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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsWhy the VA is Better than Private Sector: A True Story of a Little Piggy that Got to Come Home
True story. Diabetic develops sudden infection in his foot. Over the course of three days the lateral/distal part goes from basically normal with a small chronic wound to red/swollen/fifth toe bluish. He goes to the ER. Blood counts are up, sed rate is up (infection), xray shows no bone infection. A podiatristfoot surgeonis consulted. His prescription---schedule surgery to remove half the foot, because obviously there is a infection in the bone and part of the fifth metatarsal and all of the fifth toe have got to go. He cancels the MRI request. He does not need an MRI to know that there is a bone infection. Nope. In the last four years he has taken off 4000 of these lateral fifth metatarsals (foot bones) for infections
Patient is ready to sign on the dotted line, except a friend with medical training says Hold on sec. Why not get the MRI? Just in case it isnt a bone infection? Maybe it is a cyst instead. It sure sounds like a cyst. Maybe you can save your fifth toe (which you dont really need to walk) and half your foot (which you really do need to walk)?
So the diabetic decides to be a bad patient. He demands the MRI that his surgeon refuses to order.
Its a waste of a $1000. It will only tell us what we already know.
Ill pay for it myself, says the diabetic.
Oh, I am sure youre insurance will pay for it, admits the surgeon grudgingly. If you want it, ask the internist to order it. I wont do it.
The diabetic asks his internist to request the MRI, a very easy to obtain, reliable test which can show right away if a bone is infected. Plain xrays may take up to two weeks to show the changes of osteomyelitis (bacterial infection of bone). The MRI reveals
.
An infected skin cyst just as the friend with medical training suspected (there were clues which the surgeon refused to consider). No bone infection. Seems that the surgeons xray eyes failed him. Or maybe he was just eager to lop off half a foot along with the fifth toe.
To make a long story short, the diabetic fired that surgeon, got another surgeon, the infected cyst was removed, the metatarsal was saved, the fifth toe was also saved, and that Little Piggy got to cry Wee, wee, wee all the way home.
Now, why is the VA better than private practice? At least in my experience, the VA will do everything possible to save a foot even if it means a long hospitalization and intravenous antibiotics. Might have something to do with the fact that no one at the VA has a financial incentive to do unnecessary surgery and every incentive to keep veterans healthy.
tazkcmo
(7,286 posts)I have had some bad experiences with the VA but I still prefer them for the reasons you stated plus the front line personnel are almost always great. It has it's problems but all in all I prefer it over private practices.
Kaleva
(36,146 posts)True story.
I've been suffering from chronic diarrhea since last October and after 2 colonoscopies, numerous blood tests, urine tests and fecal samples taken, my case was referred to a private GI specialist as it was decided being sent to the regional VA hospital in Milwaukee was too far of a trip for me as I'd probably crap my pants long before getting there.
The folks at the VA are good, dedicated and hard working but it can be a mess of red tape as weeks went by between tests. It took a month and a half for the VA to transfer my medical records to the private specialist.
jmowreader
(50,451 posts)This guy works at VA one week and in private practice the next.
In private practice he is rated on the amount of money he makes the practice.
At VA he is rated on the number of correct diagnoses he makes.
The GOP hates outcomes-based medicine, which is what the VA does.
pwb
(11,205 posts)Most people who work there. Work for the veterans. A few are assholes and work for the company. ( V A ).
shockey80
(4,379 posts)My father was a Korean war veteran. After my mom passed my dad had health problems and trouble coping with the loss of his wife. They were high school sweet hearts.
My brother and I convinced him to start traveling. Go see the country. He did it. One year he went to Florida. He got a hotel room and he rented a car. He did not tell us he was going. He just decided to go one day.
I got a phone call from the VA in Miami. My father showed up there in bad shape. His heart was not pumping enough blood and they were going to put in a pace maker. They told me my father had driven himself to the VA. He did not remember where his hotel was. He could not remember where the rented car was.
I called my brother and we started making plans to fly down there. A short time later The VA called again. They told us they had found the car. They also found the hotel where my father was staying. If I remember correctly the hotel was a hundred miles away. Somehow my father knew something was wrong and he drove a hundred miles to the VA. He could not remember the drive. Unreal.
The VA called the hotel and asked them to pack up his belongings and ship it home. They paid with my fathers credit card. They then called the airport, got him a ticket home after they put in the pace maker. They gave him a ride to the airport. My brother and I did not have to do a thing. It was amazing.