Hagar documents continued frustrations that led one doctor to quit the medical center. "Dr. Jonathan Hibbs understood
what it would mean to walk away last month from an institution like the
U.S. Department of Veterans Affairs," Hagar writes. "Not
being allowed to do his best doctoring for some of the nation’s most
vulnerable patients, however, was a final straw in eight years of
working for the institution, some of that time spent in medical
management at Jonathan M. Wainwright Memorial Veterans Affairs Medical
Center."
"The physician saw the agency trip over its own rules again and again," Hagar writes.
"While he was medical director of the Yakima community-based outpatient
clinic, Hibbs said he came to regard the health care system as
top-down management designed to work against employees and patients."
"Veterans who
first go to the Yakima CBOC with an emergency situation, like bleeding
gut or a heart attack, are sent to hospital emergency rooms as protocol
demands, the doctor explained," Hagar writes. While the VA usually pays for that service, if the same veteran goes directly to either of Yakima’s two
hospitals, without first checking in with CBOC, "the VA often balks at
paying those bills, especially if the chest pain turns out not to be a
heart attack. Even though the more direct route to care is medically
safer, VA payment system encourages veterans to waste steps and time in
getting help, Hibbs said."
Another problem is travel, with planned surgeries often re-routed to VA hospitals farther away, such as Portland, Seattle, Spokane or Boise, Hagar writes. "Hibbs calls the situations horrendous. The veterans he’s cared for generally do not have the resources for such trips: Gas, lodging, meals for themselves and often for someone who has come along to help add up, he pointed out."
Not only that, but travel is risky in an area that can get severe winter weather, Hagar writes. Hibbs "supplied a number of news
reports, including one about a 51-year-old veteran who died when a VA
van driven by a volunteer drifted off the road and crashed while en
route to a VA clinic in White City, Ore., in 2011. In
winter of 2008, five veterans from Yakima were headed to Seattle for
appointments over Snoqualmie Pass when the van transporting them skidded
on an icy road and struck a median. At least one suffered injuries, and
responders had difficulty getting to the scene."
Gibbs isn't the only one with complaints. Another doctor, Don Hill, also quit the medical center citing too many problems, Hagar writes. In a 2012 letter he wrote to a state representative but never sent, he said problems included:
• Results—labs and imaging,
for example—for patients sent to Walla Walla were often delayed in
getting back to the Yakima clinic.
• “Those
had to be scanned in Walla Walla; we were not permitted to do that in
Yakima for some reason,” Hill said. “Then I would not have the report
for when the patient came back in.”
•
Referrals for diagnostic testing and specialty care often reflect more
of a concern for preserving equipment and specialists within the parent
facility—Walla Walla, Spokane, Seattle, etc.—than for the safety and
benefit of the patient.
•
Patients with established non-VA providers are required to be seen in
the Yakima clinic to get approval for prescriptions ordered by that
outside doctor, Hill said. Those prescriptions would then be entered
into the computer system under the VA provider’s name so they could be
dispensed by a VA pharmacy service, usually through the mail from the
Walla Walla VA hospital. (Read more)
Other stories in the series:
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