equivocation

Back when I was at School equivocation was as bad as lying.
How times have changed.
This morning I read in the Leaf Chronicle about Med Hold at BACH and yesterday about BACH's eagerness to hear suggestions for change.

Sugestions for change need go no further that the Complaint Box at the Patient Representative's office. Or even the notes from past Town Hall meetings with patients in Medical Hold.

The majority of providers at BACH are WONDERFUL - I personally had great experiences with my providers.

The providers who accept roles as administrators become a problem. As an administrator priorities CAN shift from patient care to systematic MANAGEMENT - and all too often the two clash.

Case managers may not be overworked - but their loyalties are to the process before the patient and that is a major systematic problem that must change.

And while BACH will, only with threat of exposure, allow patients to seek treatment outside the walls of BACH, BACH providers are known to prevent follow-through of this outside care. BACH's non-specialized general practitioners often over-rule the recommendations for treatment made by Vanderbilt or other MEDCEN specialty-trained doctors.

Most disturbing has been BACH's management of complaints made by patients. The leadership's actions have made no changes to quality of care concerns brought by patients.

Instead of closing Open Investigations, BACH allows the providers in question to deploy. Deploying the problem only drags the investigation. Worse yet, if that provider is under investigation they are now exposing deployed soldiers to known and unnecessary risk.

But none of that is in the articles in the Leaf Chronicle. The BACH leadership carefully crafted their talking points to avoid more in-depth questioning.

After major lawsuits BACH built a new "Mother-Baby Unit." Spouses can sue for malpractice, service members can't.

So, applying the backward logic so prevalent in the Military, especially the Military Medical System, it would appear that all "questionable providers" see the most vulnerable and voiceless soldiers while all the reputable providers see the other patients.

Like I said, I had an awesome experience at the hospital. I was fortunate to not have an administrator operating on me.

WRAMC ain't the first

In September, 2004 I left the 101st Airborne Division and became a MEDDAC soldier in the Medical Hold Company. I was awaiting separation from the Army because of injuries I received while deployed. My wife was also having serious medical problems (BUT THAT'S AN ENTIRELY DIFFERENT STORY).
When I came over to the Ft. Campbell Hospital, Blanchfield Army Community Hospital (BACH) I was offered a company command. The Troop Commander, a Major, was an energetic and compassionate leader - I had a great deal of respect for her and wanted to accept the job. Especially after she discussed what my duties and responsibilities would entail:
The Medical Hold barracks were horrible. Much like the ones at WRAMC now featured all over the news they were full of mold, mildew, asbestos, and deteriorating construction - holes in walls, broken window frames - these were not suitable for soldiers. There was no handicap access and no elevators - and, like at WRAMC, these soldiers were severely disabled I walked through these barracks and wanted to help get them fixed.

The Troop Commander had been working on getting these fixed since they had taken command but to no avail.
I did not accept the company command - my wife's health had deteriorated too much. If I took command I would either abandon her, or be in a position where I could let soldiers down - I was not willing to accept either of these outcomes. I helped with the company in a limited capacity and took care of my wife.
The soldier's barracks situation improved before my wife was granted access to the care she needed in order to heal.

When we requested work orders on these dilapidated buildings the housing office would explain that because the barracks were so old, and marked for destruction, funding could not be approved to renovate or otherwise fix the problems. New construction on-post had priority over old construction - understandable - but it didn't address the current housing problems.

Eventually, after many false starts, the Troop Commander found ways to correct the problem as much as possible. She found ways to get repair work done. Some soldiers moved to a hotel off-post. The soldiers got moved to a better building almost a year later. But better than what? What is considered acceptable? They just moved to a somewhat better building. It's still old and falling apart and won't get renovated, either.

AND I KNOW SHE BROUGHT THESES PROBLEMS HIGH UP THE CHAIN OF COMMAND.
She did her job but found little support from above.

But Ft. Campbell is getting a new command center - it looks nice, IT's HUGE!! Lot's of money going into that development.

The Army is about people, soldiers, not about machinery or equipment. What good will that equipment be if there are no more soldiers left to use it?

accountability

Walter Reed's Commander just got canned, NOW WHAT?
In the reports yesterday soldiers at WRAMC were being punished for their leaders' failures. The First Sergeant was fired, and now the 2-star General got fired, too.
I wonder about the people in-between . . .
There is quite a large gap in rank-structure and accountability between the Company 1SG and Hospital Commander.
BUT - the burden of Command is great and a new commander may be the right start. I trust that the investigators will discover many systematic failures as well as human failures in this whole mess - after all, someone has to design, implement, and oversee this broken system.
The President was at WRAMC a few months ago. Having prepared for VIP guests at various-level functions I can assume that the preparations made prior to the President's visit included making sure all the "bad things" were covered over.
So, while I believe our President is failing in many ways, in this instance I would not be surprised if the military shielded themselves from looking bad.
And that just goes back to integrity and the lack there-of at high levels of the military chain of command. The really good leaders, the ones who put their troops before themselves, usually get passed-over and forgotten. But that's another rant for another day.
Instead I am left to ponder what will become of military medicine - this shit storm may be the catalyst of change so desperately needed.
The Army Times is doing a great job tracking the problems with disability ratings and other issues surrounding the Medical Evaluation Board (MEB) process.
Hopefully the new governmental leadership will start doing what they were selected to do - fix the broken shit the current administration won't admit is broken.

Government Accountability

I was getting ready to make some phone calls this morning and realised I may be talking to people that need more than just my opinion and my own personal evidence. Believe it or not some people think I am an isolated case and that I "slipped through the cracks" of the system. First of all the system is broken. Second of all there are people forcing us through cracks that need not be in place and are fixable if the right people care enough to fix the problem.

These studies by the Government Accountability Office (GAO) prove that troops feeling "screwed by the system" are not isolated incidents.

When I make my calls today I intend to discuss some of the information I read in these - I haven't finished reading them yet but will post comments when I do read them.

The Army times ran an article about one of these reports a few months ago. It was on page 16 or 18 of the issue about Dress Blues. It wasn't referenced on the front page so I doubt many people read it - I almost missed it myself.


This one is titled Improved Oversight Needed to Ensure Consistent and Timely Outcomes for Reserve and Active Duty Service Members
http://www.gao.gov/new.items/d06362.pdf
It is the GAO Report to Congressional Committees


This one is titled Ensuring Consistent and Timely Outcomes for Reserve and Active Duty Service Members
http://www.gao.gov/new.items/d06561t.pdf
It is the GAO Testimony before the Subcommittee on Military Personnel, Committee on Armed Services, House of Representatives

- Ragin' Ranger Out