Fixing the Roseburg, Oregon Veterans Administration hospital is so important to interim Director Dave Whitmer, he is missing his twins’ senior year of high school back home in Tampa, Florida.
“I made a big sacrifice to come to Oregon,” he told a standing-room-only group of about 50 veterans at the Brookings VA clinic Wednesday evening. “To me, being here and making improvements to a really struggling system … I’m the kind of person who wants to take on these challenges. And I recognize that there are real challenges here.”
In a two-hour town hall meeting, he heard the usual stories — long waiting times in clinics, being kicked off hospital property, phones calls that are never returned, pain medication dosages slashed without talking to patients.
“One thing I love about this community is the passion it has for its veterans,” Whitmer said after the meeting. “When passion isn’t met by service expectations, it’s appropriate to be upset. And that’s what I heard.”
The veterans in South Curry County heard promises from the former director, Doug Paxton, who was fired and replaced four months ago.
Whitmer realizes he has to gain back their trust — he did have them laughing by meeting’s end — and come through on the promises he’s now made them.
He acknowledged, too, that his mindset, coming from a big city where people don’t have to travel far to get health care, is a far cry from the rural needs of veterans in Curry County so he’s had a big learning curve in his work addressing problems.
The town hall meeting brought people from as far away as Crescent City to complain about the usual problems they’ve encountered in the system. But others were unique.
The national opioid epidemic has affected how doctors in the VA system are administering pain killers, Whitmer said, after several people complained that their drug dosages had been cut by as much as 60 percent.
One veteran said a VA doctor told him now that he’s taking steroids, he shouldn’t tell that to a pain specialist to whom he was being referred.
“Is this the kind of medical treatment we’re going to have?” the man demanded. “Without talking to us about cutting our painkillers? Is this the kind of treatment we’re going to have, where we have to negotiate with our doctors to get the pain pills we need?”
Another said he waited two years to have his knee treated, and was told nothing could be done for him because he didn’t bring X-rays with him to the hospital. It was a similar story with the rotator cuff in his shoulder.
“I was basically told I’m an old man, no big deal and get out,” he said. “That’s why we’re frustrated with the VA. The system in Roseburg does not work.”
Another veteran, precariously balanced on a cane, said while waiting 10 years for treatment, the medicine the VA gave him in the interim “killed” his liver. Now, he said he can’t walk or bend over and has calcium spurs on his neck.
“I’m standing because I’m ready to fight,” he said. “I’m not going to lie down and take it. We fought for this g.. d….. country; we deserve some respect.”
Another veteran said he was the only one among his friends who went to Vietnam. His young pals instead drove to Eugene to get a $500 phony medical excuse to avoid service; others fled to Canada.
“If I’d known how I was going to be treated by the VA, I would have run away, too,” he said. “This is criminal.”
Another man pointed to his arm: “I’m losing my arm,” he said, “and they told me I need a colonoscopy. I don’t need a colonoscopy, I need an X-ray. Everyone gives us the runaround. That’s why we all get resentful. That’s why we look at it like ‘you’ and ‘us.” We’re told one thing and they do another. That isn’t the way to treat people.”
Delays, a lack of communication, doctors telling patients they can’t do anything to help; the list goes on and on.
It’s resulted in veterans giving up on the system.
Others have become dramatically sicker waiting.
One said she wouldn’t bring her dead dog for treatment in Roseburg.
What’s done and to come
Whitmer started the evening by informing those in attendance that in the three months he has been in Roseburg, the hospital has been re-rated as a two-star facility.
“That does not compare favorably to other hospitals, he said. “One star isn’t something to be proud of. Our goal is to be five star, to be the best rural facility in the country.”
To that end, he has met with physicians, clinic and hospital administrators in Gold Beach, Coos Bay and Crescent City, encouraging them and those in the private sector to work with veterans so they don’t have to travel the four hours to Roseburg for treatment that’s available on the coast.
In Roseburg, he’s hiring a new chief of staff and a new associate chief of mental health and has accepted an offer to fill a new chief of surgery. A chief of ambulatory and primary care is now on staff, as is a new chief of medicine and someone to mentor him in the VA system. He’s recruiting for a new chief of psychiatry. He’s got a new chief fiscal officer on board, and is looking for a veterans’ experience officer to serve as the middleman between veterans and their doctors.
The last thing he will do in his year in Oregon is replace himself, he said.
“I want and up-and-coming medical director who wants Roseburg to be their first opportunity to be a great director,” Whitmer said. “They’ll probably stay two or three years and move on to a larger facility. I know that will upset some veterans, them using us as a stepping stone, but it’s reality. It’s how some get their start. And my job is to create a great environment for success for that director.”
Whitmer said he is here to help make the rural facilities thrive.
“I don’t want vets to be given a voucher and told to get health care on their own,” he said. “I want to work with our team to get speciality care they need. I believe in that system of health care.”
Mental health care is an area he wants to see expanded, as is patient advocacy. To address the national opioid addiction and abuse problems, the VA has incorporated acupuncture to help those in pain; some in the meeting — their ears dotted with tiny gold studs — said it’s helped them cut back on prescription medications.
Other changes looming
Other changes Whitmer is considering, notably the evaluation of whether to close the Roseburg emergency room at night, weren’t received so well.
Whitmer said they get 35 to 38 patients a day in the emergency room, and two to three at night, which does not, he admitted, make financial sense. Forging contracts with other hospitals, however, could solve the problem.
“This is in step with the last two directors,” said veteran Mike Berns, who has been vocal about problems within the system. “Shutting down vital services should not be dictated by the bottom line.”
If the ER is closed, it will be because it is a patient safety issue, not a monetary one, Whitmer said.
“My principal concern is patient safety,” he said. “There is a financial issue, but the finances don’t drive my decision. And it may or may not happen.”
Other problems Whitmer wants to address are the long travel times to Roseburg, possibly by offering hotel vouchers for those who must undergo certain procedures.