My Day at the VA

As President Obama celebrates a breakthrough in his administration's handling of veterans' disability claims, one veteran questions, where is the doctor with the cure to healing the ailing VA?
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Just two days after President Obama told a Disabled American Veterans convention in Florida, that his administration was "making progress" on the backlog of veteran disability claims, I needed to see a doctor. I arrived at the Manhattan Campus of the Veterans Affairs New York Harbor Healthcare System and showed my veteran ID card, rested my bag flat on the security conveyor belt, removed my jewelry and emptied my pockets. Hurry up; get in line and wait.

I had two routine appointments, scheduled for 9:30 and 11 a.m. The receptionist at the check-in desk for the first appointment, on the hospital's eighth floor, displayed the kind of curt warmth typically found at the DMV. She wasn't interested in providing details about the doctor I'd see. "Last four of your Social," she said, barely lifting her eyes to verify that the picture on the ID matched my face. "Take a seat," she commanded. I couldn't help but wonder whether she was a former drill instructor.

As I parked myself in a chair among other veterans waiting to be seen, a familiar feeling of pride swelled inside of me. We're a special group of people: at some point we raised our right hands and swore an allegiance to this country, to defend her against all enemies, foreign and domestic.

My active duty military career in the Air Force included tours in Southeast Asia, and parts of Latin America and the southwest United States. Upon separation from the military, my enlistment secured a lifetime of healthcare services, courtesy of the Department of Veteran Affairs.

A couple of elderly men sat near the windows, under a television showing an empty channel of "snow." The pair caught the attention of another man checking-in for his appointment; the three men were wearing hats indicating the units for whom they had served. These World War II-era vets smiled and nodded in acknowledgement of one another.

"We survived [World War] Two," said one, "let's see if we'll be around long enough to get seen today."

Finally, a worker stuck his head in the waiting room, called out a name, and then quickly stepped back into the hallway to direct the vet to examination room eight. Those of us who hadn't fallen asleep exchanged glances, wishing we'd heard our name, but one elderly man stared straight ahead, unresponsive. Another vet approached him, moved his walker aside, bent down so his face was right in front of the man's and almost yelling, asked his name.

"What?" the seated man replied.

"Name, what is your name," asked the inquiring vet, even louder this time. "I think the guy called your name, room eight."

Shouldn't the worker have known the patient's hard of hearing?

The VA system is so broken; the concept of patient-centered customer service is as foreign as high-definition TV. Just getting my appointments has required me having to navigate a bureaucratic labyrinth of VA protocols that included waiting for weeks to see a physician whose evaluation and approval I needed to get a referral to a specialist. And as a female veteran, the opportunity to see physicians is further limited to the few specific days and hours the Women's Clinic is open each week.

Inside the dermatology waiting area, the man who hadn't heard his name struggled to lift himself out of his chair and grab his walker; no one from the clinic offered assistance. I asked the man if he needed help getting to room eight, but he just smiled and shuffled across the faded floor, the weight of his body resting heavily on his walker. I'm not sure if he heard me or just followed the direction of my hand, pointing toward the "eight" sign.

I work at a startup media company that's still finding its footing; fortunately, my managers were accommodating when it became clear that I needed all day for two doctor's appointments. No way would that have happened at my last company. People with a demanding job would have been in trouble.

At 1:00 p.m., my name was called for my 11:00 a.m. appointment, and within a few minutes a doctor appeared. "Miss Brown, come with me," he said. I couldn't believe it; I was excited by the possibility of being treated so quickly.

I had misunderstood: I was simply being escorted to another waiting room.

So I'm reserving my applause for the new plan to end the VA disability claims backlog by 2015. First, we need to address a pervasive adversarial culture toward the very veterans the VA is designed to serve. Disengaged, uninterested employees should not find refuge or jobs at the VA. Organizations with a proven track record of success providing quality health care should perform an audit of the VA, and provide guidelines for best practices. Get rid of the useless "white noise" that is paper-based claims, convert to electronic format and join the rest of the world on the digital highway.

Replace hurry up and wait with hurry and do something.

Christina Brown is a journalist based in New York City and an Air Force veteran.

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