By Steve Hynd
Big Spring Texas VA Hospital
I've just been passed a notice asking West Texas veterans to meet outside the VA hospital in Big Spring, West Texas, on the Fourth of July to protest drastic cuts in services at the massive, 135-bed facility. The hospital serves over 53,000 veterans "in an area spanning 33 counties in West Texas and New Mexico", according to it's website.
Veteran's groups believe the facility is being "closed from the inside out", with more and more of the medical services offered to veterans disappearing. The Urgent Care Unit has been closed as has an entire wing and five primary care clinics. There is a shortage of staff, due to cutbacks, and veterans can no longer recieve care for many service-connected disabilities because there are no Board Certified specialist physicians available for diseases like leukemia and coronary heart disease at the hospital any longer.
Due to federal regulations preventing protests on federally-owned property, the protest is asking for up to 70,000 veterans to assemble on Fourth of July, and for each veteran to walk up, calmly knock on the door, and exercise their individual lagal right to demand the return of essential services.
There will be a formal press release by organizers on Thursday, but remember you read it here first.
Update: Despite VA budget increases over the last three years totalling $9 billion, union experts say the increases aren't enough to keep pace with increasing need and that cost-cutting procedures are hurting veterans all across America in exactly the way the West Texas protesters are describing.
MaryAnn Hooker, MD, a neurologist with the Wilmington, DE VAMC, spoke for the American Federation of Government Employees (AFGE) at the Senate VA budget hearing, and testified that a number of clinical staff and resource realignments in the budget request could have adverse consequences.
AFGA represents more than 200,000 VA employees, including 120,000 who provide direct medical care.
The proposed budget assumes a yearly savings of $151 million in FY 2012 and 2013 based on conversion of selected physician to non-physician providers; conversion of selected RNs to licensed practical nurses (LPNs); and more appropriate alignment of required clinical skills with patient needs.
�Without knowing the specifics of VA�s proposed changes, I can only speak from experience,� Hooker said. �The substitution of other [personnel] for physicians may in some cases have very negative effects of the health care team�patient and provider alike.�
There is already a trend in VA to substitute less experienced healthcare workers for a patient�s primary care provider for the sake of expediency, she noted. �I am seeing patients who have not seen their primary care provider in over two years. They are already lost to the VA system, either through having to repeatedly call for appointments because there are no �real� openings, or through the lack of adequate support staff to notify them of the need to make appointments.�
Hooker also said that VA has made a practice of replacing physicians with other personnel in order to meet the goal of 30-day access to providers. That practice will only become more egregious as VA moves towards a 14-day access goal, she noted, adding. �A realignment leading to fewer primary care providers will only exacerbate these problems.�
�This constant shuffling of patients and care providers leads to high levels of staff turnover, which is very costly,� the neurologist told the committee. �Nurses forced to work at the top of their scopes, such as in the emergency department or in the intensive care unit, frequently are asked to work outside their scope. This leads to more stress, more staff burnout, more turnovers, and more medical misadventures.�
I'm awaiting comment from the VA.
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