Fed UP! – More Detestable Bureaucratism from the VA.

I-CareI hate being lied to!  More than I hate being lied to, I detest, with every fiber in my being bureaucrats and the inanity they promulgate to excuse their stupidity and throw a wrench into the works.  Today I suffered through yet another call with my VA-appointed primary care provider (PCP).  Not an online conference, but a phone call.  Who was in the office with the provider and why?  How can I guarantee my HIPAA information during a phone call on an unsecured line?  How do I know who I am talking to?  These concerns and more arise when you receive a phone call to discuss important medical information, and my PCP does not care!  My PCP refuses to use the VA’s tools to conduct patient appointments and instead creates workarounds; what an ingenious method for telling lies and spreading falsehoods as bureaucratic inertia; I’m so thrilled!

The PCP continuously claimed all my imaging is “normal” and “unremarkable.”  The pain experienced cannot be related, and the sources are questionable.  In polite speak, the PCP is trying to tell me it’s all in my head; a previous provider from the VA already used this as an excuse for not performing their job.  For more than 10-years, I have been fighting the VAHCS for help in reducing pain and in getting to root causes for the problems experienced.  Yet, today’s call was just more of the same BS wrapped in feel-good words, platitudes, and bureaucratic non-answers.  Honestly, after the third time the doctor related, the imaging was normal and unremarkable; I lost my cherub-like demeanor!  I did not swear until I got off the phone, but I am not anywhere close to a happy patient.

Honest question, does the VAHCS troll medical school for the bottom of the barrel, those people who can barely pass a class, let alone qualify for medical privileges?  I need competence, and I get useless lumps.  I ask questions, and the snowflakes pop out of the woodwork like ticks on a deer or fleas on a dog.  I am thoroughly sick of being treated like a know-nothing inconvenience.  The most important person in the VA marketed PACT Team is the patient who will be active, engaged, and informed.  The second most important member of the VA Marketed PACT team is the Primary Care Provider.VA 3

Since 2002 I have had a problem in my gastro-intestinal system; since 2010, the pain has been debilitating, and four years ago, I was diagnosed with non-alcoholic fatty liver disease.  Today, 22 March 2022, the PCP reviewed the problems area on my electronic health record (EHR), which coincidentally resides at the top of the electronic health record and was mentioned four different times by myself, and noted that non-alcoholic fatty liver disease is not listed.  Tell me, how would that make you feel?  The PCP ordered today’s call before the recent imaging appointment on my abdomen and pelvis, but the provider, who called me almost 30-minutes late, did not even look up my record before calling.  Had not studied the imaging results and formulated a plan of action to move forward, yet as the second most important member of the PACT team, I am supposed to trust this bureaucrat; I think NOT!

Through the miracle of modern technology, I had read and researched the imaging results more than 24 hours before the scheduled appointment to discuss the results.  I came prepared, but the provider could not be bothered to prepare for a call they demanded, then had the sheer effrontery to keep repeating that the imaging is “normal” and “unremarkable.”  Then the provider has the gall to tell me, repeatedly, that I was yelling, when in fact, she only did not like being spoken to with emphasis and insistence that she do her job!  Yes, I called her a bureaucrat and a snowflake, whereupon she threatened to hang up the call, but I disconnected first.  I miss those old rotary phones you leased from AT&T, they had heft, and when slammed, they made you feel better about disconnecting a call.PACT_model

From research, it is abundantly clear that pain from hernias can show up or be felt in areas far removed from the hernia site.  Constipation is both an indicator and a symptom of hernias.  Muscle weakness in the legs, burning sensations, and much more are all indicators of a hernia.  Yet, when I asked about all the other pains and problems experienced in my abdomen, I was told the hernia could not be the root cause, and the imaging is “normal and unremarkable,” but the PCP could not answer why these other symptoms are unrelated when asked.  Where is the research, seeing as “Dr. Google,” is discouraged; Johns Hopkins and the Mayo Clinic, plus I have access to the medical libraries at the University of Phoenix and Grand Canyon University.  With less than five minutes of research, I can locate and read data from reputable sources to form the basis of questions to ask a PCP, which is encouraged of patients by the VA.  Yet, the doctor cannot be trusted to provide any intelligent data, do any preparation, or knowledgeably speak to a symptom list; when will the VA answer why their PCP cannot do their job?PACT 1

If only I were the only person experiencing these problems and issues with the VA.

Former VA cardiologist John Giacomini of Atherton, California, pleaded guilty to one count of felony abusive sexual contact.  In the fall of 2017, Giacomini repeatedly subjected a subordinate electrophysiologist to unwanted and unwelcome sexual contact, including hugging, kissing, and intimate touching while on VA premises.  On 10 November 2017, the victim explicitly told Giacomini she was not interested in a romantic or sexual relationship with him.  Nevertheless, Giacomini continued to subject his subordinate to unwanted sexual advances and touching, culminating on 20 December 2017, when Giacomini turned out the lights in an office, pulled the victim out of her chair, and fondled her until a janitor opened the office door and interrupted the encounter.  The victim later resigned from her position at the VA, citing Giacomini’s behavior as her principal reason for leaving.  Sentencing is scheduled for 12 July 2022.VA 3

Will the VA-OIG troll through this former provider’s employment history seek out the other victims, or will this be swept under the rug not to tarnish the VA?  Having been an employee of the VA, will anyone, EVER, look at how employment law is abused by the leaders in the VA and correct the problems?  This incident should never have occurred, nor should it have taken years of abuse to end this despicable behavior.  Yet, what does the VA do, shut both eyes and pretend it does not occur in consequence of the designed culture at the VA.

Why did the victim have to tell another adult that their behavior was unwanted, and quit their job, before the VA took action?  Will there be an inquiry from congress?  Will any lawyers stand up and demand the VA correct this detestable hole that allows this behavior to promulgate?  I am not holding my breath!

Speaking of electronic medical health records, the VA-OIG has issued three separate reports on this topic, and none of them paint the VA with anything that shows competence.  In the report titled:

Medication Management Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VAMC in Spokane, Washington.”  The following findings were related:

Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficult—all of which can affect patient care and safety.  Areas of concern included:

(1) Data migration
(2) Medication formulary availability
(3) Medication order processing
(4) Provider notification and alerts
(5) Controlled substance tracking
(6) Prescription drug monitoring program documentation
(7) Medication reconciliation
(8) Medication list accuracy.”VA 3

As previously stated, I am not as nice and never politically correct.  VA-OIG, please allow me to correct your assertion, “Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficultall of which DO negatively affect patient care and safety.”  Trust is the first casualty in war and in dealing with the VA in ANY form, manner, or method.  When you cannot trust your data to remain confidential, the entire electronic medical record system can only be rated as UNACCEPTABLE!  The upgrading of the electronic medical records system at the VA is a 10-year, multi-billion-dollar fiasco, and as a taxpayer, I am done paying for this system!

Not to be outdone by the medication side of veteran care experiencing failures, the following VA-OIG report was issued:

Care Coordination Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

The EHR rollout caused problems in coordinating veterans’ care, ranging from the flags for patients at high risk for suicide not transferring to veterans and their care providers having trouble accessing video appointments and patient portal messaging.  Tracking outcomes were sometimes lost, and disappearing laboratory orders also resulted.  Although the OIG did not identify associated patient deaths, future deployment of the new EHR without resolving identified deficiencies could increase risks to patient safety.”VA 3

Again, the VA-OIG is practicing political correctness instead of being specific, and upfront, the entire EHR is a disaster, the cost is prohibitive, and any fool should see it is time to pull the plug, cut the losses, and hold the leadership accountable!  Yet, what do we see; the EHR is progressing into infinity and beyond at a snail’s pace!

The final nail in the VA’s EHR coffin should be that nobody involved can communicate with the IT helpdesk for the EHR as the IT ticketing system is unreliable!  Form the VA-OIG, we find the following:

Ticket Process Concerns and Underlying Factors after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

The failure to process and respond to VHA staff ticketing requests for help or report concerns resulted in reporting, tracking, and resolving problems.  These deficiencies made it difficult for clinicians and administrative staff to serve patients and impeded EHR fixes that can affect future sites.  The inspection team also identified five factors contributing to the deficiencies identified in the two companion reports above: usability, training, interoperability, needed fixes, and problem resolution.”VA 3

Imagine for a moment, you are responsible for a multi-billion-dollar IT project, and one of the first issues discovered by the users is the inability to reach out for IT help; how long would you remain employed?  Would you ever expect to ever work again if any of these problems were your legacy for leading the IT improvement on a multi-billion-dollar project?  As a consultant, I know how fast you would be fired and taken to court for business losses.  Why are these leaders exempt?  Where are the blue-ribbon panels and committees demanding people be held accountable for this fiasco?EHR-VA-OIG

When the VA-OIG casually mentions that PCPs are untrustworthy and not using the current tools correctly, should the providers be issued new tools; NO!  Yet, this is the opposite of what common sense declares.  Are you, dear reader, as a taxpayer, fed UP yet?  My wife reminds me, “These problems happen in civilian hospitals.”  No, in fact, they do not.  If data migrated from one patient’s EHR to another patient’s HER, that hospital would be sued and shut down so fast by congress at the federal and state level, all before the media firestorm would have barely begun.  If a patient were jeopardized because their provider could not track medications, that patient would sue for malpractice and possibly a class-action lawsuit.  If an IT project was occurring in the civilian world, and the users could not contact the IT helpdesk, the project would be overhauled so fast, and people fired, new records would have been set.

Knowledge Check!It is time we end this charade and money pit call the Department of Veterans Affairs, and every other agency of the Federal government bloat!  The government should be leading, not lagging, where operational efficiency and fiscal sanity are concerned.  I repeat, only for emphasis, are you fed UP yet?

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Internet Trolls, Keyboard Terrorists, and Snowflakes – This one is for you!

Angry Wet ChickenI grew up in a tough school.  I have lost my share of fist fights, I have served honorably in two different branches of the US Military (Army and Navy), which include two passes through Basic Training.  I have been unfairly accused of things I did not do and suffered the consequences.  I have been homeless, living on the streets of the Seattle Metro area in October and November.  Let me be clear, I have been around several blocks, been kicked, pummeled, and am still here.  If you want to blather; find someone who cares!

Not for the first time, and certainly not for the last time, a troll has raised their ugly head and provided me advice that presumes the moral high ground.  I laugh at you!  In the politest way I know how to communicate, go pound sand!  Better still, put on your man-jammas, grab a cup of warm stupidity, and crawl under your blankie, you cannot “Skeer” me!  I have thick skin, big shoulders, and the experience to back up what I say.  I carefully reference what I write.  If you want to go “toe-to-toe” with me, bring your lunch, say your farewells to your loved ones, and put your big-boy pants and boots on.

Bird of PreyIf you think for one particle of one nanosecond you can put the “Skeer” into me, you have no idea!  My wife asked me what I would do if LinkedIn kicked me off their site, again.  I laughed.  I would write the same article I wrote the last time demanding an end to censorship and keep right on doing what I know is right.  For there is right and wrong in this world, and a good moral compass has been possessed since I was a young child!

A friend asked me if I get bothered by the negativity that swirls in the world.  The honest answer, nope!  See, I will tell you a truth, when you know right from wrong, possess a good moral compass, and have experienced life; the negativity becomes little chihuahuas nipping at your feet.  Well, I love the taste of dog!  Bring it on!Dont Tread On Me

In the US Army, South Korea (1995-1996), I was on Tank Table 12, the Colonel walked into “Ma’s Tent” and ordered a dish I had never heard of before.  As the Chaplains Assistant, I did not have much to do that day, and got the same dish 20% off because “Ma” needed to finish off the meat she had prepared for the Colonel.  Turned out that delicious meat was dog.  I loved it then, and have no problems eating more now.  Try me!

In the abusive home I endured as a child, I was raised to be the biggest and baddest bastard.  Then I was taught how to be the last bastard standing.  I hate being that person; but I know where he sleeps and can wake him if needed.  You do not rule me; you do not even measure in my world.  You cannot “Skeer” me, and if you need a history lesson on the origin and meaning of the term “Skeer,” come meet me face-to-face.Plato 2

I might be a mobility disabled person with neurologic issues, a bad spine, and other health problems.  But I still know how to put small and insignificant imbeciles into their place, and keep them there, forever!  If you choose to take offense, that is YOUR choice, and may you enjoy all the consequences of YOUR choice; but do not dare presume to tell me what I can and cannot do!  Do you dare stick your little head up; I like the game of Whack-A-Mole as well and play it really well.

America, we need more standing and less groveling!  We desperately need to be able to have the courage to discuss the issues openly and freely to gather the solutions and present a united front to those who deem themselves our masters.  I repeat only for emphasis, “Those currently elected to rule, you do not have my consent to be governed!”  I will support any and all who stand with me to become stronger, more confident, more capable, and more able in declaring we will not allow this the American Republic to fall into that dark abyss of failed experiments on our watch!

Angry Grizzly BearKeyboard terrorists, you do not “Skeer” me!  Internet Trolls, go find a bridge to haunt!  Snowflakes: well, I grew up shoveling you out of the way and still know how to melt you into insignificance!  May I invite you to cease drinking the “Haterade,” end the dietary supplements from Jim Jones, put your big-boy and girl pants on, and either declare yourselves part of the solution, or fade into nothingness as part of the problem.  You will not dissuade me, you will not win against those like me, the adults in the room.  You might make noise, but so do pulling babes when they get hungry.  Except, I wont feed you like mommy does, I will cut off your government teat, I would see your government benefits end, and I would see your world turned on its ear where you can choose to survive through changing yourself or die an unpitied sacrifice in a contemptible struggle!

What do I plan to do with this article; present it to every single internet troll, keyboard terrorist, and snowflake who crosses my path.  It is time we start passing along messages with power to those who desire the fall of this the American Republic, a free constitutional republic, only if we can keep it.  I do not pull punches, I will not be silent, I have never been meek, and I have never been able to get out of the way.  So, I stand, like a rock in a river, forcing the river to go around me.  I might appear insignificant, but put a few more people beside me, and a dam is built, the flow of water changed, and then we can judge who is insignificant or not.

Do Not Go Gently into That Good Night
Dylan Thomas

Do not go gently into that good night,
Old age should burn and rave at close of day;
Rage, Rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightning, they
Do not go gently into that good night.

Good me, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sand the sun in flight
And learn, too late, they grieved it on its way,
Do not go gently into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on the sad height,
curse, bless, me now with your fierce tears, I pray.
Do not go gently into that good night.
Rage, rage against the dying of the light.

Knowledge Check!America is not going to die while I draw a breath.  When freemen stand and should-to-shoulder act, we cannot lose!  Believe this, you who would destroy the heritage of freedom in the world, and fear.  Not from violence, but from logic and a lack of emotion when all free people stand.  I will declare one more truth, when America wakes up, like the Ent’s in Lord of the Rings, they will find they are strong, and the world will tremble for the betrayal felt by honest people hoodwinked by government, betrayed by the businesses they have helped create, and the world will change!

A Nation’s Strength
William Ralph Emerson

What makes a nation’s pillars high
And its foundations strong?
What makes it might to defy
The foes that round it throng?

It is not gold.  Its kingdoms grand
Go down in battle shock;
Its shafts are laid on sinking sand,
Not on abiding rock.

Is it the sword?  Ask the red dust
Of empires passed away;
The blood has turned their stones to rust,
Their glory to decay.

And is it pride?  Ah, that bright crown
Has seemed to nations sweet;
But God has struck its luster down
In ashes at His feet.

Not gold but only men can make
A people great and strong;
Men who for truth and honor’s sake
Stand fast and suffer long.

Brave men who work while other’s sleep,
Who dare while others fly…
They build a nation’s pillars deep
And lift them to the sky.

© 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.

LinkedIn Jail – Shifting the Paradigms on Social Media Power

20 August 2019 marks the fifth day I have been in LinkedIn jail, where my account is being reviewed for having broken some mysterious rule. I verified my identity immediately upon recognizing my account was suspended, I have done nothing wrong, and yet here I sit waiting for some magical decision by someone in LinkedIn’s mass bureaucracy to allow me back into my account and professional network. In the sparse emails received from LinkedIn, I learned that I had been placed in LinkedIn jail because of hate speech; this is where the paradigms of social media need correction.

LinkedIn Jail

On 18 August 2019, I sent the following message:

“What specifically about this message is “Hate speech?” Nothing in the ambiguous policies declares what “Hate speech” is, no definition, no clear line of demarcation; yet, I am being singled out from all the other responses for “Hate speech.” Interesting peek into social media, LinkedIn specifically, snowflake melting syndrome. I am aghast to see this behavior leveled against me.  Clearly define “Hate speech!”

I have asked for an explanation regarding how the above violates the user agreement, the posting policies, and the rules of LinkedIn, all to no avail. This comment was posted to a report regarding Representative Rashida Harbi Tlaib (D), and her continued flaunting of American Tax Law added to her hubris, individual ambition, and avarice, shown at every event. Except that some snowflake on LinkedIn has the power to place me in LinkedIn jail over a comment they disagree with politically.

The arbitrary actions by LinkedIn is a problem; people’s livelihoods are wrapped up in their LinkedIn profiles. I write articles and post them to LinkedIn on a myriad of topics to engage conversation and drive business to my consulting firm. I am not a 30,000-person networker on LinkedIn. My professional network includes many of those I have worked with professionally across the last two decades and 26-moves in the United States. I do accept invitations from veterans, unemployed people, and associates I meet who need a hand up.  I employ my professional network to help others.

All of my articles, but especially the articles discussing politics, religion, the VA, and elected officials are carefully written, sourced, packaged to present ideas, solutions, and explain beyond a single post why something is the way it is. I have never had any problem in the almost two decades I have been a member of LinkedIn. I don’t Facebook as that entire platform is heavily biased against new ideas and changes in thinking. I do not Tweet on the Twitter platform as that platform remains useless, and the ties that bind and gag on Facebook are the same ties that bind and gag on Twitter. I have accounts on both but rarely use them. Hence, my social media is limited to LinkedIn, and now I am left to wonder if maybe I should be changing this as well.

Where is the appeals board for the decision to close access to my business and my personal LinkedIn accounts? Who has the authority to close access? Why does this person have this access? Why can a single snowflake melting be the reason any social media account is placed into access limbo? All these questions and more the elected officials should have been asking in the committee meetings on social media, yet the items were never addressed; why? Where are the warnings and the opportunity to discuss differences in opinion between LinkedIn and the user?

I have heard discussed on LinkedIn multiple times regarding how too many LinkedIn accounts are fraudulent, or the owners are there to cause trouble; was the person reporting my comments as “hostile, hate speech” also investigated for veracity? If not, why? In more carefully reading the new LinkedIn User Agreement and the policies and rules documents, I have been amazed at the fake account language, and I would presume that both parties should be investigated when a claim of “hate speech” is reported. I would presume that LinkedIn is more interested in getting to the truth and ferreting out that trolls, the hacks, the criminals, and the dregs of society, rather than giving honest people a hard time. LinkedIn, what is the answer moving forward?

Here are five potential solutions:

  1. Before shutting down access, send an alert to both users in disagreement, investigate both users for content and appropriate user agreement adherence, look at the content posted, the threads, and evaluate both on professional merit. Then communicate with both parties the decision.  Your platform is neutral ground for expressions of personal opinion, and Freedom of Speech means the “yammer heads and trolls” get their say within reason. For example, the legal bounds of Free Speech as set forth by the Supreme Court.
  2. Filter out the miscreants and fake accounts. I do not know how many times I have been attacked on various threads by an account that is there one day and gone the next.  I was forced to submit my government-issued ID to prove I am a real person.  When investigating accusations are both users required to verify through government-issued ID their reality?  If not, why is this not standard practice to aid in eliminating erroneous accounts causing trouble?
  3. Put into the user agreements clear, concise, and easily followed language regarding where the limits are in speech. I know, this should be obvious to professional adults.  But, the necessity is evident due to the miscreants and malefactors currently residing on LinkedIn, who are abusing LinkedIn rules, regulations, and agreements for personal satisfaction.
  4. No single person should have the power to harm another for personal gain. From the time something is reported to LinkedIn, to the time action on a user’s account is taken by LinkedIn there should be communication between both parties and a neutral party at LinkedIn discussing the accusation, proving the account is real and detailing what is happening.  Specifying the penalties, how long any penalties will last, and how to appeal the decision.  Barring this type of process, the abuse of LinkedIn will continue and harm LinkedIn, not the users.
  5. Start holding false account owners responsible for the damage they do to LinkedIn’s brand. I have several accounts in my professional network that have proven to be false but only after engaging in business with the user. False accounts are very frustrating, wasting my time and resources, and doing damage to LinkedIn’s reputation.  Why doesn’t the user creation process have a veracity checker using government-issued ID, biometrics, or some other technologically powered method to weed out the charlatans?  What is LinkedIn doing to protect themselves from the hacks and trolls after an account is discovered to be false, or mass owned by a troll?

20 August 2019 – Before completing this article, an email was received, part of that message is copied below:

“We’ve reviewed your appeal. Based on the information you provided and if you agree to abide by LinkedIn’s Terms of Service: https://www.linkedin.com/legal/user-agreement, we’ll grant this appeal. You can agree to abide by our Terms of Service by replying to this email with your explicit consent.

Please note, that LinkedIn expects all members to behave in a professional manner when engaging on the platform. Should this account violate our terms in the future, we may restrict the account again. Any future violations of our Terms could result in a permanent restriction.

To learn more about what is and is not acceptable on LinkedIn, please review LinkedIn’s Professional Community Policies: https://www.linkedin.com/help/linkedin/answer/34593.”

I have responded.  Since I have done nothing wrong, have never abused LinkedIn’s rules, regulations, and user agreement, and I do not plan to in the future, I remain appalled at my treatment by LinkedIn and will continue to search for a LinkedIn alternative.  The lack of clarification, the lack of action, and the disgusting lack of reply to my questions are beyond the pale, and if LinkedIn does not change, I will.  The power of social media to block, harm, and restrict without cause and justification must cease, and I do not care how much money George Soros pumps into social media to demand the social media platforms obeisance to his personal agenda.

To have the final word, the following was received announcing I have been released from LinkedIn Jail:

“However, please be advised that this is your final warning regarding abuses on the LinkedIn site. If your account is reported again after today’s date, your LinkedIn account will be subject to termination.”

LinkedIn has concluded that I did nothing wrong, but if another snowflake reports me, I will lose my LinkedIn professional network.  They threaten me, but cannot answer simple questions, propose solutions that can protect me, or even engage in polite conversation.

America, social media’s pernicious, and self-inflated power over us must cease.  LinkedIn, I will either find a new platform for professionals or will cease all contact on your platform.

Threatening me without cause and justification is the last straw!

 

© 2019 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.