The Fiasco at Walter Reed Hospital

[joeG]

Today, wounded Iraq and Afghanistan veterans testified before Congress about the horrible conditions at Walter Reed Hospital. Rodent and cockroach infestations, black mold, asbestos, and an outrageously byzantine bureaucracy made recovery and rehabilitation nearly impossible for the thousands of troops who wait patiently for medical treatment at Walter Reed and other VA Hospitals around the country. Intrepid reporting--real muckracking--by Washington Post reporters Dana Priest and Anne Hull exposed the deplorable conditions returning soldiers face when they come home from war. Their investigations into conditions at Walter Reed, first published two weeks ago, led to the firing of the Army Secretary, a two-star general, Congressional hearings, and the appointment of two special commissions to further investigate the shoddy treatment of veterans. Since the Post articles shined a bright light on this dark and shameful situation, stories of neglect and substandard care have flooded in from soldiers, their family members, veterans, doctors and nurses working inside the system. No matter what you think about the war, veterans deserve decent health care in return for their sacrifices.

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[GeneralVeers]

While I haven't worked at Walter Reed, I did spend plenty of time at the VA in Indianapolis, a large (approx 200 bed) VA facility. There were no cockroaches, mold, and things seemed reasonably clean. The employees were a big problem though, as the indifference, laziness, and sense of entitlement county employees often had seemed to be magnified. Everything seemed to move in slow motion there.

 

[NinerNiner999]

Today, wounded Iraq and Afghanistan veterans testified before Congress about the horrible conditions at Walter Reed Hospital. Rodent and cockroach infestations, black mold, asbestos, and an outrageously byzantine bureaucracy made recovery and rehabilitation nearly impossible for the thousands of troops who wait patiently for medical treatment at Walter Reed and other VA Hospitals around the country. Intrepid reporting--real muckracking--by Washington Post reporters Dana Priest and Anne Hull exposed the deplorable conditions returning soldiers face when they come home from war. Their investigations into conditions at Walter Reed, first published two weeks ago, led to the firing of the Army Secretary, a two-star general, Congressional hearings, and the appointment of two special commissions to further investigate the shoddy treatment of veterans. Since the Post articles shined a bright light on this dark and shameful situation, stories of neglect and substandard care have flooded in from soldiers, their family members, veterans, doctors and nurses working inside the system. No matter what you think about the war, veterans deserve decent health care in return for their sacrifices.

Anybody have any more thoughts on standardized/national healthcare?

 

[DogFaceMedic]

While I haven't worked at Walter Reed, I did spend plenty of time at the VA in Indianapolis, a large (approx 200 bed) VA facility. There were no cockroaches, mold, and things seemed reasonably clean. The employees were a big problem though, as the indifference, laziness, and sense of entitlement county employees often had seemed to be magnified. Everything seemed to move in slow motion there.

You have zeroed in on the key problem of the gov't -- it is not political or military as such as the civil service mentality. THere is very limited accountability and it is amazing how little can get done with employees more interested in self-preservation of their positions than patient care.

I could go on indefinately at the nature of bureaucracies. It is a conspiracy of the incompetence.

The problems with Walter Reed are near identical with Drew/MLK. Interesting how the media avoided talking about that experiment in gov't healthcare.

 

[met19]

You have zeroed in on the key problem of the gov't -- it is not political or military as such as the civil service mentality. THere is very limited accountability and it is amazing how little can get done with employees more interested in self-preservation of their positions than patient care.

I could go on indefinately at the nature of bureaucracies. It is a conspiracy of the incompetence.

The problems with Walter Reed are near identical with Drew/MLK. Interesting how the media avoided talking about that experiment in gov't healthcare.

if you want to see what the military medical folks are saying...browse on over to the forum here....its pretty agressive on pointing out all the pitfalls prior to the articles.

 

[DogFaceMedic]

if you want to see what the military medical folks are saying...browse on over to the forum here....its pretty agressive on pointing out all the pitfalls prior to the articles.

Actually be wary of what is posted over there. There are legitimately and illegitimately bitter people posting on that site. Legitimate is demonstrating the inadequacy and incompetance of the overly bureaucratic gov't run healthcare (federal or county in my opinion) that is devoid of accountability.

Illegitimate complainers are the whiners who want to be treated as elite and resent saluting RNs -- honestly, several posters complained that saluting RNs had an emotional cost, which blew their credibility.

Much of the problems are why socialized medicine ranges from inefficient and incompetant to nearly evil in the disregard shown patients. That is not to say the current state of private healthcare is adequate -- but that is for another thread.

 

[Dr. Dukes]

Walter Reed and other VA Hospitals around the country.www.nyemergencymedicine.blogspot.com

Walter Reed is run by the Dept of Defense. The VA is run by the Dept of Veterans Affairs. Although they serve the same general purpose, military hospitals and VA hospitals are in no way connected.
Yes, there are problems with the outpatient healthcare at both, but is a symptom of the current executive branch, which runs both Depts.

 

[c.bear]

I believe our VA in San Antonio has unionized nursing that creates some problems.

 

[DropkickMurphy]

Actually be wary of what is posted over there. There are legitimately and illegitimately bitter people posting on that site. Legitimate is demonstrating the inadequacy and incompetance of the overly bureaucratic gov't run healthcare (federal or county in my opinion) that is devoid of accountability.

Illegitimate complainers are the whiners who want to be treated as elite and resent saluting RNs -- honestly, several posters complained that saluting RNs had an emotional cost, which blew their credibility.

Much of the problems are why socialized medicine ranges from inefficient and incompetant to nearly evil in the disregard shown patients. That is not to say the current state of private health care is adequate -- but that is for another thread.

And then there are some who are so gung-ho and eager to please their higher ups that they will gladly bring their own ball gag and tube of KY to meetings with their superiors. Their presence in a very tiny minority does not discount the numerous members of the military medicine forums who have overwhelmingly legitimate complaints as supported by what was revealed recently at WRAMC.

 

[DogFaceMedic]

I believe our VA in San Antonio has unionized nursing that creates some problems.

Yes, all gov't is essentially unionized in its protection of employees, and combined with the inherent nature of bureaucracies at self perpetuation makes for a poor system.

When management is held accountable, then staff will be held accountable. So, firing the generals is a start, but the senior civil servants have to be fired as well. Only then will they fear enough to supervise what is going on. Firing a sniveling servant is difficult, but it can be done when management fears being fired themselves.

I once worked in an excellent union ER as a tech. It had professionals at all levels with an outstanding RN manager and group of charge RNs. The ICU and med-surg were worthless, however.

 

[MirrorTodd]

I believe they're going to be investigating Tripler (the army hospital here in Hawaii) soon enough. The building is old, but is nowhere near as bad a condition as Walter Reed. However, they have had problems with mistakes during childbirth etc. i.e. giving CO2 instead of O2 to a newborn.

 

[racerx]

but is a symptom of the current executive branch, which runs both Depts.

Yes, and I am sure the system was all wine and roses under the previous administration too. We all know that the government was never inefficient, nor the civil servants as sullenly slow before the current administration came into power. Always gotta throw the political insults.

Here's a question. If all of these senators, like Chucky Shumer and John "the cadaver" Kerry really cared about the wounded soldiers, don't you think they would have already have been at Reed? If so, I would think they would have seen the conditions, and done something at that time, rather than waiting for a more politically advantageous time, while the soldiers suffered. I am sure they have received letters of complaint before this from their constituents whose sons/daughters were there and had to deal with the substandard conditions. Why didn't they do something then? They waited until it came out in the press.

They, as the holders of the purse strings, are as guilty as the administration for not exercising the proactive oversite they are supposed to.

 

[nocallaochicas]

since we are already getting polictical here and someone already started bashing the president, I would like everyone to remember - especially when GW and the VP start talking about caring for the wounded in Iraq and how they deserve the best medical care - that just a few years ago the president wanted to cut funding for the VA and other veteran benefits
ncc

 

[DogFaceMedic]

since we are already getting polictical here and someone already started bashing the president, I would like everyone to remember - especially when GW and the VP start talking about caring for the wounded in Iraq and how they deserve the best medical care - that just a few years ago the president wanted to cut funding for the VA and other veteran benefits
ncc

So, we should throw money at a systemic problem? The problems at Drew/MLK, e.g., were not solved by throwing money at incompetence.

 

[Homunculus]

the primary issue raised during all of this was outpatient care-- specifically discharged OEF/OIF soldiers who were assigned to an administrative "medical purgatory" unit (everyone has to be assigned and accountable to a unit, even as a patient). the facility they lived in was disgusting-- WRAMC proper has a few gluetraps and mousetraps scattered about, but is not anything *near* the single outpatient building identified on the news. it has been known for years-- which is why people were fired. instead of owning up to it, they acted surprised. they BS'd and got called on it.

once that was investigated, other stuff came out-- primarily beaurocratic and administrative BS that servicemembers had to deal with in trying to obtain and continue care. the system is overtaxed on the outpatient side-- inpatient care and even primary care clinics operate well. it's the 'tweeners that are getting the shaft (likely everywhere).

the VA is a different system, yes. but it, too was already overburdened just taking care of old farts with BPH. add a huge influx of amputees, TBI's, and people with guts rearranged, and you've got a mess on your hands. these aren't post CVA rehab gomers-- these are young men who are gonna live a long time and are going to be needing complex care. we've advanced our battlefield and combat support hospitals to the point where we're saving an unprecedented number of lives-- at the expense of arms, legs, and cognitive function. until our chronic medical care becomes as good as our acute medical care, this is something that is going to be faced for a long time. and it's good that it's finally coming to light-- because in the military only two things can really make a change-- outside political pressure and outside financial pressure. internal changes, because of the intertia involved, take eons and rarely are across the board changes.

i'm looking forward to seeing what happens.

--your friendly neighborhood army pediatrician caveman

 

[nocallaochicas]

So, we should throw money at a systemic problem? The problems at Drew/MLK, e.g., were not solved by throwing money at incompetence.

Are you actually saying that you agree with cutting veterans' benefits? then, now, or ever?
ncc

 

[EctopicFetus]

Anybody have any more thoughts on standardized/national healthcare?

Not only am I for it, but I think the staff at the hospitals should be so difficult to fire that murder or something similar should be the only way to fire someone. Along similar lines, in order to minimize work performed all labs should be performed every other day. "Stat" labs should take no less than 24 hours and Xrays should be abolished as they simply help the process along. Witch Doctors should be hired and they should sense if fxs pneumos etc are present. Using this system the witch docs should only work 2 hours per day, but only at the oddest of hours.

 

[EctopicFetus]

Are you actually saying that you agree with cutting veterans' benefits? then, now, or ever?
ncc

I think the point is that throwing money at a systemic problem does no one any good. Restructuring is the way to go. Also "cutting" benefits depends on where you are starting from. Again throwing good money after a bad problem doesnt solve anything!

 

[nocallaochicas]

I think the point is that throwing money at a systemic problem does no one any good. Restructuring is the way to go. Also "cutting" benefits depends on where you are starting from. Again throwing good money after a bad problem doesnt solve anything!

I completely understand his knee-jerk response. However, it has no place in response to my statement, unless DogFaceMedic (is that a great Eels reference?) believes that by trying to cut vets' benes the president was suggesting a "restructuring"?

Also, just because there are some problems in outpt. rehab at Walter Reed doesn't mean that the many other vets' benes are great.

My point was that the pres. choose to send more and more troops off to a stupid war in the middle east and repeatedly expressed great gratitute and understanding of their service (which is also laughable) while trying to cut their future benefits.

The Republican talking point of "throwing money" is not a logical response to my point, it is just an emotional response.
ncc

ncc

 

[racerx]

witch docs should only work 2 hours per day, but only at the oddest of hours.

I believe that their union makes this one of the main points of labor negotiations.

 

[DogFaceMedic]

I believe that their union makes this one of the main points of labor negotiations.

Is there an HPSP for witch doctors? sign me up.
As for the other stuff: careful reading would indicate that no comment was made by me regarding veterans benefits. THanks Ectopic for defending my honor (somedays I need all the help I can get.)

It is not the benefits at issue; rather, it is the gov't system that has exceptionally poor accountability for incompetence. Money is not the answer but reform of accountability. I have some thoughts on the matter, and I tried to have an intelligenct conversation in the military med forum with little success - I kept on being insulted irrationally.

Much of the military and veteran system could be outsourced and be more responsive. It is not that contractors are better than civil service, but you can let a contract expire -- for sniveling servants, you have to wait for them to expire.

On a far more serious note: what/who are the great eels?

 

[EctopicFetus]

I completely understand his knee-jerk response. However, it has no place in response to my statement, unless DogFaceMedic (is that a great Eels reference?) believes that by trying to cut vets' benes the president was suggesting a "restructuring"?

Also, just because there are some problems in outpt. rehab at Walter Reed doesn't mean that the many other vets' benes are great.

My point was that the pres. choose to send more and more troops off to a stupid war in the middle east and repeatedly expressed great gratitute and understanding of their service (which is also laughable) while trying to cut their future benefits.

The Republican talking point of "throwing money" is not a logical response to my point, it is just an emotional response.
ncc

ncc

One I am NO republican. 2 throwing money is a logical response to your question. Things need to change. I bet if they privatized this program things would be better. FWIW very few people in congress or lawmakers in general "understand their service" they are nothing more than money grubbing lawyers placed in a political position.

 

[racerx]

Is there an HPSP for witch doctors? sign me up.

Yes, but you can only go into a primary-witchdoctor specialty. You wouldn't be able to go into neurowitchdoctoring, for example. Of course, OB/GYNwitchdocs have always been popular, as there is a big demand for the fertility incantations. Unfortunately, the trial witchlawyers have caused a high cost of liability insurance and many OBshamans have left witchpractice.

Now, back to my studying of chicken bones and potions.

racerx

 

[joeG]

One I am NO republican. 2 throwing money is a logical response to your question. Things need to change. I bet if they privatized this program things would be better. FWIW very few people in congress or lawmakers in general "understand their service" they are nothing more than money grubbing lawyers placed in a political position.

Just so you know, part of the problem stemmed from the fact that they have privatized many of the services and THAT's why there are problems. Privatization has caused all kinds of problems in Iraq, New Orleans and other places where the government could have done a better and more efficient job.

 

[DogFaceMedic]

Just so you know, part of the problem stemmed from the fact that they have privatized many of the services and THAT's why there are problems. Privatization has caused all kinds of problems in Iraq, New Orleans and other places where the government could have done a better and more efficient job.

All of my experience and education has demonstrated that gov't is never better. For every time you can show gov't doing something well or private sector doing it badly, there are thousands of counter examples. And going through the exercise is not worth my time. The civil service is the core of the problem, not the private sector.

The problem with discussing topics with political implications is that no matter how much evidence there is to the contrary, the politically faithful will always throw up some inane piece of rhetoric in defense of how they want to feel. Then when their rhetoric is shown wrong, they will not change their mind, they will come up with some new rhetoric or conspiracy theory. It is easier in political psychology to invent new rationalizations, rather than suffer the wounds to one's own ego that he or she may be wrong.

Aristotle said man is a rational animal. He wasn't quite right: man is a rationalizing animal.

Walter Reed is the result of a poor civil service unsupervised by poor civilian and military leadership.

 

[met19]

Just so you know, part of the problem stemmed from the fact that they have privatized many of the services and THAT's why there are problems. Privatization has caused all kinds of problems in Iraq, New Orleans and other places where the government could have done a better and more efficient job.

that is a good point. There was an article where they privatized the maintainance and cleaning of building 18 (the outpatient hold bldg). prior to that (>1 year ago) there was a staff of 350 military personal to take care of it.

Im not saying they did a good job, but the company whose job it is now replaced them with 100 workers. Clearly that is a HUGE decrease in manpower.....and to make matters worse they probably wanted to barely get by to make a large amt of profit.

So yeah, privatization can be a good thing if the company is responsible but often that is not the case b/c their real responsibilty is to the shareholders and to make a profit rather than give good care.

BTW: there haen't been too many complaints about medical care there. More complaints about administrative, cleaning, and beauricratic bs.

 

[joeG]

All of my experience and education has demonstrated that gov't is never better. For every time you can show gov't doing something well or private sector doing it badly, there are thousands of counter examples.

Sure, I agree -- Nonetheless, there is a fundamental conflict of interest when private (read for profit) enterprises provide basic services that directly affects the life of people. This is what, I believe, plagues our healthcare system. Privitization represents optizmized profits. Consumers (citizens) lose out, executive officers gain. Governement - our money, our solutions.

"Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door."

-Emma Lazarus, carved on the Statue of Liberty​

JoeG

 

[DogFaceMedic]

I think we will have to agree to disagree. Otherwise, we will all end up writing book length blogs about why we think we are right, which I don't have either time to write or read.

I suggest a review of GeneralVeers comments about the fiasco at MLK/Drew - a union run, politically protected excuse for patient mistreatment. And, lastly, I don't disagree with problems with contractors, but you can fire them; you can't fire civil servants.

 

[DogFaceMedic]

I completely understand his knee-jerk response. However, it has no place in response to my statement, unless DogFaceMedic (is that a great Eels reference?) believes that by trying to cut vets' benes the president was suggesting a "restructuring"?

Also, just because there are some problems in outpt. rehab at Walter Reed doesn't mean that the many other vets' benes are great.

My point was that the pres. choose to send more and more troops off to a stupid war in the middle east and repeatedly expressed great gratitute and understanding of their service (which is also laughable) while trying to cut their future benefits.

The Republican talking point of "throwing money" is not a logical response to my point, it is just an emotional response.
ncc

ncc

Who are the great eels (a band?) and why would my image be a reference?

 

[racerx]

Who are the great eels (a band?) and why would my image be a reference?

I think the reference was regarding your handle. I always thought DogFaceMedic alluded to maybe that you were an infantry medic.

dogface = slang for footsoldier
medic = well, medic. . .

regards,

racerx (former 11C20 and 13F30)

 

[DogFaceMedic]

I think the reference was regarding your handle. I always thought DogFaceMedic alluded to maybe that you were an infantry medic.

dogface = slang for footsoldier
medic = well, medic. . .

regards,

racerx (former 11C20 and 13F30)

Not an infantry medic, but I was infantry and now in medicine.
As for the "great Eels" which is a band I have since learned: I'm reluctant to accept my age, since there was a time that even though I may not listen to a band, I at least had heard of them. Now, alas, I know not of what others speak in music. Still, what do the great eels have to do with infantry, medics, or both? maybe I should listen to their music.

I knew a 11C who refused OCS because he thought he would never be free of carrying the base plate. Stethoscopes are lighter.

 

[racerx]

Not an infantry medic, but I was infantry and now in medicine.
As for the "great Eels" which is a band I have since learned: I'm reluctant to accept my age, since there was a time that even though I may not listen to a band, I at least had heard of them. Now, alas, I know not of what others speak in music. Still, what do the great eels have to do with infantry, medics, or both? maybe I should listen to their music.

I knew a 11C who refused OCS because he thought he would never be free of carrying the base plate. Stethoscopes are lighter.

That's why I liked carrying the sight case as a squad leader or the M23 as part of the FDC section. Much lighter. The E-1/E-2 ammo bearers get to fight over the base plate all they want.

I was in so long ago, the biggest system we had was the 107mm (4.2"). Now the US has a 120mm system. Yeah, I'm old.