During Army Veteran Joy Ilem’s recent visit to the Washington, D.C. VA medical center, her primary care provider referred her to a specialist in the community for her annual mammogram. Ilem has received her medical care from VA for the past 25 years and was a bit skeptical at first.

“When my provider told me that I needed to be seen in the community, I wasn’t sold on the idea,” she admitted. “I would have preferred to wait for an appointment in VA but that just wasn’t possible in this situation.”

To her surprise, she had a very positive experience. She received prompt, courteous service from her VA medical center’s new Referral Coordination Team.

“My primary care provider said someone from the coordination team would reach out to help me schedule an appointment,” she said. “The coordinator called and made it easy. Even when I left a message because I needed to reschedule the original appointment because of changes at work, she called me back the same day and helped me get it rescheduled.”

Referral Coordination Teams

One reason the process was easier is because VA is using Referral Coordination Teams (RCTs). RCTs simplify the process when a Veteran’s health care provider refers them to another provider, whether in VA or in the community.

“We want to empower Veterans to make more informed decisions about when, where and how to receive their health care,” said Mark Upton, M.D., and acting assistant under secretary for health for Community Care. “Like they did with Ms. Ilem, our RCTs are providing Veterans with information about their options before they decide where to receive care, in VA or the community. This is making the referral and appointment process easier than ever.”

The teams at each facility are dedicated to connecting with Veterans quickly to improve scheduling timeliness. Team members are knowledgeable about the specialty care resources available within their facility. They work with Veterans to understand all eligibility and preferences when scheduling appointments with specialists.

Army Veteran Joy Ilem

What can Veterans expect

Teams are now being set up at each VA medical center and the new referral coordination process is essentially seamless for Veterans. Veterans can ask their provider or PACT team for more information. They can expect these three changes when the teams are in place at their location:

  1. More information about available options for appointments, including face-to-face care, virtual care options or even a telephone appointment if that’s appropriate.
  2. An easier experience resulting in faster appointments, and an all-around better experience when providers make referrals to a specialist.
  3. Appointments that reflect each Veteran’s preference for direct care in VA or care in the community.

“Veterans should know that these referral coordination teams really are there to assist you and help you through the process,” Ilem added. “They get you the information you need. They know how to help you understand if you’re eligible for or need to see a provider in the community.”

Preparing for increased demand

The use of RCTs is a critical part of VA’s strategy to prepare for increased demand for care later in 2021, as many Veterans elected to put off routine health care during the pandemic. Millions of routine procedures and appointments were canceled, changed or deferred over the past year to reduce unnecessary risks and potential exposure to COVID-19.

Fortunately, VA was an early adopter and pioneer in telehealth. It quickly ramped up the use of virtual care, primarily video and phone visits, when the pandemic began.

VA’s use of video visits increased by more than 1,700% within fiscal year 2020. Video visits accounted for 160,000 video visits to homes in a single week.

“In-person care is absolutely the right way for a provider to meet with a patient for many health concerns. VA will continue to provide face-to-face care,” said Susan Kirsh, M.D., the executive director of VHA’s Office of Access to Care. “However, video visits are also appropriate. They’re equally as effective as face-to-face visits and often the preferred choice of Veterans for many other health care visits.”

With increased safety measures to minimize exposure to COVID-19, VA completed more than 66 million Veteran visits in fiscal 20, including in-person appointments, telephone and video visits.

As demand for care is expected to rise later this year, VA will continue to leverage all available care options to make sure Veterans get the care they need while enabling clinicians to spend more time providing direct patient care.

Expanded services and access

The expected increased demand will occur alongside VA’s unprecedented efforts to provide COVID-19 vaccines to Veterans and staff. While continuing to meet Veterans’ health care needs each day, VA has also already provided at least one vaccine to more than 2.4 million Veterans and staff.

In all, VA has administered more than 4 million doses to Veterans, employees and federal partners.

VA is also continuing to address the challenge of providing care to millions of Veterans who live in rural America. This has included adding VA medical centers and outpatient clinics in communities where it makes strategic sense.

With the MISSION Act, VA has also increased opportunities for Veterans to receive community care when VA facilities are too far away, have longer wait-times, and don’t have the care services Veterans need, or other circumstances.

Even amid the pandemic and the rollout of vaccines, Veterans have more options for health care today than at any time in history and most continue to choose to receive their care in VA.

VA has hired more than 86,000 employees since the end of March 2020. That includes 18,000 registered nurses and nurse practitioners. As VA puts RCTs in place across the network, we are strongly positioned to meet Veteran’s health care needs now and in the future.

Veterans can continue to count on VA to provide the highest-quality care. Referral Coordination Teams will help make it easier and faster to schedule appointments with specialists.

When Veterans have a choice where and how to receive their care, we want them to choose VA.


Rick Fox is the communications director for the VA Office of Veterans Access to Care.

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51 Comments

  1. Bonnie McMillan April 8, 2021 at 6:24 pm

    I receive outstanding care from New Orleans VA. I have had several Primary Care Dr.‘s over 7 years at their dedicated female veteran clinic. Each one provided excellent care and treated me as a whole person and not a sum of my chronic medical problems. My specialist care from the physical rehabilitation dept has referred me out for neurosurgery and PT. TRIWEST had probs at times but the VA worked to resolve. Just worked w/ Community Care for outsourced PT….referral and approval took 5 days. I’m sorry others have had so many problems.

  2. Ted Rodosovich April 8, 2021 at 5:54 pm

    I have had excellent service from 2 VA Med Ctr since 2005. 78 yr old. They are Loma Linda, CA Pettis and San Diego/La Jolla.
    In fact, with the enactment of the Mission Act I dropped my Medicare Part B. That has saved me a net of about $60 per mo. (out of $130) because I did have to sign up for dental via VADIP for about $60 per mo.
    Reading some of the complaints here is kinda scary now that I dropped the Medicare Part B tho.

  3. Gary Bakka April 8, 2021 at 2:29 pm

    Community care words are the farthest from the truth. They give a call back number and never answer. When they call I asked what is going on and he says I’m only 1 person here. What ever the problems are at the va please get someone who doesn’t have their head up their ass. Get with it s$&t or get off the pot and let some one who knows what the h&$l they are doing.

  4. Veteran Health April 8, 2021 at 2:17 pm

    We’re glad to see this post has generated such a great discussion about referrals to specialists and has provided real examples where we can improve. Due to privacy laws, we can’t discuss specific cases in this forum. Please speak to your provider or patient advocate about specific requests. We do understand your concerns and this is exactly why we’re making these changes. Adding Referral Coordination Teams at each VA medical center will simplify the scheduling process, ensure you understand your options, and improve your overall experience when it comes to appointments with specialists – for direct VA care and when eligible, for care with providers in VA’s community care network.

    • Anna Wildman April 8, 2021 at 7:15 pm

      I am a service connected totally and permanently disabled veteran, all of my health care including dental is 100% covered by the VA. Under Community choice I got routine care and had my choice of providers. Its now been over a year since I received mental health for my C-PTSD/TBI and I’ve been waiting so long on dental that small cavities have developed into cracks and chips and require crowns.

      There is no point to this. All of my non-elective health care is covered. I should just be given a TriWest card like any other insurance and allowed to find my own care. The VA could have saved thousands by giving insurance cards to veterans who have full coverage, instead of making us wait, call, call again, call again, call again, call again etc etc until the problem is so bad we have to go to an emergency room. Multiple emergency and urgent care appointments could have been avoided if the VA would just allow me to make appointments with providers myself. I can understand verifying eligibility, but once its verified, veterans like myself should be able to get care in a timely fashion.

      Seattle Veteran with untreated PTSD.

  5. Amanda L McGary April 7, 2021 at 8:47 pm

    I had my yearly physical back in July 2020, I requested to have a referral placed for my tubal ligation. I didn’t recieve a call from the referral team until late September. That call was a joke. They tried to send me to a place 5 hours away. I informed them of a place 30 minutes from me that would handle it. (The same hospital that the military sends people to all the time in this area) It took until January 2021 for them to get the referral sent to where I mentioned. I had my surgery on March 1st, bumped to a tubal removal to help ease other conditions I suffer from. I received a letter from community care stating that VA hasn’t covered any of the surgery costs because their referral wasn’t within the 30 day window of the procedure. 6 month wait time for an appt and 7.5 months from initial request to actual procedure date…. and still not covering it. The same thing happened with my yearly optometry appt. Lawton VA couldn’t schedule me, so they referred me out in July 2020, wasn’t seen until end of September on that referral, and yet another letter from community care stating that VA hasn’t paid anything because it’s out of network and no referral sent within the time limits. Plus I had to pay out of pocket at the appointment and didn’t even recieve all the services I would have gotten had I been seen at the actual VA. I even had to pay for my “free glasses.” This entire system is all a joke. I know I am not high priority since I’m only 70% rated, but I can’t even get an appt to be seen for my rated disabilities out here. It’s so disheartening. I’m lucky to get my yearly physical, but good luck with anything else around Lawton/Fort Sill area.

  6. Matt Saunders April 7, 2021 at 7:07 pm

    1st off I love the idea of community care being that I live 2hrs from Audie Murphy VAMC. However, the VA’s typical bureaucratic morass has reared its ugly head once again. Ever since it took over referrals from Triwest (not the best management group anyway) everything has come to a complete standstill. My pain specialist put in a referral for a trial spinal cord stimulator (SCS) back in mid-Oct. Whenever I would call the community care office I would get various excuses. “We have it but we’re not to it yet.” “We’re currently x weeks out from approving it.” Then 3 weeks ago I call & they tell me they never received it!!! They made my Dr’s office resubmit it & now I’m at the back of the line. This will be my 2nd SCS, 1st 1 for my lumbar pain & this 1 for my neck. I started all this back in the Fall of 2019!!! Due to my intractable pain I want them both done before having my knee replacement surgery (approved by VA ortho back on 31Oct19) but I don’t know how much longer I can hold out. Basically anything the VA has too much control over goes to hell. Run the program similar to Medicare where we have approved Drs & facilities in the civilian sector that we can go to & present a card. Don’t have to reinvent the damn wheel.

  7. Jim April 7, 2021 at 6:12 pm

    I have been in the VA health system for over 10 yrs. Between the Minneapolis and St Cloud MN VA health care systems I have had no issues what so ever. I rate both of those facilities the best.

    • Steve Peterson May 5, 2021 at 5:39 pm

      I too use the Minneapolis VA and have always had the best care whenever I needed it. For a rare eye cancer I was sent by community care to the U of M for cutting edge treatment. Once a year I have to contact Community Care to renew my authorization for continuing cancer care at the U of M. Outstanding service!!
      When getting a routine eye exam with my regular VA Optomotrist, Community Care again promptly( 4 days) called to ask where and when I wanted to go. That provider called the next day to schedule an appointment!
      We must be lucky up here and I Cannot say enough good about the Mpls MN VA Hospital.

  8. Brian Charles April 7, 2021 at 3:05 pm

    My ass! Just spent 3.5 months getting a referral…

    • Shun E April 7, 2021 at 9:59 pm

      This is most definitely a lie and very disingenuous. The process is broken. I relocated from coast to coast. Prior to moving all of my monthly appointments were virtual. I had a great community care provider. Since the move, VA has stopped the care and refuses to allow me to continue the relationship I’ve already established. Instead, they have gone silent and yet to provide any information to help me restart much need mental health therapy. BTW, I work for VA and know for certain this is not right! The article does not represent the reality.

    • Jason Northedge April 25, 2021 at 12:23 pm

      Amen brother. This process is getting worse not better. I even called their community care because the 2 surgeons I was sent to disagreed on what to do. The community care person told me to pray on it. WTF? And now have been waiting for months to get my spinal injections.

      It’s broken not better!

  9. Shanice Braun April 7, 2021 at 1:06 pm

    You are up in the night. Since Biden took presidency it has become even harder to get care. The VA doesn’t care about your quality of life like they claim. Veterans are nothing more then the amount of funding the VA gets to keep the over run over populated facilities in business. They micromanage your care and force you to get subpar care because the hospitals and clinics have more patients then they can accurately treat. They have a time frame calculator that determines whether you can get care near you or have to drive to the facility itself. Anyone under an hour is being forced to go to a facility that when they get there a 15 minute appointment takes 4 plus hours. Who finds that acceptable? Some clinic’s even disregard other thing’s that make you eligible for care in the community and I have been told and I quote we are not going to refer you out because we like our ortho team or we like our pain management team. So instead of helping us they inconvenience us and make us feel we do not matter and we end up not going unless it is life threatening. Would you like care like this?

  10. Forrest S Iwaszewski April 7, 2021 at 1:23 am

    Hello,

    Veterans should be able to go to outside medical facilities of their choice. Such as, UCLA, USC or any other first rate Hospitals. There are people on welfare going to top rated Hospitals and veterans should be a priority. We veterans have fought for this country and we deserve the ” VERY BEST”

    God Bless America no one else will!!!

  11. Harry J. Teti April 7, 2021 at 12:12 am

    I am currently waiting 6 weeks for two outside provider referrals and this is not the first time this has happened. It happens repeatedly.

    The VA Is supposed to provide you with the option of a community care service referral if they can’t provide in house VA service within 30 days. If you are having problems with getting a community
    care referral to an outside provider call the VA complaint line in Washington DC. Their numbers are 1-855-948-2311 or 1-202-456-1414 and this avenue is the equivalent of a Congressional Inquiry. I’ve used this avenue on numerous occasions with extremely effective and rapid results. I’m guessing a lot of veterans do not know this number exists. The VA does not advertise the availability of this avenue. I highly encourage any veteran who is experiencing issues with the VA to use either number (same location) to get results….it works!!!

  12. Donald Eugene Bettner April 6, 2021 at 11:13 pm

    I have all but given up on the VA. First, they refused my Kidney Transplant based on age and an aneurism ( considered medium). The University of Washington took me in, and using Medicare and tri-care for life, I now have a good Kidney. I also had a Sciatica operation done by UW Hospital using the same Medicare and Tricare. All of this because the VA will find an excuse to not help the veteran, and the outside sources will find an excuse to get it done. I know other 100% disabled vets that will not go to the VA as the supposed improvements and faster service is for newspaper stories and do not apply to Veterans. We all use our Medicare Tricare to get the help we need.

  13. Frank Gibbs April 6, 2021 at 9:44 pm

    Understand why the VA does not want the responses published. It will be too damning to them.
    I will not ever recommend VA health care to any veteran if they have any other choice.
    The VA treats veterans with a “herd” mentality. In other words, medication and procedures that are good for one veteran are good for all with the same condition. BUT, medications and procedures that are not good for one patient are taken away from all other veterans. The VA has suspended medications on me twice with no contact from my provider or any other VA employee. Ordered meds by calling the VA pharmacy, as I always do. Meds did not come. Called the Pharmacy again. Was told that the VA no longer issues these meds. Was given no alternative treatment or advice. Also, my team in Dublin, Ga. changes their primary provider just about as ofter as I change T-shirts. Never get to build a relationship with any provider.

    I do not and never will trust VA for my health care. I cannot afford to be kicked out of the VA system because I do take a lot of medicine that VA covers. The VA system is just like any other federal bureaucracy. They provide high paying jobs ford those that cannot find employment elsewhere. Problem is, they provide poor quality health care, very poor communication. and could care less about those that have fought for THEIR freedom……..

  14. Walter Harold Nash, Sr April 6, 2021 at 9:39 pm

    I continue struggled with the Phoenix VA for community cardiology care. VA sent me to this doctor over three years ago. I have angina. Whenever I need regular or emergency care,
    there’s, too often, is a problem with having an Authorization for community care in place. I have been turned away at the doctor’s office, had a procedure followup for bandage/stitching removal denied and I’ve been threatened by collection agencies for bill payment of some of these services. I have asked too many folks at the VA for a permanent authorization, since I am rated 100% Disabled because of my Heart. But, the answer is always a “Definite, No Way”!
    I feel like they think I’m going to die, anyway. So, why bother.

  15. JOE JONES April 6, 2021 at 8:24 pm

    HOW SAD IT IS THAT THE VA CAN NOT PREFORM IT MISSION. ALL SICK VETERANS GET IS MOKE SMOKE BLOWN UP THEIR ASS. EVEN MORE SAD IS THE FACT THAT THE FORIEGHN MEDICAL SERVICE PROMISES TO REEMBUERSE FOR OUR OUTSIDE TREATMENTS BUT NEVER DOES. NO WONDER SO MANY TIRED VETERANS JUST GIVE UP AND END THEIR MISERY WITH A SLUG TO THE HEAD! WHAT A SAD SAD STORY.

    • Jason Northedge April 25, 2021 at 12:27 pm

      Amen!

  16. Julie Deel April 6, 2021 at 8:09 pm

    The VA sucks. If you actually get a live person on the phone, you are quickly transfereed to a dead end. Specialty care referrals are a joke, the VA takes so long to approve, a person could die before being authorized for care. Our veterans deserve better than this crap.

  17. Sean April 6, 2021 at 6:50 pm

    Depends on the process you used to request a referral

  18. John Clark Jr April 6, 2021 at 6:49 pm

    I have parallel neuropathy, it’s now spring from my hands and feet to up my legs and chest I have requested a community doctor referral as of 3 weeks ago and I have not heard anything from the VA they keep going to give me Gapatin prescription which only mass the problem and not resolve the issue. There is a treatment center in the community that assures me that they can reverse my type 2 diabetes as it relates to my neuropathy but it was seem to be really want to continue giving me medication rather than resolve my issue. I’ve been to free VA one in Memphis one in Detroit and now we’re here in Texas I have no problem with the VA they have been wonderful by me but when it comes to community referrals when it takes one to two months if not longer to get a video appointment order for years and still have not resolved the issue I think it’s time to allow the community doctors to do their work.

  19. Sean April 6, 2021 at 6:47 pm

    Persistence is always the key when dealing with the VA. In the case of medical care, always know your rating and care tier so you know what your priority is.

    https://www.va.gov/health-care/eligibility/priority-groups/

    Know your rights, ie the mission act etc.

    https://militarybenefits.info/va-mission-act/

    When you get a no, ask why. If they hem and haw, and you refer (know your rights), appeal to a supervisor.

    Always, always be nice, cordial, and cooperative; it will get you further (trust me, I know).

    I have experienced almost every VA region in the country, and there are good ones and bad. NJ, Albuquerque, Houston regional systems; terrible. Northern California and Tennessee regions; as good, if not better than private health providers

    Your mileage may vary.

  20. Megan chambera April 6, 2021 at 6:26 pm

    I agree with everyone of these reply
    Veterans im 100% disable. I am told now no referrals in the private sector so where do I go to get referral for real i have read over and over from higher up ppl workin at the VA but nobody that has this problem are regular vet and we cant get things like this VA blog and ppl like this has no ideal what we have to thru . example i wanted to see pain management so i got appt and he was only offering shots I guess it was steroid shot i want something different primary doc said sorry o sent you there and you Decline and I will not be sending you out to the private sector
    WHAT???? where do we find a PACT person? Thank you

  21. Charles R. Cooper April 6, 2021 at 6:07 pm

    I am a cold war veteran, I served from 1975 to 1990 and got out of the army on a medical discharge and have been dealing with the VA ever since. The VA is a joke. They had tv ads not to long ago saying how us vets love the VA and our care that we receive, it is a bold face lie. In 2018 I had a tkr(total knee replacement) , done by the VA at a VA hospital in Denver, Colorado. After fighting with the VA for 20 years about it. Well the cement that they used to secure the caps (as they call them) had expired so they did not set up. The caps kept turning aroung the bone and was destroying the bone, the told me to live with it. I finally got a referral from Community care to see a specialist outside of the VA about it. After a revision surgery(a new knee with metal rods stuck in the bone, above and below the knee), I am a lot better. I hate the VA care, and I love the Community Care the only problem with it is it has only a year authorization for it. My community care DR is great, he puts referals in for my care with specialist and they get approved. We have a CBOC (Community based outpatient clinc) with a FNP who does only triage. My wifr who is 100% disabled has to go to Denver which depending on weather and driving conditions can take up to 6 hours to get there, instead of being able to use the hospital here in the community. The VA is a joke. They do not care about the veteran at all.

  22. Michele Bailey April 6, 2021 at 6:02 pm

    I too feel there is a lack of care and followup. After 40 years of VA and the lack of a listening ear I choose to keep an additional physician locally.
    Just recently my VA doc stated she requested for me to have a CT scan and scope done locally. When scheduling called they said that was not what was entered. I live 85 miles from the VA hospital. I have excellent healthcare which is charged either way. My treatment other than the CT is paid 100percent by my insurance as well as my mammograms.

    Last time i used VA to schedule a mammogram it took weeks to get appointment only to arrive and find the VA had not followed up. Luckily they accepted my insurance and said the old Choice program charged peoples insurance anyway.
    I can pick up the phone, schedule my own and have appointment scheduled same day.
    Im tired of being led astray. I will continue followups with VA due to being a Camp Lejeune vet. Otherwise Ill find care locally. Some Choice eh?
    Whatever happened to rural areas being assisted?

  23. Mark A Reeves April 6, 2021 at 5:20 pm

    Why does the people hired by Government act as if there are improvements making appointments, referrals better. They are no better than they were 2 years ago. They collect their paychecks and don’t really care about whether the Veterans are taken care of. I haven’t used the VA much because I was still working full-time. Now I’m retired and seem to get the run around when trying to speak to my Physician. I gave 20 years of my life to protect my Country, they could at least help me when it’s needed.

  24. Art Kretzschmar April 6, 2021 at 5:09 pm

    My “primary” told me straight out, there is no possibility of a referral outside of the system in NJ, I did try but the requests never went anywhere… after 3 years of begging for pain relief I went outside the system on my own and found surgical and medication relief in short order. I have stopped using VA care for anything but prescriptions… it is a shame… De Opresso Liber.

  25. Rhonda DiStefano April 6, 2021 at 5:04 pm

    I am disappointed in the VA services. It’s either the appointments are so long to get one or my needs haven’t been met. I don’t know about the referral team. I can’t see my provider on a zoom call. I can’t update my healthy Vet or the portal. And I can’t find a counselor to update my benefits. There needs to be more information available!!Even when I had my Covid19 Vaccine, they didn’t want the paperwork about symptoms I had after both Vaccines and didn’t know anything about an antibody test!!

  26. George bryan April 6, 2021 at 4:57 pm

    As a 100 percent disabled vet I could not even get the dental clinic on the phone when I needed a tooth pulled. I went to a outside insurance company, bought a small plan and had the work done by a good dental office. Yes I had to pay some out of pocket expense, but the pain is gone. VA is scrap in a lot of things they say and do!

  27. Bertram J. Ralph April 6, 2021 at 4:43 pm

    G O D Forbid, That I should have my 3rd Heart Attack, & I do NOT reside near VA. Appreciate knowledge in knowing I’d be accepted at Local Hospital?!! Since I am UNABLE to speak with my VA Dr. Greatly appreciate an answer back. Many TNX.

  28. Craig Paulson April 6, 2021 at 4:37 pm

    I’ve had nothing but excellent service from the Nashville V.A.

  29. sandra gentry April 6, 2021 at 4:36 pm

    Can’t the VA c by all the comments that they’re not doing anything for the veterans I’ve been waiting for a referral and I’ll still be waiting because they don’t care. I’m a 100% service connected and it makes no difference it just seems like they all act like you’re wasting their time the doctors are great that’s not a problem the problem is the VA administration if they would fire all of them and hire veterans to do the job maybe we can get some help

  30. Robert McCarty April 6, 2021 at 4:08 pm

    The VA should be abolished and Veterans should be able to go to whatever provider they want to go to. The VA sent me to a pain clinic that was a 7 hour round trip for me. I’m already in terrible back pain and then I have to drive 7 hours. There are clinics 30 minutes away from me yet I have to go where the VA says. Most clinics and dentists don’t want to take VA patients due to the paperwork and extremely late payments from the VA, this gives Veterans few choices for care. Give us the rights we fought for. Give us the best medical care available, we earned it!

  31. Patrick J Moonan April 6, 2021 at 3:54 pm

    Sussex County Delaware is 70 to 100 miles. They are not telling Vets about Community Care and keep pushing old very sick veterans to Wilmington Med Center.

  32. Donna Jean Crum April 6, 2021 at 3:27 pm

    I have received medical care from the VA since 1996. I have never had the issues I am experiencing now. I understand that Covid has changed things. However, my primary care provider passed away last summer. My new provider is a Nurse Practitioner or a PA. Not sure which. Just prior to my my previous provider’s passing she had referred me to an outside specialist for a biopsy of 9 nodules on my thyroid with an outside provider. Thankfully, they were all benign. The doctor from the VA that called me said that they would continue to monitor my thyroid function with blood tests. However, when I had my telephonic appointment with my new primary care provider, she did not order the test nor did she even mention it in the phone call. From the conversation, I deduced that she had not read or possibly not even looked at my file prior to the phone call. She certainly did not know my medical history or what my medications were for. I had to ask her to renew medications. She did renew some of them but not all of them. I needed to send a message, through “my healthy vet”, to request the others be renewed. In the past, I have received my annual mammograms from a community provider. When I received a notification from that provider that I was due for my annual, I first called and tried to schedule with the provider, paying with medicare/tricare for life. She said she could not schedule it without a referral from my provider. I e-mailed my provider asking for a referral. I was told it was done. However, after 3 weeks, I checked back with the community provider. They had not received a referral. The scheduler from the community provider had tried to contact the VA to get the referral. She told me no one called her back. After my second call to her, she contacted another individual in the VA who told her to go ahead and schedule it and she would get the referral from the doctor and forward it. Finally, it has been scheduled for 4/16/21. Six weeks after it was due. On another occasion, I had sent an e-mail to my new doctor asking to be seen due to swelling in my leg that had persisted after a metal gate came off of the hinges and fell on it. Someone from the clinic called me back and just scolded me for not going to the emergency room when it happened and said they were not taking any appointment. I emailed again asking if I could come in as a walk-in when I was scheduled for my 2nd covid shot. I said I was concerned that there could be a blood clot. I was told to come in. When I got there, it was on a Monday, I was told that the clinic was closed. I explained that I had been told I could come in as a walkin. The nurse, who usually does the screenings, checked the emails, saw that I was told I could come in as a walkin. However, the doctor was working at another clinic and was not available. When she tried to call her, the doctor did not return her calls. The nurse finally contacted y provider’s supervisor, who agreed that it could be a blood clot, and arranged for me to go to the emergency room for testing. Thankfully it was not a clot. But, my primary care provider was unwilling to even return the nurse’s call, let alone see me. Since I have been receiving my care at the VA, I have never had a primary care provider who seems to have so little concern for me as a patient or who sees her job as only treating injuries or problems the patient ask s about, like going to a civilian clinic for treatment of a recurring sinus infection. All of my other VA primary care providers would discuss test results, ask about my general health, discuss life-style issues that I could benefit from. They seemed to actually have read my medical history. But not this new provider. As I get older ( I am now 71) it is even more important for my provider to treat me as a whole person, not just a specific complaint. The same thing happened when I went to my lipid clinic appointment. My provider of many years retired. At each appointment, we discussed changes in my test results, tried to figure out what caused the changes, then she would make dietary recommendations and discuss whether a change in medication was warranted. My new provider, a young man, just gave me my test results. Some of the numbers had gone up. When I tried to get recommendations from him as to whether, a change or increase in my medication was warranted, he just asked me what I wanted to do about it. Again, I don’t believe he had not even looked at my records prior to my appointment. I am not a doctor, I depend on my provider for medical advice. My new providers, just don’t seem to care. They see me as an old woman who they just want to placate. And, as I said previously, the older I get it is more important now for my providers to take a whole person approach to my care then at anytime in the past. Prevention of illnesses in their elderly patients, which only happens if they take a “whole-person” approach, is critical for our future health and well-being. I am more fortunate than a lot of my peers, and am still in relatively good health. That is because, up until now, my providers worked on prevention and provided sound advice regarding lifestyle changes that would help me maintain my health and lifestyle. One provider told me, after I had gained over 50 pounds, my blood pressure had skyrocketed, and my knees were buckling from the excess weight, that she could prescribe medication to treat these problems, but she could guarantee me that if I made some lifestyle changes (basically healthy eating, exercise, etc.) that I would live longer. From that point forward, I have tried to follow that advice and all of my doctors have helped me and encouraged me to do just that with only the minimal medications necessary. It seems that era in my care is gone and I am just another elderly patient they are forced to see. It is very frustrating.

  33. david eugene Duckworth April 6, 2021 at 3:07 pm

    I have had so much trouble getting the V.A. to do anything but drag their feet .
    V.A. talks the talk but don’t walk the walk .
    I trust the V.A. as much as I trust china ———- NOT .

    • Charles R. Cooper April 6, 2021 at 6:09 pm

      The VA is a joke.

    • Amy Strand April 6, 2021 at 7:13 pm

      My spouse’s dentist sent me a letter stating how the VA never paid for preauthorized care and proceedures so now he needs to find a new dentist. The referral system is a nightmare. I want to know their definition of “easier”.

      My spouse’s psychiatrist put him on meds he reacted badly to and would not tell me (I have release of info) what med it was they added that was causing so many things. Even after he got locked in a psych ward the psychiatrist would not help. Then two meds were removed and he was sent home to withdraw at home and almost 3 months later he still hasnt talked to his psychiatrist ….

      yeah the VA is sooo easy to get referrals and help…they do not care if you almost die in their care…

    • Aspie Mom April 6, 2021 at 11:31 pm

      I 100% agree! I have a broken foot bone, where it’s located requires a CT. I called my PCP two weeks ago and got a referral to podiatry last Thursday. Podiatry did new X-rays, I have yet to hear a word about the results or when they will get around to scheduling a CT… meanwhile I still can’t walk on my foot!

      Someday perhaps the VA healthcare will be good again, so far I am not convinced with their change to Optum insurance and the insurance BS of having to have an X-ray, then a CT, then an MRI.

  34. Geraldine Johnson April 6, 2021 at 1:49 pm

    I also have been denied appointments and there are times the medical care is so bad here in New Mexico that I refrain from even asking. This community care thing is for the birds. I can’t even get my teeth cleaned at the VA let along a referral for the local dentist.

    • Sean April 6, 2021 at 6:53 pm

      I am an old Roswell guy. I was in the Albuquerque system for years with zero results and finally went to private Healthcare where my issues were addressed and resolved within 2 years. I try feel your pain, but keep with it!

  35. Richard Terrell April 6, 2021 at 1:41 pm

    I accept the article by Mr. Fox as aspirational. In other words, I think the VA is moving in the right direction to make outside referrals easier and quicker. But experience in the field isn’t up to par yet. I had a referral for a diabetic eye screen recently in Las Vegas that was messed up from the word go. After 3 or 4 weeks, the provider canceled on me and I had to reschedule at the main VA facility for 3+ months later, due the backlog in optometry due to Covid. Not enough RC team members trained at VAMC, and outside provider not sufficiently briefed, I believe. Keep working on improvement, please.

  36. Tom Star April 6, 2021 at 1:39 pm

    In 2005 I had a massive heart attack which resulted in having open heart surgery on an emergency basis at an outside hospital. They did a 3 bypass procedure. I was told I would be taking certain drugs for the rest of my life.

    In the Fall of 2017, the local VAMC performed a surgical procedure called “‘cardiac catheterization’.
    After the heart scan, the surgeon told me since there was no sign of any blockages or any other problems, I did not need to take any more of the meds I had been taking for my heart, namely 81mg. aspirin, atenolol and Lisinopril.
    As ordered, I stopped taking them.

    In July 2019 I had another heart attack, went to a different outside hospital. After doing the Cath test, I was told that two of the bypasses placed in 2005 were totally blocked, and I needed another open heart procedure performed.
    At age 83 years old, I did not want to do that again.

    After telling the Dr. what I was told in 2017, to stop my heart meds, he said that was probably why I had my second attack.

    We agreed to place 5 stents in the heart, up through the groin, instead of open heart.

    Now, The VA wants me to have the local VAMC take over with follow up procedures, instead of my seeing the outside Dr.
    that placed the stents do it, since an inhouse Cardiologist is available.

    Any suggestions, anyone?

    • Sean April 6, 2021 at 6:56 pm

      Make sure all records from outside get transmitted to your VA docs and files; it creates an audit trail and liability trend. I honestly would not change back to VA unless you absolutely have to for the heart as they already proved, to you, they are not capable of managing that aspect

      Just my 2 cents

  37. Robert Wetick April 6, 2021 at 1:11 pm

    I had three VA doctor appointments scheduled only to be cancelled three times on short notice by the VA. I then requested in writting a waiver to be seen by a community doctor. No response from the VA was ever received back. Is this an exception or norm? Does the VA really know?

  38. Richard M. Levine April 6, 2021 at 12:48 pm

    Whenever I ask for a referral it is usually denied. I did manage to obtain one about a year ago for x-rays of my feet. However, since then my GP/other VA employees refuse to refer me. I am a senior citizen veteran who does not like to travel far for an appointment. I feel I am risking my life driving to the VA hospitals from Bergen County NJ. In the last few months I have had two collisions with my car which required body work to the car. I recently have had cataract surgery and am getting used to my new lenses. I have ischemia and have seen several cardiologists at the VA. I feel very uncomfortable driving, and every time I state this to the VA, they still refuse a referral. There is a hospital just two mi. from my home in NJ in NY. That is Good Samaritan Hospital in Suffern NY. I wish I could obtain all of my medical services from them.

  39. Aurora B Flame April 6, 2021 at 11:35 am

    I don’t know about others, but I have to talk to 5 different people before I can get an appointment, and usually I’m told that its not important and I can wait. I went into the hospital in July 202O and when I got out, the VAMC told me I didn’t need to be seen by my cardiologist, even thought that was what the hospital wanted – a full follow up with my primary cardiologist. This is why I have to have a dr in the community because VA constantly dismisses my requests for appointments.

    • Sean April 6, 2021 at 6:58 pm

      Importance is in your eyes, not theirs. Keep up the good fight and learn your rights and escalation paths through supervisors

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