I promised a follow-up article after Chapter 5; it took me the better part of 48 hours to cool down sufficiently to write coherently to effect an update. On 18 March 2002, I wrote about an appointment with my Primary Care Provider (PCP) being tardy, unprepared, and bureaucratese in supposedly holding a phone appointment with me. 01 April 2022, not an “April Fools Joke,” at 0731 hours, lasting 9 minutes, my PCP called me to get my approval to have me changed from her PACT team to another provider’s team. Apparently, in the highly red taped world of PCPs at the El Paso VAHCS, there must be an hour-long handoff call when a provider initiates a change of PACT team. I have my doubts and smell designed incompetence!
Let me pause here for a moment. I generally need two hours to write an article after conducting research. 18 March 2002, it took a bit longer to draft that one due to the need to blow off steam with some choice words and choke down the urge to beat a few brick walls with my fists. I am generally a very controlled person, and the fact that this PCP was so stunningly incompetent, rude, and HIPAA clueless, I admit I lost my cherub-like demeanor! That the patient advocate was able to get my secure message, upload the comments into the electronic medical record, and contact the provider before the provider had even logged the patient notes, speaks volumes about the ineptitude of the PCP. Worse, in the call on 01 April, the PCP was still on speakerphone, still disregarding HIPAA security, and quoted lines out of context from my message to the patient advocate. Speaking volumes about the processes and procedures of the patient advocate’s office to investigate patient claims without breaching confidentiality. Another topic for another day entirely!
28 March 2022, I received the following from the patient advocates office, quoted completely:
“We have received your secure message addressing your concerns. I will be sending a Patient Advocate Tracking notification with your concerns to our Primacy Care Service for review. They will be contacting you via telephone to discuss your concerns.”
I never heard anything from this mysterious “Primary Care Service” group/team. 01 April 2022 was the first response, and that was from the PCP. Sourcing the Department of Veterans Affairs (VA) and the Office of Inspector General (VA-OIG), the PCP is the second most important member of the Patient-Aligned Care Teams (PACT) at the VA; the patient is the essential member and an actively engaged and knowledgeable patient is preferred. I promise the VA-OIG has not even scratched the surface of the problems with recalcitrant, snowflake, and bureaucratic PCPs endangering patient health with the VA. Not my first run-in with an inept PCP; I sincerely hope it is my last!
In returning to the 01 April call, we find another interesting piece of data. The PCP affirmed that abdominal pain could radiate from, say a hernia, to other parts of the abdomen, but this is for a specialist to diagnose, not a Family Practitioner. Get that; the PCP is directly reversing all the published documentation by the VA and the VA-OIG by declaring that a specialist is the only person who can adequately decipher and detail why pain is occurring—putting all the PCPs in the VA Health Administration under the bus as merely button pushers and drug dealers. Then the PCP has the temerity, nay the chutzpah, to suggest a trust deficiency existing between myself and the PCP. Is it any wonder that people are detested, forlorn, melancholy, madder than a wet chicken with a raging case of hemorrhoids with the care they receive from VA healthcare providers?
Again, I repeat, only for emphasis, when any updates arrive on this issue, I will publish them in their entirety to allow the VA the opportunity to rebut, refute, or explain. Like the ongoing saga with VISN 22, the Phoenix VAMC, and being arrested and injured three times by the VA Police, I am not holding my breath and awaiting a logical response. If this were the only problem in the two weeks since the PCP shenanigans, the VA would be in pretty good shape. Alas, we know, dear readers, that the VA is in dire condition, and the elected leaders need to be scrutinizing the VA a LOT more closely than they are.
We begin the latest chapter of VA-OIG reports with yet another physician bilking the government:
“Robert Clay Smith, a Louisiana physician, pleaded guilty to conspiracy to commit healthcare fraud, wire fraud, and illegal remunerations (taking kickbacks). According to court documents, the scheme, which ran from 2013 until 2017, involved individuals associated with a medical supply and billing company recruiting Smith to dispense pain creams and patches to his workers’ compensation patients by offering him a split of the profits. The company acted as the billing agent for Smith, handling all the paperwork and submitting the allegedly fraudulent claims to the US Department of Labor, Office of Workers’ Compensation Programs, and private insurers. In exchange, the company paid Smith 50 to 55 percent of the profits collected from successfully billing insurers, at markups of 15 to 20 times what the medications cost.”
Plus the following:
“Robert Schneiderman of Langhorne, Pennsylvania, admitted to participating in a massive compounded-medication kickback scheme that he and others ran out of a pharmacy in Clifton, New Jersey. Schneiderman pleaded guilty in federal court to one count of conspiracy to commit healthcare fraud and one count of conspiracy to violate the Anti-Kickback Statute. From 2014 through 2016, Schneiderman and his coconspirators used Main Avenue Pharmacy, a mail-order pharmacy with a storefront in New Jersey, to run a fraud and kickback scheme involving compounded drugs like scar creams, pain creams, migraine mediation, and vitamins. Schneiderman was the president of Main Avenue Pharmacy and was a founder and CEO of its corporate parent. Main Avenue Pharmacy received over $34 million in reimbursements from healthcare benefit programs on compounded medications alone. Approximately $8 million of that total was paid by federal payers. Schneiderman himself earned over $400,000 through the course of the scheme. This case was investigated by the VA OIG, FBI, Department of Defense OIG, Defense Criminal Investigative Service, and Department of Health and Human Services OIG.”
Don’t forget this one:
“Dr. Harry Doyle, a psychiatrist from Philadelphia, Pennsylvania, and his wife, Sonya Doyle, have agreed to pay $3 million to resolve alleged violations of the False Claims Act. The alleged violations include submitting false billing to the US Department of Labor Office of Workers’ Compensation Programs (OWCP) for psychiatric services that were not provided and upcoding and double-billing patient claims. The Doyles have also agreed to be voluntarily excluded from federal healthcare programs for 25 years as part of the settlement. This is the largest recovery against a single psychiatrist in the history of the OWCP. A multiagency investigation of Dr. Doyle’s practice revealed that from January 2013 through April 2021, the Doyles allegedly billed for services not rendered, some of which occurred when they were not physically present in the United States. This case was investigated by the VA OIG, the Department of Labor OIG, and the United States Postal Service OIG.”
More is coming on this one:
“Ten Texas doctors and a healthcare executive have agreed to pay more than $1.68 million to resolve False Claims Act allegations involving illegal remuneration in violation of the Anti-Kickback Statute and Stark Law. According to a multiagency investigation, from 2015 to 2018, the doctors allegedly received thousands of dollars in illegal remuneration from eight management service organizations (MSOs) in exchange for ordering laboratory tests from Rockdale Hospital doing business as Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation. Little River funded the illegal remuneration to the doctors in the form of volume-based commissions paid to independent contractor recruiters, who used the MSOs to pay numerous doctors for their referrals. The MSO payments to the doctors were disguised as investment returns but were based on and offered in exchange for the doctors’ referrals. As part of their settlements, the defendants have agreed to cooperate with the Department of Justice’s investigations of other parties involved in the alleged law violations. To date, 17 doctors and two healthcare executives involved in this scheme have agreed on settlements totaling more than $2.7 million. The civil settlements resulted from a coordinated effort between the VA OIG, Department of Health and Human Services OIG, Defense Criminal Investigative Service, and the US Attorney’s Office for the Eastern District of Texas [emphasis mine].”
Elected officials, the next time you are asked about the incredible amounts of fraud in government-provided healthcare and insurance, do not buy the media talking points that the fraud is minimal, contained, or anything but designed incompetence on the part of the bureaucrats to act as a jobs program for investigators! The same investigators who are refused sufficient tools to investigate shenanigans by employees in the Federal Government adequately.
Frankly, all of these cases need the government workers to be held accountable, and the myriad of red tape loopholes CLOSED! I remember an election; I forget who and the exact when, but a significant election plank in the platform was healthcare reform, promising to clean up the swamp and bring accountability to Washington and the government. The public is still waiting, and I know enough of you have run on this topic from both parties to repaper the walls (inside and outside) of the White House.
Yet, even if only outside providers and executives were scheming, the VA might not be in too bad a condition. Except for the employees of the VA, VHA, and VBA, which continue to be caught up in ethics violations at a minimum:
“The VA-OIG conducted an administrative investigation that included a congressional request to look into allegations that Charmain Bogue, former executive director of the Veterans Benefits Administration’s Education Service, committed ethical violations arising from her spouse’s consulting work for Veterans Education Success (VES). VES is a nonprofit advocacy group that regularly had business before the Education Service. The allegations also pointed to possible incomplete financial disclosures by Ms. Bogue concerning her spouse’s consulting business. In their work, investigators uncovered evidence of other potential conflicts of interest and related misconduct by Ms. Bogue [emphasis mine].”
VA-OIG finding:
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- Bogue participated in Education Service matters involving VES without considering whether it raised an apparent conflict of interest and acted contrary to the ethics guidance she received from her supervisors.
- Bogue sought résumé feedback from the president of VES to aid in her search for career advancement without considering whether this raised apparent conflict of interest concerns in subsequent VES matters. VES also endorsed Ms. Bogue for presidential nominee positions.
- Bogue provided insufficient detail about her spouse’s business in 2019 and 2020 public financial disclosures; VA ethics attorneys had found them compliant. She remedied the subsequently identified deficiency in her 2021 disclosure.
- The OIG found that Ms. Bogue refused to cooperate fully in the OIG’s investigation by refusing to complete her follow-up interview. Her husband and VES president also refused to participate in OIG interviews, and the OIG lacks testimonial subpoena authority over individuals who are not VA employees. Bogue resigned from VA in January 2022.
UPDATE: 14 April 2022 – Sen. Grassley was hoodwinked by the VA on this issue and The Daily Signal (linked) has more of this report. I covered this before, I repeat only for emphasis, when you are discharged from the VA, you lose your ability to be a “whistle-blower.” As a point of fact, this is how the VA is able to hide a lot of their shenanigans, get rid of the person rocking the boat, invent the paperwork, cover the whole incident over as a “bad-apple” and keep you collective heads down and mouths shut until the VA-OIG investigation concludes. The VA’s ability to abuse whistle-blowers is further compounded by Federal Attorneys who cherry-pick the cases they know they can win. Which further protects the VA’s shenanigans and disheartens and mystifies those who have been wrongly terminated. The Daily Signal reflects this pattern of corruption perfectly citing the records obtained by Empower Oversight.
Some commentators have claimed that blaming elected officials for not scrutinizing or not providing tools to investigate entirely is unduly unfair to the congressional representatives. Really?!?!?! The VA-OIG conducts an investigation, the people being investigated refuse to comply, and the VA-OIG is toothless to enforce a full and complete investigation to initiate Attorney General and FBI investigations and actions to recompense the defrauded taxpayer. Ms. Bogue and the VES have invalidated any trust the taxpayer should have in their respective activities, but this, like so many other investigations into VA employees, will die of apathy before anyone is held accountable. Even though a congressional representative demanded an investigation, nobody is being held liable. Nobody is forced to compensate the defrauded taxpayer, yet the taxpayer is still expected to elect the same old representatives to their jobs. Blaming the congressional representatives (legislative branch) for not scrutinizing the executive branch, one of only two jobs these people have, is somehow unfair? NO!
Remarkably, between the 18 March disaster with the PCP and 01 April’s compounding idiocy, the VA-OIG published an ironically titled investigation report.
“Improved Governance Would Help Patient Advocates Better Manage Veterans’ Healthcare Complaints.”
Imagine that, more designed incompetence negatively impacting the veterans seeking care at a VA medical facility, stating the obvious by the investigators. Who on earth would be responsible for seeing that regulatory agencies had the tools needed to scrutinize and demand corrective action? Calling all elected officials, did you notice that one of the prima facia tools a veteran has to report problems, conveniently called “patient advocates,” does not have the sufficient authority, adequate oversight, and tools to execute their jobs? The VA-OIG reports the following:
“The Patient Advocacy Program helps advance the Veterans Health Administration’s (VHA) efforts to improve customer service, support veterans’ access to quality care, and provide a mechanism to resolve healthcare issues. Patient advocates document veterans’ concerns, communicate the resolution, provide follow-up and feedback, and identify trends for potential opportunities to improve medical facilities. In FY 2020, VHA tracked about 162,000 serious complaints in its patient advocate tracking systems.”
On a side topic, VA-OIG, how do you define a “significant complaint” and separate it from other types of complaints? Honest question, the information was, to quote my PCP, “remarkably” missing from your investigation report! Would the VA-OIG like to know why so many veterans’ complaints have risen to a “serious” level? You reported the exact problem:
“A complaint is considered resolved when the complainant communicates the outcome, and the record is closed in the tracking system.”
Maybe, the VA-OIG merely overlooked the logic problem, but complaints increase when the solution pushed down the throats of the veterans does not fix the actual situation. Honest question, no sarcasm involved. Is a “serious” complaint one where significant harm or death to the patient has occurred? Is a serious complaint one that breaks federal laws, EMTALA, comes readily to mind?
Having had “solutions” forced down my throat, speaking only for myself, I am thoroughly sick of having the patient advocates bureaucratize my complaint, then fail to act, and then compound the problem by quoting policy to me as a reason to close the complaint, when the VHA never have written policies and procedures! Maybe, you might want to look into the root causes of some of those “closed” complaints and ask root causation questions!
What did the VA-OIG find when they investigated the patient advocates?
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- VHA lacked adequate governance of the Patient Advocacy Program.
- VHA did not effectively issue and implement adequate policy, monitor complaint practices, and provide guidance to medical facility directors responsible for local program management.
- Patient advocates did not always enter complaints into the system.
- Even though complaint records generally appeared to be closed on time, patient advocates did not always document the communication of the outcomes to the complainants.
- The VA-OIG substantiated an inadequate program policy to identify clear expectations and responsibilities.
- The VA-OIG found that they (patient advocates) did not always adhere to the documentation requirements to show full complaint resolution.
- At the local and VISN levels, responsible personnel did not consistently analyze patient advocate tracking system complaints about trends.
Feel free to read the complete abomination of designed incompetence for yourself. Essentially the VA-OIG concluded that the VHA has been burning taxpayer money in a patient advocacy program, and the designed incompetence is so apparent it can be tracked from L2, where the James Webb telescope is located! Worse, you won’t need the James Webb telescope to see the designed incompetence!
Unfortunately, I could have guessed the first three findings without looking. Every VA program is designed so ineptly, reprehensibly led, criminally incompetent, and with such dastardly deceptive doings that fiction writers’ storylines have to be written better to sell books. You cannot make this stupidity up and make a profit. Hollywood would run screaming into the night if they made a true story about the ineptitude found at the VA!
Elected officials, where are you? The VA-OIG presents copies of their findings to you, and I have yet to witness a single one of you holding the VA Leadership criminally responsible for the failures at the VA. Even when the VA is killing hundreds of veterans, the US Congress refuses even to act upset, let alone scrutinize for a change! Remember how many veterans were intentionally killed in Phoenix waiting for treatment? How many VA employees lost their jobs and pensions or were forced in front of a judge for murder? It is a fair question, where are the elected officials in the legislative branch working to end the criminal “fraud, waste, abuse,” and designed incompetence in the executive branch?
© 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.
Earlier this week, I went to a doctor’s appointment that included 
For example, calories from sugar are not the same calories from kidney beans, even though both are units of energy, and 2000 calories of chocolate are not the same as 2000 calories of carrots. If we are clear on this, let’s discuss why this is important. 2015, a neurologist told me all my problems with my nerves lay in how much fat I was carrying around. He claimed that if I reduced the amount of calories I consumed and increased the number of calories burned, I would quickly lose weight. Losing weight never happened, nor could I keep any weight lost off for any length of time.
I am sure that energy sources are not equal, even though calories are simple units of energy, per the laws and rules of physics. However, I am not a chemist, a physicist, nor exceptionally well versed in diet and health. I am not a dietician and am left to try and figure out the best advice and live that advice. As a foodie, I have yet to find any diet, as the first part of a diet is “die” dying of hunger! Before you ask, yes, Garfield is a hero of mine and has been my whole life.
Meaning that what I have been declaring about the mask policy, the mask mandates, and the hypocrisy of zealot VA Police Officers at the Carl T. Hayden VAMC is 100% true, and my treatment was not in accordance with the mask policy (emailed directive) from Washington DC. I hate being lied to, detest being arrested and injured when I am right and refuse to be silent about how poorly the VA is treating veterans! Does anyone know a lawyer who is willing and hungry enough to take on the VA?
Monday and Tuesday this week, 28 and 29 June 2021, the Department of Veterans Affairs – Office of Inspector General (VA-OIG) returned three more investigations, inspections, or criminal reports. While no veteran is dead in this batch of reports (Thankfully!), the behavior exhibited remains egregious and blatantly criminal, and the bureaucrats and bureaucracy remain intact to continue to commit 
Contracting officers and third-party contractors act under Federal Regulation called “Federal Acquisition Regulation (FAR). FAR is like the Bible; it has everything in it outlining duties, responsibilities, and authorities. Contracting officers are supposed to know the regulations before contracting goods and services, and they teach the contractor their responsibilities. Especially where a PIV has been issued, the contracting officer, as the liaison, IS THE Responsible Party, not the contractor.
I cannot understand how a contracting officer, with all the training, re-training, and refresher training that is mandated, could use the excuse, “I didn’t know that was part of my job!” As a person who has worked around contracting officers, I knew this was their job, and I am not a contracting officer. It is simply common sense; if you facilitate obtaining identification, keys, and access codes, you are responsible for getting these things back!
Thus, I call upon every American to share my disgust and demand action! Stop allowing this detestable behavior, paid for by taxpayers, to thrive. End the abuse! Not just for veterans harmed by the VA bureaucracy, but for your hard-earned tax dollars and the disrespect the elected officials display towards you, the boss! Tell me, if your employees displayed the same behavior witnessed by elected officials and bureaucrats of all stripes, how long would they keep their jobs? If your boss showed you the same disrespect, how fast would you be looking for new employment and telling everyone not to apply there? Now, answer this question, “Why do we accept this abuse by government officials and elected representatives?”
By tracing behaviors, attitudes, and influence to their source, the police chief acts as he considers appropriate, but the underofficers generationally multiply and mirror his behaviors. The same is true for the chief who takes his example from the assistant director, director, and hospital leadership. Chains of command always have this consequence; the example of those above are mirrored, replicated, and multiplied to impress the higher officers to gain attention and promotion opportunities. Want to take a measure of a leader; look to the most junior person in the chain of command and watch them for behaviors, attitudes, and actions that originate in the leadership.
Case in point, long have I detailed and described the failures of leadership at the VA. The latest is a wire fraud scheme in 
Did you catch that; the office specifically tasked with handling estimates intentionally low-balled estimates, did not include all necessary contractual requirements, and then lied to Congress to cover their hides, and fell back upon designed incompetence to skirt blame, responsibility, and accountability when the VA-OIG came investigating. 
I am not asking these questions and not expecting an answer! I am asking these questions looking for and expecting real results to begin immediately, if not sooner! This is a national embarrassment with a global impact, and it is time for the United States to lead in correcting their detestable government workforce!
23 February 2021: UPS delivered a letter package containing a single sheet of paper from Dr. Karen MacKichan MD, auto signed, and dated 09 February 2021. Declaring that the Phoenix VA is absolutely correct in behaving as petty tyrants and denying me medical care, illegally sharing and knowing my HIPAA information with VA Police Officers, breaking EMTALA, and treating me to injuries, all because I cannot safely wear a mask. My only infraction at the Phoenix VA is not to wear a mask. Yet, this is considered a “behavioral problem,” and I am wrong for behaving in a manner that insists that my safety comes first!
What are petty tyrants?
On the topic of written directives, written operational policies, written patient guidelines, and written job descriptions and duties, let’s talk about how the VA Police can injure people and not be held accountable! The VA Police attacked me on 07 December 2020, violently pushed, then spun into a wall. My C-and L-Spines did not move, and my T-Spine turned; I dropped like a rock sustaining spinal injuries, knee injuries, and got cut on my right hand and arm. Worse, being handcuffed with my arms behind my back caused bruised wrists that were jerked by more VA Police officers on 10 December when I sought medical attention. I am an 80% disabled person with mobility issues, yet your letter claims all the action of the Phoenix VAMC was in accordance with written policies, guidelines, and directives. Well, I possess a Missouri mindset, “Show ME!” Show me the written and published policies, guidelines, and procedures that allow VA Police Officers to physically assault patients! Show me the written and published policies, guidelines, and procedures that allow me to be refused treatment. Prove through written and accessible documents how the decision for this hodgepodge of ineptitude can label me a “behavioral issue” when my only discretion is not physically and safely wearing a mask!
You claim to have reviewed the actions of the police officers who routinely have medically protected HIPAA information about people being arrested, joke about this information, act in a manner that brings shame to all Federal Police Officers. What happens to these unprofessional officers and their despicable commander? When do my rights to have my HIPAA-protected information withheld from parties who do not need this information? When do all the other veterans being served and not being served by the Phoenix VAMC become protected under HIPAA? I am not the only veteran being refused service, denied care, and abused and injured by the VA Police for not wearing a mask, while also not being a “behavioral issue.”
Your letter discusses “the most effective manner to have the behavioral flag lifted” as “checking-in with the VA Phoenix Police.” Do you know what that entails? Did your “thorough, comprehensive, and independent” investigation uncover what happens at this “check-in?” I was told clearly what happens; I will be evaluated for wearing a mask, found not wearing a mask, arrested, cited, and denied service for not wearing a mask. Then, I will have a black mark on my behavioral flag record for disorderly conduct! I am not disorderly in my behavior because I cannot safely wear a mask! What part of this do you, as a medical doctor, fail to comprehend?
I always interact with the staff at VAMC’s, even when they are wrong, in a respectful manner, knowing that the problems of dumb policies, time-wasting procedures, and bureaucratic inertia are the fault of the leaders hiding in their offices and cubicles. I have been interacting with the VAMC’s across America, and the inept staff, since I left the service in 2004! Never having a problem, never having an issue, and never getting injured by or even interacting with VA Police. This all changed in June 2020. The VAMC refused to write down a comprehensive directive for COVID Patient Mask Wearing. I get blamed for following the unwritten policy and directives, then falsely accused of being “disorderly” in my behavior, then falsely accused, again, for being a “behavioral issue!” I am not in the wrong here! I am not a “behavior issue!” I am not disrupting hospital operations, placing other patients at risk, or being violent! Where are my rights in this farrago and railroading scheme?
Your boilerplate response indicates this issue has reached the final point. I beg to differ! I will have my name cleared of these false charges. I will not be blamed for the ineptitude of the leadership at the Phoenix VAMC and VISN 22! I will not be silent and meek in the corner because you cannot tell the difference between standing for one’s rights against tyranny and compulsion and oppression through bureaucratic fiat! I have done nothing worthy of these fallacious claims, false accusations, and the Phoenix VAMC and VISN 22 will admit this publicly when I am done cleaning my name of the scum you have thrown upon it! Make no mistake; I am not angry, but I will have my rights restored, my name clear, and satisfaction from the injuries and treatment I have been made to suffer!
August 2020, I was informed that I had been hired with a September 2020 start date. The same day, I contacted my Department of Veterans Affairs Primary Care Doctor for a workplace accommodation letter. The doctor and I discussed my problems and what aids and equipment I need to be more productive in a work environment, which during COVID mandates includes my inability to wear a mask. The doctor wrote a workplace accommodation letter, and the employer and I have worked out a workplace accommodation. I hope to work for the company on the 11th of January 2021.
As a professional organizational psychologist, I place my integrity and honor on what I have reported, observed, experienced, witnessed, heard, and I fully and unequivocally attest that the majority of the Federal Police Officers in the Carl T. Hayden VA Police Force need immediate retraining; except for those fired for unprofessional behavior and misconduct! There is NO EXCUSE for Officer Interpreter on the 08th of December 2020 to have grabbed me, after physically pushing me, and try to spin me into a wall. There is no reason, at all, for a VA Police Lt. and a Sgt. to grab my wrists, bend my arms into positions they do not travel, aggravating the handcuff injuries from Monday, and then have the gall to tell me, “Well, how could I know you had painful wrists, you are not wearing a bandage.” I told them about my injures before they started grabbing, jerking, yanking, and hurting me. Then I get ordered to “Shut up; I was under arrest.” But I never had my Miranda Rights read. I complied on the 10th, I complied on the 8th, and was in compliance in July.
Let’s be perfectly clear; hospital mandatory mask policies must have exceptions for patients who physically cannot wear a mask. Patients unable to wear masks include some patients on cancer drugs, some asthmatic patients, people with breathing problems, and much more. The Carl T. Hayden VA Medical Center COVID Mask policy is the biggest problem I face when trying to obtain treatment after the COVID Pandemic Declaration from Feb. 2020. I am certainly not alone in having breathing issues with the COVID Masking Policies, and with the zealotry, which those policies are being enforced. The VA has established an organizational design that requires business to be conducted face-to-face. Hence, the VA is a Ghost Town; patients are canceling their appointments, FOIA’s are not being submitted, and so much more because of the masking policies that endanger patient health and place patients at risk of further injury!
In August 2020, I received a call to schedule a multiple hour MRI with the Phoenix, VA. My Primary Care Provider had made multiple orders for my injured spine to obtain new data and examine the S-Spine and C-0 specifically. The earliest MRI was 07 December 2020 at 1400. Important to note, since this appointment could not be scheduled any closer to a 30-day turnaround, I was supposed to be sent to Community Care for a faster appointment. Instead, I had to wait.
Later that afternoon, Jennifer returned my call. Everything was assured to me to be in order. The workaround we worked out was for me to hold a mask in front of my mouth and nose. That way, the mask is not causing breathing difficulties and I am then in compliance. This arrangement had worked previously during an Emergency Room visit; thus, I kept my appointment.
My return trip to the dressing room is important for two reasons: 1) I kept losing my leg strength. This is normal after MRI’s, but coupled with the lack of food, and I am in trouble if I cannot get food soon. 2) Nothing else is said about my not wearing a mask. I exit the dressing room, walk out through the traffic control door, and spot two VA Police Officers looking like they are involved in a long discussion with Peter, the supervisor dispatched to help me navigate the bureaucrats at the Phoenix VA.
Officer Interpreter then tells me, “You collapsed on purpose, your injuries are faked.” This mantra is quickly picked by the supposedly superior officer, Sgt. Huff. In July when the VA Police arrested me for not wearing a mask, the officers touched my back, collapsed my legs, and left me with a sore right knee. Today’s attack (07 Dec 2020) has left me with increased pain in both knees, cramps in the L-Spine, a feeling of disconnection between my T- and L-Spines, and my cut fingers just keep bleeding. I guess the cuts on my fingers were intentional and the blood dripping across the floor of the VA was just staged for public sympathy.
Let us talk about process irregularity for a moment. I spoke to the Chief of police in August who claimed the COVID Mask policy does not allow face shields, and there was some “minor” confusion about the use of face shields at the Phoenix VA Campus back in March, which has since been cleared up. Today (07 Dec 2020), after the policy was supposed to have been clarified and re-communicated, I am offered the option of a face shield by another officer at the VA as an option to the mask mandates. In July, I was wearing a face shield when I was arrested, because a face shield was not a face mask. So, I ask again, what is the policy/mandate/whatever governing COVID Masking? Where is a copy of this mask demand?
Wednesday 09 Dec 2020, I receive a call from Nurse Crawford from the “Organizational Behavior Committee (OBR)” about the “disruptive incidents” at the VA Hospital. Due to the injuries sustained on 07 December, I had spent all day Tuesday and Wednesday in bed too sore to move; this began the nurse Crawford conversation. I explained to the nurse that I am not causing “disruptive incidents,” the VA Police in their zealotry are causing these incidents. Yet, I am still threatened with having to show up to the VA Police to get a card, allowing me on premises at the VA, provided I wear a mask. I explained multiple times that I cannot wear a mask and have tried all avenues to find reprieve. Including sitting down, at the Wendy’s across the street, with the supervisor of Patient Advocacy, Jennifer, and hashing out a plan where I can hold the mask close to my face when closer than 6’ and dealing with VA employees. This plan worked once, then never worked again, because of the bureaucrats at the VA, and the failure of leadership to act with patient safety in mind.
During this altercation with the VA Police, three things of note are important:
I have been laughed to scorn for complaining the VA Police Officers were hurting me. VA Police officers have made jokes about my mental diagnosis, physical diagnosis, medications I take, all of which are direct HIPAA violations. I have been left with bruised knees and wrists from the treatment received at the hands of the VA Police. I have been ridiculed for complaining and asking questions, asking for a copy of the policy, and asking for administrative assistance in knowing and securing my rights. I have been accused of crimes I never committed, cited for crimes not committed, but were made to appear. I continue to be refused service, a Federal Crime under EMTALA, by the VA Hospital. Shame on the VA leadership in Phoenix, VISN 22 HQ in Long Beach CA., and in Washington DC, for allowing this type of treatment to perpetuate. Shame on the VA Police for acting in a manner that is beneath their badge and oath of office. Shame on the VA Staff who watch these interactions with glee and merriment, then gossip, joke, and make fun of the veteran who is being treated thusly.
Late last week, I received a call from the Chief of police at the Phoenix VA Medical Center. In July, I had been arrested for not wearing a mask. By late August, I had figured the Phoenix VA Medical Center Director was going to just “forget me” and hope I go away, then the call comes in. The Chief of police begins by stating, “I do not know why I am calling you, but I was requested to call and see what I can do to help.”
The VA-OIG conducted a healthcare inspection at the Atlanta VA Health Care System (VAHCS) in Decatur, Georgia, and found they had a backlog of open community care consults, and the OIG found deficiencies in processing, scheduling, and timeliness of these consults. Important to note, the contributory factors included but were not limited to, inconsistent scheduling processes, inconsistent oversight, and deficiencies with third-party administrator scheduling oversight, shortages of scheduling staff, and lack of training and supervision for scheduling staff. The facility did not consistently meet facility process requirements for scheduling audits and lacked a process to identify consults that were missing documentation after administrative closure. While the Decatur VAHCS should be praised for not having any critical patient concerns due to the scheduling failures, this appears to be more luck on the patient’s part, than efficiency on the scheduling staff part.
Imagine you’re a patient, or worse a family member escorting the patient, with suicidal ideation, and you hear the doctor say, “the patient can go shoot themselves. I do not care,” How would you feel about the 12-hour stay in the Emergency Room, after seeing seven different providers who did not read the notes, complete adequate patient handoff between the ER and outpatient mental health, which also includes deficiencies in the hand-off processes, and providers’ failure to read the outpatient psychiatrist’s notes, which led to a compromised understanding of the patient’s medical needs and a failure to enact the outpatient psychiatrist’s recommended treatment plan. Completing six-days later in the veteran taking their life. 
When any veteran dies by their own hand, it is a tragedy. But, when the VA has any responsibility in that veteran committing suicide, heads should roll, individual people should be held accountable, and in this case, especially, criminal proceedings should commence! I worked in the VA ER, I know what the providers, nurses, and other staff providing patient interactions say. I have reported several inappropriate comments that the patients heard to no avail, no recourse, and no action by hospital leadership. I know, intimately, the political chicanery that occurs at the VA, and I can tell you, this IS a pet issue with me, and I am unapologetic in calling for criminal charges on these providers who are abusing veterans and their families!
The VA-OIG inspected the VA Illiana Health Care System (VAHCS) and multiple outpatient clinics in Illinois. The VA-OIG also inspected the William S. Middleton Memorial Veterans Hospital and multiple outpatient clinics in Illinois and Wisconsin. I have been in both and I can say unequivocally, more progress is needed and the leadership desperately needs to improve professionalism among staff, improve patient safety from the bureaucrats not providing care, staff competencies, and staff training. All of which were among deficiencies mentioned by the VA-OIG. There is great potential in these VAHCS’ for achieving greatness, but the bureaucrats need deep cleaned, and removed!
The behavior of the VA as recorded in these VA-OIG investigations and inspections continues to reveal significant problems with staff, where the staff has designed processes and procedures to allow a ready excuse for any problems that arise and continues to prove that a veteran takes their life in their hands when visiting the VA. These actions must cease forthwith. There is no excuse for the behavior investigated and reported.
DNC-Consulting 