So, I had my yearly checkup. You know, that visit with a regular doctor where they’re basically just making sure you’re still alive and not suddenly…less alive than you were previously. A time to get medications changed or renewed.
It’s something that everyone’s supposed to do. Just a once-a-year wellness thing. But it’s an adventure if you’re a veteran.
Let’s kick this off by mentioning one important detail: my appointment was in July.
Let’s step a bit further back, though, to when I first made the appointment. That was at the beginning of June. And…holy shit, this is a mess.
Things have changed a bit since I was first service connected. There was a time when you didn’t make appointments for certain things. You were issued appointments. You got a letter with a date, a time, and a location you better hope was clear, otherwise you might have to call and hope you can find someone who can tell you where you need to go, because if you go to the main hospital and your appointment is at the Fitzsimmons clinic? Well, you’re fucked, because getting there involves Colfax and it’s probably busy.
They eventually switched to a ‘reminder card’ system–and the reminder cards are really quite lovely. They have a map portion on them clearly showing where the facility is, and a nice little request for you to call them because it’s that time again, so make an appointment please.
But we can’t have the same system every year. Oh no. Now, we fuck with what happens when you call in. Now, we fuck with you directly.
Initially, it wasn’t very fun. It was phone tag. Call, leave a message, wait for a call back, hope you don’t miss it.
Then, they consolidated the appointment-making system. You call and get someone in a special stable of phone-people or something, after pressing the number the phone system tells you to press [which may be different this time, because fuck routine!]. This can lead to very long wait times–but they eventually got that callback system that I think I first encountered with Comcast, so you call, either decide to wait for the inaccurate number of minutes because it didn’t seem that long initially but you gave up your chance to get a callback, talk to one person, get your appointment set up, and wait for your reminder letter.
Not the best system, but not what I ran into this year.
This year, I called, pressed what I hoped was the right numbers, and got Person A. I told Person A that I had received my Make An Appointment card. Person A responded incomprehensibly. I asked her to repeat herself.
…and was immediately transferred to…hold music.
Person B picks up.
‘Hi, I’m supposed to make an appointment for primary care?’
What followed was…anxiety. A series of questions delivered so tersely I became worried that I had been transferred to some emergency dispatch system. I answered all the questions about my name, my address, and other details, then asked, “Did I press the wrong number? I just need to set up an appointment….”
Apparently, I did. I was in the right place. Except…this was only step two. I had to be transferred to Person C.
C was able to help me set up an appointment. Just not within thirty days, so she was required to offer to put in a request with Veteran’s Choice.
I declined, because I would rather see the doctor I already know.
Cinematic fade to a few weeks later, when I get a call from the VA hospital. We need to reschedule my appointment, because…my doctor is leaving. Has, in fact, already left. For an administrative job.
I’ve been assigned to a new doctor who cannot see patients past a certain date, so I need to reschedule my appointment.
Oh.
You’d think I would be used to this by now, right? If I haven’t explained in detail, I can at some point, but I’ve been through a few unexpected doctor changes.
Anyway: used to it, I am not.
I make my appointment–just. Traffic was pretty bad that day, and parking was even worse, with quite the line of cars in the poorly-designed parking garage. Just crawling along, looking for spots, trying to get in, trying to get out. Creeping around those terrible corners….
At least all four elevators were working that day. And the guy on the phone was able to tell me for sure where my appointment was–and by that, I mean ‘what floor it was on’, since these details are not included in appointment letters. Last year, my appointment was on a completely different floor. A few years before, it was moved up to the 8th floor [where this year’s was]. Prior to that, it was across town in a building they no longer use.
What the guy on the phone was unable to do was let them know I might be five minutes late, because there is now no way to contact anyone up there, apparently. I certainly don’t have the numbers. I guess they don’t, either.
I don’t suppose I’ll ever see that doctor again. If I do, I’ll be surprised. I think she was new, too. It went normally–prescriptions renewed, old prescriptions re-added because I missed having them on hand when I needed them. Requests put in for a few new braces for some problems that are becoming worse….
Braces I still don’t have, because it’s all done through Prosthetics, and that’s…a subject for another post, probably.
I also requested an eye appointment. My old glasses are super-old, my replacement glasses were wrong, and I missed my chance last year because the calls made me nervous.
This, finally, brings us to the point of this post. Or, very nearly so.
Our VA hospital has no facilities for eye exams. I don’t know if they ever did. My first one, ages ago, was done much like my other appointments of the time. “Report to the designated location at the designated time.”
My second–the one that worked out best for me, in the end–involved sending me paperwork to give to any location that would accept it. I ended up going to WalMart with that, and everything went well.
My third, they called me, and set up an appointment at a place I didn’t know existed, in a strange little office complex. They botched my exam, or my prescription [not sure which], and forced dilation on me after I declined it.
Last year, Veteran’s Choice was a thing, and the setup was handled through that. I did not follow through, though. Why? I mean, I’m obviously crazy and horrible for not jumping at a free eye exam, right?
Well, I did not want to call them back after getting calls, ostensibly from Veteran’s Choice, where all I could hear in the background were children crying and the sounds of children’s television. Like this person was calling from home.
I think they were. If I still had the call records, I would check.
I resolved to take the calls this year, because, godfuckingdamnit, I need glasses. And they are included in my benefits. I suppose I am literally entitled to them or something. And I’m going to fucking get them, and they are going to work this time.
I get the call. On Tuesday. August 2nd. And it was a machine calling me to let me know that they have received a request.
I figure it’s too late to call them back that day, because the VA in general seems to knock off at four at the latest, so I call them back the next day, and press all the required numbers to finally reach a human.
I’m not sure I reached a human….
I mean, I know I reached a human, but…is there a verbal form of ‘uncanny valley’? If there is, I was there, in the nadir, wondering how a 100% natural, organic, free-range, grass-fed human being could be like that.
Every request for information was prefaced with a warning that the information was about to be requested. Every time I gave the information, the response expressed gratitude for giving the information that was asked for.
“I’m going to ask you for your Veteran’s Choice identification number. Can I have your Veteran’s Choice identification number? Thank you for giving me your Veteran’s choice identification number.”
That number, by the way, is completely different from the number the VA uses to identify me. This is mildly confusing, and I would be glad, since the VA ID involves my social security number, but…nope. They have that, too. So it wasn’t for security reasons, unless ‘security reasons’ was because they print that damn number on the flimsy little card they issued when all this rolled out.
I answered a lot of questions I barely remember, all presented in the ‘warning/request’ format. I remember being asked how far I was willing to travel [I don’t know–I’m terrible with the concept of distance], and how long I was willing to travel. That second question was even harder for me. I have almost no sense of time, and the only thing I really know for sure is that travel time from point A to point B in this area can go from ‘five minutes’ to ‘one hour’ based on time of day or random chance.
I was also asked to express a preference regarding the gender of my provider. This actually froze me for a minute. I locked up thinking about it, thanks to all the time I’ve spent on the internet. Running through subroutines of ‘is this an okay question for them to ask? If Other People knew about this question, would it become some big bullshit problem? Oh shit, she’s waiting for an answer.’
There’s a reason for that question, of course. A reason everyone knows, and everyone already talks about, so I’m not going to go into it here. But, it’s a hard question for me, because, while I do feel more comfortable with female providers, my comfort level with them is not perfect, and it tends to go down rapidly in certain situations, for very personal, very personally upsetting reasons.
Where was I? Oh, right. Questions answered. Do I have an appointment at this point? No. My answers will be sent to an appointmenter–an agent in charge of going through a list of providers that work with Veteran’s Choice, to see which fit my very specific criteria of ‘nearish, shortish travel time, female provider of basic eye exams’, and reach out to them in an attempt to make an appointment in the general, cable-company-installation-visit block of time I was allowed to specify. I was told to wait for a call back from them, but, if I don’t hear back in ten days, to call back.
Ten days.
That didn’t even surprise me.
Getting a call back the next day? That surprised me.
The man on the phone–a Darth Vader sounding man who I swear was named Courtney–told me the date and time, and where my appointment was. No address, just a name that I could not make out, and asked him to spell. And then further asked him to spell: ‘Is that ‘Bravo’ or ‘Delta’?’ ‘B as in ‘Boy’.’
…damnit, stop making up phonetic alphabets….
I was told I would get a letter with the relevant information. I asked if I would need to take my confirmation number with me to the appointment.
“No, I’ll transmit that to them now.”
…I’m going to take it with me anyway, because I have some pretty valid trust issues.
And that was it. Three surprisingly rapid phone calls over the course of three days, and an appointment much later in the month was made.
But: there wasn’t a lot of choice involved. Choice isn’t really there at all. I was permitted to choose generalities, but had I wanted a specific provider [like that scary Russian lady who still works out of WalMart], it would be out of pocket entirely, including glasses.
The process doesn’t leave a lot of room for options. You have to pre-qualify by meeting specific criteria, just to gain access to the system–distance to travel to a VA facility, or a waiting period longer than thirty days, I think, is the standard just to get a request into the system. And you can’t use it without that request.
Once that request is in, you’re waiting for them to process it and give you that ‘welcome to our system, please call us back’ call.
Then, you wait more for them to assign you to a provider.
All that waiting has a very real potential to stack up to waiting longer than you would have to see a doctor at the VA itself.
The entire thing left me feeling as if I’d been gently beat about the head with a pillow labelled ‘bureaucracy’, honestly. I’m sure it’s working out well for most people in the system, and I’m betting there are outsiders dealing with the for-profit healthcare industry who think I shouldn’t complain about this, because it’s simple and I’m lucky because I’m not paying, but…I don’t fucking care.
This is something I now have to deal with. Just to get an eye exam. And it feels a little overly complicated, but I can’t explain why.
And the whole thing just makes me anxious and leaves me feeling like things could work better, if not more quickly.
Maybe it’ll improve by next year. This call did come more quickly than last year’s call. Last year’s call was more along the lines of the paperwork they sent–my doctor warned me that those referrals could sometimes take six months. So, things do resemble ‘improvement’–I’m just not sure it’s a real improvement, or if it’s just becoming so complicated that it will fail, and we’ll be left with another empty promise represented by an ever-more-dusty model sitting in an overcrowded atrium.
I think you should feel okay complaining. Look at it this way. If you would pay a Korean kid playing World of Warcraft money to level grind his way through the process in your stead, and that amount of money exceeds the amount of money others spend on health care, you are dealing with an excessive level of fucked up edness.
It’s just that…I don’t know. Maybe it’s that Panopticon thing we were discussing. That sense of ‘I may be watched, so I should police myself’ thing. A thing that my anxiety has been really bad about lately.
How dare I complain when I have free health care? I have a thing that the people around me wish they had, and I’ve never really been in a position where I had to deal with the normal American for-profit system, so I don’t even understand what other people are going through.
That shouldn’t, and likely doesn’t, detract from what I’m going through myself, but that nagging sense of ‘if I step out of line, I will get in trouble’ is there, and it will probably always be there.
But, if I don’t talk about it, maybe it won’t get talked about.
And, if I do talk about it, maybe it won’t be noticed.
I am just one person, whispering into the maelstrom.