A doctor working at an outlying community outpatient clinic managed by the Jonathan M. Wainwright Memorial Veterans Affairs Medical Center said he is as confused as his patients over the rules of the VAs new Veterans Choice program.
The program, launched last fall, allows veterans to get care at private providers if their wait for a VA appointment exceeds 30 days or they live more than 40 miles from a VA facility.
The physician, speaking anonymously because he fears job repercussions if he were identified, said he has worked for the Walla Walla VA for years and loves the job and the people.
He said was as happy as anyone about the prospect of care options for his patients.
Initially there was a lot of excitement about this card, he said. Veterans were excited about getting local help. But we were not given much information about what it meant and how it was to be interpreted. We found it was not 40 miles as you drive, but as the crow flies.
That restriction can carry a heavier weight in instances calling for specialized care. When that 40 miles is measured from any VA clinic, be it a community outpatient center or rural clinic, it becomes a critical issue for rural veterans needing non-emergency heart care, for example.
Cardiac procedures are done only at main VA medical centers like those in Seattle or Boise, but a veteran living within the Choice care programs radius are unlikely to be eligible for the Choice card. That means those veterans may not be given the option of getting that procedure done closer to home and will likely have to travel far more than 40 miles, to a tertiary care center, the physician said.
He and other health clinic staff quickly discovered they were not looped in and not supposed to be the ones trying to make those outside appointments for patients, the doctor said.
Theyve done a good job of making sure we know very little about it, he said. Walla Walla told us not to tell the veteran anything about it. They have to be referred to someone in Walla Walla.
Still he tried to help, but some private clinics he contacted knew nothing about the program and one refused to participate in it, he said.
You would think this would be better thought out. Thats one of my main concerns, the doctor said. Peoples expectations get elevated and then come crashing down, and it leads to disgruntlement.
Such complications are one of the driving factors for staff leaving the VAs employment, he added.
The VA, to its credit, is functioning now better than it was 20 years ago. Now there is a lot more access. But when it comes to specialized care, (patients) still dont have access, he said. That was the intention of the Choice card.
Veterans deserve a fully functioning system of care, inside and outside the VA, the doctor said.
They are honorable people, as a group, and I tell you, I love serving them. These are my people.
