boberic Loc: Quiet Corner, Connecticut. Ex long Islander

The Manhattan VA is the best VA center in the City. Mainly because it is located inbetween 2 of the best hospitals in Manhattan. Cornell and NYU

jeep_daddy Loc: Prescott AZ

I saw that episode in which the guy took his own life. I think this happens quite a bit with vets that have seen combat and that there probably isn't too much that can be done about it. Many homeless vets that have seen combat are homeless for this very reason. They can fix a lot of combat injuries but trauma to the brain or psych issues are difficult to treat. It's not like they can just fasten on a prosthesis and send the vet to PT.

That episode was very sad for sure. I do think that if the vet goes to the VA hospital and there are delays in which an appointment is postponed for a certain amount of time, they can refer the vet to a private clinic and the VA will pay. I've received letters to this effect on numerous occasions but never tried it because my appointments haven't been bad and my issues aren't all that time sensitive. Mostly old man prostate issues is what I'm dealing with. I have been to a private eye clinic for an exam and glasses before because of the VA eye clinic being so overworked and appointments so far out.

There was another TV show called New Amsterdam the other night about a vet that needed bladder surgery and the VA couldn't do it so they gave him a voucher to have it done at a private hospital. But the show stated that the voucher only pays 75% and the vet had to foot the bill for the other 25%. I don't know if this is true or not. But if it is, it's wrong because this Viet Nam vet was probably exposed to Agent Orange and as far as I know, just about any vet in Viet Nam at certain times were exposed and any that get cancer are eligible for a 50-100% disability with back pay and a military disability payment for the rest of their life. I know this because a friend of mine was a Ranger in Nam and he got prostate cancer. Because he had it treated and was deemed cured before he went to the VA he was awarded a 50% lifetime disability and got back pay.

therwol Loc: USA

At the HMO I retired from last year, new primary care recruits are offered a $300,000 signing bonus if they stay for 3 years. They will get essentially free medical care for life through the same HMO. They get long term care. They get a company sponsored retirement account in addition to any money they choose to place in a 401k. They will get a generous pension for life after retirement with retirement possible at age 60, but the pension is calculated as if they worked until 65.

In the last three years I worked, up to 50% of the new recruits bailed. Why? Workload. 12 hour days, charting after coming home for hours, answering patient messages, managing refills online, writing letters to go along with lab results etc. Schedules are impossible to keep because of volume. Patients become angry. Dare I say there is no empathy for them when someone is in survival mode and having marital problems over never being available for a spouse and family.

The EMR (Electronic Medical Record) and all one has to do within it has increased workload tremendously. Those nearing retirement when it was implemented were and are just counting the days. Those starting out have the other option, and many take it. Is the grass greener for them anywhere else? I don't know. I retired.

The point is that if you show up for a "physical" or other appointment and have to wait or feel you've been shortchanged on time, your doctor may not be at fault. No one would make a patient wait for hours on purpose. It's a very toxic situation.

Sunnely Loc: Wisconsin

Congratulations on your retirement. Smart move. Good for you.

Your summation is right on - "very toxic situation." A lot people of don't realize that doctors are not machines or programmed robots. (But, won't be surprised if robotic AI MDs replace the human MDs in the future.) Like most of us, they also have families to attend to, friends and other relations to visit and interact with in their lives. Taking work home is a surefire recipe for family relationship dysfunction. One night my wife's family physician called her at around 10 pm to inform her of a lab result done recently. She was very apologetic for the late call due to hectic office schedule that day. (I will surmise this is her regular daily routine and probably, the rest of the family physicians.)

EMR changed the way doctors interact with patients from being personable to an aloof party in the delivery of care. Gone are the relaxed "face-to-face" encounter with the patient now replaced by the doctor-to-computer encounter. Most of the time the doctor listens to the patient but looks at the computer at the same time. You don't dare inadvertently enter the wrong data (or miss it completely) in EPIC as this may haunt you in the future if a medico-legal issue arise.

To the young docs, be wise with your money. Don't spend foolishly. A Toyota or Honda will get you to work and anywhere same as a Mercedez or Porsche. Take advantage of company sponsored 401K (contribute to the max) and open that IRA like, yesterday or last year. Time and compounding are your ally. Social Security may not be there anymore when it's time for you to retire.