SHOW LOW — “It’s not a perfect system and there are problems, but I owe my life to the VA health care system,” says Vietnam veteran Gary Ellison of Overgaard.
Ellison speaks critically, yet also very highly of Veterans Administration (VA) Healthcare. Recents changes in the way veterans access providers and obtain authorization to see a provider within the VA “community network” can be cumbersome.
Ellison was Born in Los Alamos, New Mexico and also lived in Mercury, Nevada because his father worked at the Nevada Test Site (NTS) where above ground atomic bomb testing was conducted. After above ground testing was banned, the family moved to Livermore, California where Ellison's father worked in a federal research facility.
He served in the 57th Assault Helicopter Company in Vietnam in 1968-69. They had Russian-made missiles and rockets and were at a place referred to as “Rocket Ridge,” says Ellison. “We had about 39 rocket mortar attacks while I was there.”
Ellison served in the Army for three years until he was honorably discharged. “My assigned skill-set was avionics and radio navigation equipment on helicopters,” he explained.
Ellison suffers from almost a total loss of hearing, Post Traumatic Stress Disorder and many other illnesses or injuries that require treatment through the VA health care system. He is a 100-percent, service-connected disabled American veteran.
Despite what he’s endured physically and emotionally, he still says that the VA healthcare system saved his life.
“I thank God for all of those people in the VA system that have helped me. The VA has been a huge help to me and being assigned a Priority 1 rating from doctors in Oakland, California, saved my life,” he testifies. “Although it took two years to be rated because of the backlog in evaluating veterans, the determination was retroactive which really helped me.”
“I owe my life to the VA,” repeats Ellison. “Everything that I am today and everything that I have today is because of the VA.”
The Mission Act of 2018
“No system is perfect,” says Ellison who was willing to sit down with the Independent to share what he has experienced since the implementation of the VA Mission Act of 2018, which is supposed to provide better access for veterans to healthcare within the VA and even providers outside the VA system.
“The Mission Act has added steps for veterans and VA employees,” says Ellison. “The VA commercials brag about veterans being able to go to the doctor of their choice but the VA added people and steps to the process. In June, the VA added about another 20 to 30 people between me and my doctor,” says Ellison.
The TriWest/Choice healthcare system he describes is complex and convoluted.
“VA providers cannot accept an appointment with me until they have orders. My primary care still has to write an order to go to the panel in Phoenix,” describes Ellison. “Then the appointment order goes to purchasing. They have to approve what the doctor says I want or what I need. Then it goes back to TriWest/Choice who is supposed to call me and tell me that I have an order. And, to create the order, they have to have an appointment date available with the community provider.”
“This is where it’s gets dodgy and muddy,” continues Ellison. “Before, the provider only had to write one consult request. From what I’m experiencing now, each time I want to go to my dermatologist, for example, my primary care doctor has to go through the same loop.”
“Last year, as long as the order that the provider sent to Phoenix was still effective (say for 1 year or 12 visits), then the VA healthcare system could go ahead and authorize an appointment,” he adds. “That’s only if the order was written properly. To see the dermatologist, the pulmonologist, the chiropractor, the eye doctor, whatever it may be that I need, everything has to be approved and sent back and forth over and over.”
Call center circles
“About two to three years ago, someone in Washington determined that the phone call shouldn’t go to VA in Show Low, it should go to the VA in Phoenix. It’s ridiculous what you have to endure to get help for the something that should be a simple phone call,” says Ellison.
“If I have a question or need to confirm an appointment or procedure, I have to call a centralized call center; there is no way to call the Show Low VA office directly,” says Ellison. “When you call, you are routed to an incoming call group, an outgoing call group, a scanning group, an address group; everything has been compartmentalized,” he explains. “No one knows what the other is doing, you start over again with every call.”
“When I call the number listed for the Show Low VA on Cub Lake Road, I have no idea who is going to answer that phone,” he says. “My call routes to the main call centers in Texas, Oregon, California, Washington, Arizona, Louisiana or Michigan. I could make the call right now and ask the person where they are sitting and you would be shocked.”
About Show Low VA
“There are some really good people in the Show Low office like Brandi who knows everything I’ve gone through,” says Ellison. “She has stuck with me through all of this but she has to wade through the system too. There are no shortcuts for employees working on the front lines,” he explained.
At times, veterans become exhausted with the phone tree system and what Ellison describes as a system-wide “disconnect.” This is when they visit the nearest physical VA office in person. For Ellison, who lives in Overgaard, he travels to Show Low because the Show Low VA is managed by the Phoenix VA office.
Ellison has asked his Nurse Practitioner to refer him to a family or general practitioner in Overgaard so that he doesn't have to drive the 70 miles roundtrip to Show Low for care but the request falls on deaf ears, he says.
Fortunately, Ellison is in relatively good shape and able to drive himself back and forth as needed but “it takes some planning,” he says.
His other point of contention following the phone system is the absence of a full-time doctor in the Show Low VA Office. For now, Ellison says there are physician assistants available.
It’s unclear how long the Show Low VA has been without a doctor. The Independent contacted the Show Low VA for comment but was referred to the Phoenix VA. To date, calls and emails were not returned prior to deadline but the hope is for contact to be made soon, leading to a better understanding of the Phoenix VA system.
“We have a real hard time keeping doctors in the Show Low VA,” says Ellison. “They get a medical doctor in and they just burn them out.”
“My primary care provider has been a nurse practitioner for quite a while. On one occasion, the NP walked out into the lobby and saw the 10 to 12 patients sitting in the lobby. His response was ‘there goes my afternoon,’ recalls Ellison. “I don’t know how many actually had appointments.”
“I had repeated ear infection issues and it took seeing a physician’s assistant for one and a half years before I finally got to see a specialist – an ear, nose and throat (ENT) doctor.”
“I had to travel to Phoenix to see that ENT but he only needed a few minutes with me before telling me ‘we are doing surgery asap.’”
“If I hadn’t pushed and pushed that PA see a specialist, I would have lost my ear,” assures Ellison. “The PA’s do the best they can but sometimes veterans have multiple issues that require escalation to a specialist.”
“The point here is that, as a veteran, you really better know the healthcare system,” says Ellison. “You almost have to call it cognitive dissonance.”
“I’m not trying to criticize anyone unfairly because I know that the VA employees and outside providers have to work within the VA system constraints,” summarizes Ellison. I am so thankful for what people like Brandi and Tanya at Arizona Dermatology have for me. And, I know for a fact that if I walk into any VA facility in the Continental US, I’m going to get treated.”