If Everyone Cared – More Detestable VA Stories

I-CareAs I went to catalog more of the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) reports, Nickelback’s song, “If Everyone Cared,” was playing.  I cannot think of a better title to proclaim the need for raising awareness and what is needed to fix the VA.  Until everyone is aware and the scab hiding the infection inside the walls of the VA are ripped away to be exposed to the sunlight disinfectant, nothing will change, and taxpayers will continue to pay for the abuse of veterans who deserve so much more.

We begin with an indictment and a reminder.  An indictment does not indicate guilt or innocence, and the parties mentioned are presumed innocent until proven guilty in a court of law by a jury of their peers.

Scott Mitchell Brown, John Henry Swiencki, and David Jeffery Hughes, Jr., were all charged with one count of conspiring to distribute hydrocodone, oxycodone, and amphetamines. Brown was also indicted for stealing prescription medications, possessing stolen mail, and obtaining unauthorized health information from the Kerrville VA Medical Center in Texas.”VA 3

I am a big fan of punishing liars and thieves of all stripes and support justice served in this case.

David Naylor, 59, of Spring Hill, Florida, was sentenced to two years and three months in federal prison, followed by three years of supervised release, for theft of government funds. Naylor made false representations regarding his physical limitations in connection with his application for VA disability compensation.”VA 3

While the following perpetrator has been caught and sentenced, she represents but the tip of the iceberg.

Rita Copeland, 59, of Portsmouth, Virginia, was sentenced today to nine and half years in prison for wire fraud and aggravated identity theft in connection with schemes to defraud veterans. She operated Veteran Services of the Commonwealth, which claimed to provide veterans with caregiving, contracting, and rental assistance services. In total, from at least 2017 through 2020, Copeland’s schemes impacted at least 29 victims and resulted in a combined loss of approximately $430,000.”VA 3

Again and again, the following questions are asked and never answered; yet, the questions remain pertinent.   Who at the VA had to have known this abuse of veterans was occurring and did nothing to stop the abuse?  There are too many checks and balances, too many hands, and too many inspectors for fraud of any magnitude to exist for very long without raising flags needing investigating.  Where were the VA employees?  Who knew?  What did they not do?  Are they still Federal Employees?

Another veteran died, needlessly at the hands of VA providers, due to ineptitude, failed management, poor training, and a series of unfortunate events that cascaded.  I weep for the family of this veteran and mourn for their loss.  I am sorry you have had to experience this tragedy and wish there was something more I could do than simply spread the story of this deleterious behavior and hope for sunshine disinfectant.  The patient died from “presumed anoxic brain injury (his brain failed to receive enough oxygen).”

The VA-OIG found that physicians’ failure to provide adequate benzodiazepine dosing to address the patient’s delirium tremens, review the patient’s abnormal electrocardiogram before haloperidol administration, and transfer the patient earlier likely contributed to the patient’s deterioration and ultimate death.  The VA-OIG substantiated that a non-VA paramedic documented that the oxygen flow was not active.  Facility leaders and staff reported a lack of knowledge about the failed oxygen delivery. The nursing staff did not complete all required alcohol withdrawal assessments.  A physician improperly ordered restraints, nurses failed to obtain full vital signs while the patient was in restraints, and nurses did not receive restraint training as expected.  The VA-OIG substantiated that facility leaders and staff did not communicate initiation of emergency detention with the patient’s family; however, notification is not required.  Leaders did not conduct an institutional disclosure with the patient’s family timely or in person and did not provide a relevant update.”VA 3

Did you catch that last sentence; while the patient was dying, the facility leaders and providers, including the nursing staff, were more concerned with CYA (covering their own acts) than notifying the family they had screwed up, and their family member had died.  If the nursing and staff did not have the training, why and how could they use restraints on a patient? This is blatantly illegal!VA Seal

Let’s cover one more egregious item from this summary of unfortunate events; I visited a doctor who is transitioning out of medicine who made the following comment, “Medicine has changed, practicing medicine has changed, and the practice of medicine is no longer about treating people, but checking boxes, the patient be damned!”  The patient was a “walking chemistry experiment, and no single nurse or provider took a minute to stop providing care, assess the patient, and stop administering drugs!  Instead, they just kept pumping more drugs in until the patient died and then covered their tracks with designed incompetence to protect their failed inadequacies.  This is not “practicing medicine,” you would not treat an animal in this manner; at least not and keep your license!

A death row convict is not allowed to die from anoxic brain death, as it is considered incredibly painful and a cruel and unusual method of death, which is why the gas chamber has been banned as a legal means of causing death for death row inmates.  Yet, under a medical team’s care, a patient in a VA hospital is allowed to die in this horrific manner, and nobody is held accountable.  Is it any wonder why this article is suitably titled “If Everyone Cared?”LinkedIn VA Image

Not many outside of the veterans affected and their families know that the VA has been pushing opioids for decades down the throats of veterans.  At the height of the opioid crisis, the VA shut off all opioid drugs and told the veterans to seek help for addictions to pain medications.  The VHA did not evaluate the individual patients for need, did not seek alternatives, did not try to reduce dependency over time, simply cut off all opioids, and told the veterans to deal with the problems.  Unfortunately, opioids were not the only drug series that the VHA cut off suddenly on veterans without notice, cause, or individual patient consideration, and deficiencies in coordination for the care of patients and drug mandates from VHA has lead to suicides, murders, and other violent problems as addictions cause social problems.VA 3

When discussing failures to coordinate care for patients, abuse of patients, and the need for patients to be housed in the proper treatment centers for their needs to receive the right care, the following should boil your blood and comes from Fayetteville VAMC in North Carolina.

The VA-OIG identified that the psychiatrist used the involuntary commitment process in a manner that was inconsistent with the state’s established parameters and failed to adequately assess and document the patient’s capacity to make informed decisions and determine whether the patient had a healthcare agent. In addition, the patient’s primary care providers and psychiatrist missed an opportunity to coordinate specialty care needs for the patient.”VA 3

Essentially, a bureaucrat incarcerated a veteran against their wishes, without a trial, an appeal process, and proper medical care.  Now, imagine you are the family of this veteran or a friend, and you see this occur and feel powerless to help, impotent to intercede.  Every avenue you approach is blocked because of the authorities, the bureaucrat in charge who wields their power illegally.  How do you feel?  What do you do?  Where do you turn?  Is it any wonder why this article is suitably titled “If Everyone Cared?”

I-CareAmerica, we need to care about what is happening in our representative government, in our name, with our tax dollars, and to our neighbors, family, and friends.  There are no excuses for the abuses witnessed!  There are no excuses for medical providers to get away with this outrageous behavior in private hospitals or government-paid-for-care.  Let us all heed Nickelback’s song and the intent; let us be the “everyone” who cares!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

The Role of Customer Service – Find Solutions!

Bird of Prey24 September 2021 UPDATE:  For the record, the doctor’s appointment forming the central element of this article was with Advanced Neurology Epilepsy & Sleep Center (ANESC), Dr. Aamr A. Herekar M.D.  The staff are now trying to report that I was threatening, demanding, insulting, and reportedly told the commando secretary to “sit on my lap.”  All of which I strongly and hotly contest.  I was at all times professional, but firm.  I did not swear.  I did not insult the staff.  I did not breach professional conduct.  I have never asked any male or female to EVER sit on my lap.  When told to get a face shield, I went to my vehicle, retrieved the face shield, and wore the face shield for the appointment.  For the commando secretary and other staff to accuse me of this behavior is disingenuous at best and I am glad to be rid of this provider.  If you are in the El Paso, TX., are, beware if you are referred to this clinic!

I do not care if there is a pandemic or not!  I care even less if there is sunshine or rain, wind, snow, sleet, or hurricanes.  Guess what; neither do those people expecting customer service.  They want solutions, and when they do not obtain solutions, that customer will be looking at your competition and wondering if their needs can be met elsewhere.Angry Grizzly Bear

Let me set the scene.  I have a follow-up doctor’s appointment this morning.  I traveled more than an hour for an early morning appointment, which included surviving multiple school zones, crazy rush hour parents trying to get kids into school and themselves onto work, and the inevitable school buses working tirelessly to deliver children to school safely.  All of this I can accept; I agreed to the early morning doctor’s appointment as I need to do things this afternoon.  Upon arrival at the doctor’s office, I am greeted by a commando secretary, who knows I have a breathing problem and cannot wear a mask.  Who invents a reason to deny me care.  She calls a supervisor, then “politely” invites me to a back room to try and tell me off.  She then walks out when I suggested she had two options, move my care to another neurologist or have me wear a face shield, and I was leaning towards option 1.

Since January, this scene has repeated itself more than 10-times in two different states, and frankly, I am sick to death of customer service people who refuse to look first for solutions!  Your first duty in customer relations is to find solutions, not complain someone is not wearing a mask, not embarrass, isolate, and denigrate.  Your entire mission is to find solutions that will work with government mandates, business policies, and customer needs.

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1For example, I was a new patient at a medical clinic.  I explained my mask predicament, and the business already had a procedure to protect those wearing masks and accommodate those who could not wear a mask.  Better still, it did not require a supervisor, it did not require special approval, I did not have to be embarrassed by office staff judgments, nor did I have to fight for my right to breathe.  Two different medical offices, two wildly different approaches to the same customer problem, and two phenomenally different solutions and different mental strategies from staff to provide customer service.

Was discussing cellphone service providers; provider one has deplorable customer service, provider two is not much better, and there is no third option.  I asked about solutions for small businesses to compare between the two providers and was aghast at the lack of interest in providing help to owner/operator small businesses.  I do upwards of $3600 in cellphone business a year; yet, even though I have five lines personally and pay for an additional one for my spouse, and am a small business owner, the cellphone provider is not interested in looking for solutions for small businesses.  Is it any wonder that customers are looking for options to ditch their phones?

Call Center BeansInternet providers are another huge pain point for me and my business on the topic of service providers and detestable customer service.  After moving, I am paying double for my Internet service connection, not paying double for the same speeds.  Paying double and not getting similar speeds.  Worse, the customer inattention has gone downhill since I was last a customer of this company 18-months prior.  I have been told that deregulation is why Internet providers cannot compete fairly in markets and scoff.  I have been informed, several times, that the reason the costs are so high for Internet connection is from outdated equipment.  I have scoffed again.  When Google tried to muscle into Phoenix, the current Internet providers threw an unholy fit, and Google was rejected the permits through legal, regulatory means.  Apparently, competition continues to be anathema to cellular phones and Internet service providers, all while these same providers abuse customers and refuse to perform basic customer service, such as finding solutions!

What is the solution; I offer the following as potential places to begin launching a customer service revolution.

    1. Commit to finding solutions first. Quicken Loans is one company I know that asserts that they want to say YES before saying no.  Commit to the same; demand your people learn how to say YES!
    2. This might sound old-fashioned, but believe it or not, it works. Smile and say please and thank you!  When you are thanked, say you’re welcome.  Manners matter in setting the tone in customer relations.  A smile goes a long way to setting the proper tone.
    3. Another potentially old-fashioned idea, but worth considering if your front office staff looks rough. Customers will automatically not want to do business with you if their first impression is tattoos, body piercings, crazy hair, long nails, and scowling faces.  The doctor’s office, the lead office support person, is covered in tattoos, has a body piercing that draws attention to body areas that make professional interactions difficult to conduct. Her hair matches her demeanor, rough and disruptive.

Knowledge Check!Please note, I am not against tattoos and body piercings.  In professional settings, restraint is needed to show respect to the business environment and not distract properly.  The nursing staff all have tattoos, and they are not as disruptive as the lead office support person.  Others have body piercings on their faces, ears, heads, and body parts.  But, these are not distracting, and drawing attention to body parts best left unnoticed in professional settings.  There is a distinct difference between acceptable and unacceptable, and business owners will need to draw a line or be prepared to have problems with customers.

    1. Post in a prominent position what the customer commitment is and who to contact if customer attention fails. Want to raise awareness of customer solutions, post your commitment, and then live that commitment.
    2. Technology is wonderful; there need to be reliable replacement channels when you eliminate a communication channel. For example, the doctor I visited they do not have incoming phone calls.  You can text the doctor’s office, you can fax the doctor’s office, you can send messages through a group insurance website, and you can email the doctor’s office.  When you insist the doctor’s office do something to fit another bureaucracy, e.g., the VA, the office support staff through a fit and stop responding to text messages and emails.   So, not only is their attitudes inappropriate, the customer service communication channels are throttled intentionally to avoid angry callers.  Forcing patients to have to deal in person when technology is made to fail.

WhyCommit to customer relations, find solutions.  Commit to saying YES!  You will be surprised how fast people become customers and want to remain customers when employees representing your business are committed to finding solutions first and excuses NEVER!  End the abuse of customers; I know which doctor I will be ending my relationship with as soon as humanly possible, and I will leave online customer service reports.  Abuse me as a customer, and I will go out of my way to make sure other customers and potential customers know.

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.