How the Portland Va Fails Veterans at Every Step
This is my call to action for every service member and veteran who has ever had a terrible experience at the VA. We have been working within the system to fix it for far too long without any meaningful gains. We need to share our stories across social media and harass our local newspapers until they investigate the practices at VA hospitals across the country and bring the attention that will force our politicians to start caring about and solving these issues.
I normally don’t write about these kinds of issues but after almost six years of receiving my medical treatment through the Veteran Affairs Health Care System, I’ve decided to turn to the power of social media to hopefully enact change in what I have found to be a woefully inadequate standard of care.
I served for eight years in the U.S. Marine Corps and, without getting into it, I left the service with a handful of disabilities that I take medications for. For five years I received my care from the Miami VA, and it was a deplorable mess. However, in the months leading up to my relocation to Portland, Ore., I started to see some positive changes particularly because of the hard work of their patient advocates.
Knowing that I was moving to a new VA hospital and expecting to get lost in the system as always, I triple and quadruple checked everything I needed to do to ensure a smooth transmission from the Miami VA to the Portland VA. Instead of a month’s worth of medications, I stocked up on three months. I signed all the release paperwork and had it sent ahead of time. I even scheduled an appointment with a new primary care manager before I completed my move and got my former dermatologist in touch with my new dermatologist to ensure I’d have access to a medication that I absolutely need to ensure a healthy quality of life. Yet despite all my precautions the Portland VA has proven to even worse than its Miami equivalent, and has failed to provide the most basic standards of care without multitudes of lost hours from veterans.
When I first stepped into the Portland VA, I was actually impressed. I had zero problems finding parking (which was a first at a VA facility). The hospital looked great. The check-in kiosks actually worked and in typical Portland fashion, everyone was SUPER nice.
My mind was blown. This was night and day from my experience at the Miami VA.
I met with my primary care manager. She was a resident, as they almost always are because VA hospitals are mostly populated by medical residents and very few full time/ experienced physicians, but I’ll get into that another time. Either way, she was very nice, asked a lot of getting to know me questions, and then after about 20 minutes, which did annoy me a little, she finally started talking about medicine. I made it very clear that my biggest concern was ensuring the medications I’d been taking were properly prescribed and transferred to the Portland Pharmacy so that when I ran out, I could simply order my medications, no fuss. She went over my medications, ensured it would be handled, and I was on my way.
Three months later, I log onto MyHealtheVet to order my medications and they were all still prescribed to the Miami VA pharmacy. I called the Portland VA Pharmacy and they confirmed what I suspected. My new super nice doctor forgot to do the one thing that was the entire purpose of my initial visit with her. To make matters worse, if I just ordered them from Miami, it would take an additional two weeks in addition to the 10 standard processing days for me to get my medication, which was now running low.
All of a sudden I realized that the days of work I put into ensuring this exact scenario did not happen and my initial appointment with my PCM, was an utter waste of my time. So, I did what the Miami Patient Advocates had told me to do for years. I messaged my doctor on MyHealtheVet, I messaged the Portland VA patient advocates and I called Primary Care leaving a detailed message and was told my doctor would call me by the end of the day.
The end of the day rolls around and no word from the hospital. Finally late afternoon the next day my doctor responds to my email. She tells me the medications have been prescribed and mailed to me from the Portland Pharmacy. Two weeks later, my medications still hadn’t arrived in the mail. When I call the pharmacy, two of my medications weren’t even in their system and the other medications were sent to me via UPS and my meds had apparently been sitting at the UPS store because I wasn’t home during the delivery attempt.
So, I went back through the process, messages to the advocates, my PCM and calling Primary Care. This time yet again, the reply comes the next afternoon, all of my meds are finally transferred and are in my possession three weeks after I ran out of all of it.
This was unacceptable to me. So, I messaged patient advocates requesting a new PCM after calling primary care and being told that it wasn’t a big deal, because my incompetent resident was graduating soon… which is wrong and problematic in so many ways that I am awestruck as I write this.
There was no grace period. This was just horrendous from the beginning. So, my new dermatologist walks into the room and starts talking about my treatment. I have chronic guttate psoriasis. Without immune suppression and steroid cremes, let's just say, it’s a condition that can get freakshow bad, but when properly medicated, my skin Is clear and my quality of life is significantly improved.
However, because I have the rarest type of psoriasis and fall into the bottom third of psoriasis folks who suffer chronic symptoms instead of periodic episodes, finding the right treatment plan for me involved three years of testing 16 medications, some of which can cause cancer and other serious health issues, before we found what worked for me. That is why it was so important that my previous dermatologist was in contact with my new one, so he’d be informed and understand the severity of my case and the medical justification for my rather expensive immune suppressant.
My new dermatologist confused me for a different patient with an entirely different diagnosis and scared me to death for a solid 20 minutes before realizing I was a different patient. He then essentially babbled medical jargon to himself for another 5 minutes before I stopped him and said. “can we just go over my medications so they are properly dispensed through the Portland VA pharmacy?” He ceases his babbling goes over my meds and tells me it will be taken care of… you guys know what’s coming next right?
Three months later, I go to order them and they are all still coming out of the Miami VA pharmacy. So I go through my complaint process. Two days go by, I call Dermatology again. I leave a message again. Also, keep in mind, whenever we call the VA, we get bounced around and spend ridiculous amounts of time on hold so each time I go through this cycle it takes anywhere between 2-3 hours of wasted time to fix issues that take 2-3 minutes if done correctly in the first place.
Finally a week later, after receiving no responses to the phone calls I’d made, my dermatologist finally responds to my email.
This is the response I wanted: “I’m so sorry. I went through the notes and your medical record, all your derm meds are in the mail.”
This is the response I received: “Which medications are you taking?”
This began three days of messaging back and forth where my dermatologist kept asking questions when the answers were sitting on his screen. It was as if he could not be bothered to actually read my medical record. I also was out of my steroid cremes at this point.
Finally after I was blunt and essentially accused him of what I just wrote, he stopped the nonsense, looked in my record and mailed out my medications a week later, which was yesterday, so I still don’t have my medications, and when I checked with the pharmacy yesterday one of them was still missing.
So, I went through the process yet again, this time speaking to 3 nurses, 2 patient advocates and at least two other random VA employees before I was told that medication has to be ordered and go through a review process for an unspecified period of time before it would be prescribed to me.
Yet again, all the prep work before I moved was designed to avoid this specific scenario.
Throughout all of this process, I never got a reply to a single email or voice message I left patient advocates.
The Miami VA was also terrible about responding to voicemails, but when you walked into a patient advocates office, they moved mountains for veterans.
If you wanted a new primary care manager, you had a new one in an hour or you could just email them and a new clinic would call you to schedule an appointment in days. If there was a medication issue they were calling everyone on your behalf on the spot and would harass the staff until the problem was fixed. They were my warriors. Their approach to serving Veterans was that the VA is a broken system and it was their job to fix the problem and leave a paper trail to make sure it didn’t happen again.
The Portland VA takes a friendlier approach. They believe that the doctors and the departments need to be given an opportunity to address our concerns on their own before they get involved. This sounds like a nice and reasonable philosophy… if you worked in a system that isn’t catastrophically broken and actually has things like oversight and people who give a damn. The consequences of this philosophy are its almost been a month and I don’t have my medications.
Imagine if I was a diabetic or had some other condition where due to what every myriad of excuses and conditions the VA comes up with and I went without a life-saving medication for a month or longer. That is what really fires me up about this VA’s attitude to patient advocacy and not holding their staff accountable when they drop the ball, it could actually mean someone dying. and in this case, it lead to needless suffering.
In addition, turns out that despite the eight emails and half a dozen people I’d spoken to about getting a new PCM and Dermatologist, in order to start the process at the Portland VA one has to first fill out a physical request at the clinic, which then has a 30 day processing period and no one said a thing to me about it the entire time.
The Final Straw
This morning's events are what really had me saying ENOUGH! Two weeks ago, I go into the ER to get myself checked out. My meds have been out of whack because I don’t have all of them. I’m on edge and I’m feeling like crap. I ask to get some testing done. Only half of the tests get done.
The next week I message my PCM to make sure the labs are ordered. She confirms that they are. I get a call this morning confirming my labs are in the system. I go to the VA, they draw my blood… turns out they forgot one of the labs… again.
So, I walk over to primary care, demand to see a department head. When I am finally greeted by the department head, she simply doesn’t care about any of it. There is never an apology for wasting my time, nor does she care to hear about the rollercoaster nightmare that has been ordering some routine tests for a patient who has been failed every step of the way for months!
Nope, she just puts in the other lab, doesn’t even offer to call and have them expedite me so I don’t have to wait for another half hour on top of the one I already waited the first time they drew blood.
At the end of the day, there are two things that really brought me over the edge. First, its that no one ever apologized. They all reacted as if ‘oh well’ stuff happens completely ignoring the systemic consequences of their actions. The other thing is the hours upon hours of wasted time. I am grateful that I have a job where I make my own hours because if I had a 9-5 job, I would have been fired after the 8 hours of time I had to take off this last week to fix problems that take minutes when done correctly in the first place.