Thomas W. Stoddert, US Army Retired, is right on every point and I applaud his courage to write a very exacting letter. My tenure at Madigan Army Medical Center as the NCOIC of the Department of Medicine made me aware of mismanaged policies and management issues. I worked with a wonderful staff of professionals and paraprofessionals who conducted themselves very appropriately and courteously, with politeness, knowledge, experience and timeliness. However, all of our efforts were frequently clouded by the frustrations of personnel shortages, ancillary demands of personnel, frustrations secondary to multi-echelon mismanagement issues, and numerous other problems.
The Department of Medicine includes 13 separate sections, clinics, and sub-departments, each with specific medical missions comprised of doctors, PA's, nurses, medical technicians, and support personnel, including military and civilian staff. Some clinics have direct access through central appointments while many others required a referral from the primary care provider. All too often miscommunication between various services and ancillary personnel would complicate scheduling problems. An appropriate example: Patient "A" might be scheduled to see doctor "Z" in a specific clinic, but Dr. Z had to cancel all appointments because he/she had to support another military mission somewhere else on post or deploy to another country.
Frequently, the appointment schedule confusion was not because of medical staffing, but due to Central Appointments or Tri-Care issues for providing less than appropriate information to the patient and the provider. Regardless who was at fault, the senior enlisted member of each clinic, section or department always tried to resolve relevant matters at the lowest level before involving the members of the Patient Representative Office and Patient Affairs Office.
As the NCOIC or the department, I coordinated with the Patient Representative Office and Patient Affairs Office and designed placard's which identified the OIC and NCOIC of each clinic, section and department with a current photograph and a customer service statement bent on resolving problems or complaints at the lowest level. The commanding general at the time accepted the design and ordered that it be implemented throughout the hospital. The implementation was done in 2000 and I hope it is still in place. I am confident that the NCO's and OIC's at each level are fully capable of resolving conflicts and complaints, providing they get support from the senior management of medical care at Madigan Army Medical Center.
On the other hand, I and many others have all too often witnessed many frustrated and dissatisfied patients and family members who lack the patience to allow the system to work as it is designed. These patients complain every chance they get and they become very loud and ugly about it, making treats, breaching the chain of command, and writing letters and memos to anyone who will listen. The members of the Patient Representative Office and Patient Affairs Office do everything possible to bring providers and patients to a equitable arrangement, resolve appointment conflicts and ultimately bend-over-backwards. Still, the patient complains and will ultimately use the same tactic every time they feel the need, regardless of how well or how often they have been treated with the same professional level of care that all patients and family members are given.
I am not blind and I do not wear rose colored glasses. I know there are problems with the management of care at Madigan Army Medical Center and other military medical facilities. However, there is no single mission in the military service that is as resource intensive as the medical mission on a daily basis. Then the medical facilities must comply with and satisfy military and civilian laws, protocols, standards, inspections, and funding agencies. All of this while still supporting the military missions of deployments, training, education, reassignments, and command emphasis issues.
So, yes, a problem exists, but it will take the collective initiative of the soldier's at each facility to make the improvements, with the support of the Army Medical Corp senior management and mass influence of money and personnel.
Sincerely,
Alan B. Candia
U.S. Army (Ret.)
Reader's Response Below
Thank you for your courage to tell it like it is! The General is a good person but what can one person do? Do you know who the members of her so-called command group are? The Deputy Commander for Administration is ineffective, disinterested, weak and lame. The Deputy Commander for Clinical Services is pretty smart but he is a poor leader, has no clue what his subordinates are supposed to do and he is leaving in a few weeks. The Deputy Commander for Nursing is also lame and she is about to retire. The Hospital Sergeant Major is also about to retire! In addition to the problems you described, there are many others. For example, I wish someone would approach Mr. and Ms. Horrell and ask them what they know about nepotism and the merit system! Madigan is a wonderful institution and has many great people but the fat, ineffective and overstaffed upper management needs to replaced and realigned now!
Husband of a very concerned member of the Madigan Team
Question:
I am rated 100% unemployability. My ratings are as follows.
30% for chlorache from Agent Orange exposure
30% for PTSD
40% for diabetes
It also says on my award letter, "No Future Exams."
My question is do you think they can re-examine me in the future and take away my benefits?
Thank You,
Bob Clark
Answer:
Bob, Thanks for writing in to the "Veteran's Voice."
The VA can require a future exam at any time if they feel there may be an issue of fraud or if a gross mistake was made. But generally in cases like yours where they say no future exams,
they mean just that.
The VA can, if they have sufficient reason, propose to lower a rating percentage only if they believe you may have gotten better or something has happened and they have to review
certain awards. This can happen as an example as the result of a mandate from Congress. The issue of PTSD, was getting a lot of nasty attention by the national press and the VA went back and started looking at this issue when it was awarded to non-combat veterans.
However, the general rules are basically after five years, service connection can not rescinded, but the rating percentage can be lowered; after ten years there can be no reduction in the rating percentage or severance of a service connected condition unless there was fraud.
All this to say, if you got a fair rating and they have said no future exams, just run with it. The VA does not like to hassle vets when they do not need to.
Now, the down side, FYI. The VA does routinely check up to see if you are working and so does the Social Security Administration. They both allow you some grace in making some extra income because they know staying home vegetating is harmful. However, 100% unemployability is just that and both agencies frown on a veteran receiving benefits because they can not work and then go out and work full time. So check carefully and see what they allow you. I was told recently that these rules may have changed not too long ago.
Assuming you are not working you may want to consider doing volunteer work in the community and/or working with veterans. Here is where the fun starts. The VA, through the education department, will sometimes purchase items to make a veteran's life more meaningful. In my case they helped me purchase computer equipment so that I can write like I am now and aid other veterans. Now that there is a war on, there are many opportunities to use your talents and experiences for others, particularly other vets.
So good luck and welcome home.
Thom
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What Tony Ton Can Teach Us
By Thom Stoddert
It is not the fact that Tony Ton is recently nationalized and legally living in Seattle that makes him significant; nor is it because he once served in the South Vietnamese Air Force, survived 3 years in a Communist re education/concentration camp, and then navigated a boat with 23 other Vietnamese to a refugee camp in Thailand that makes him special. It is what he can teach us about the price of freedom and patriotism that makes him so important, especially now that we are at war again.
As a teenager he was forced to hide in a cellar while the fighting went on between the US Marines and the Communist forces during the bloody, 28 day battle to liberate the city of Hue, Vietnam. When he was old enough, he joined the battle and entered the air force training as a pilot and navigator in Texas and California, later navigating in C-130s and flying C-119 aircraft. During the last days of the war he was ordered to evacuate with his family from Tan Son Nhut Air Force Base, but in the chaos of the last minute desperation to flee and the carnage of enemy fire, Tony was forced to seek shelter in a village.
After the initial takeover of the former democratic country of South Vietnam by the communist forces, all former soldiers of the south were ordered for three days of citizenship certification at a local school. But this was trick the communist used to learn who was still in the country. Later Tony was ordered to attend 10 days of re-education so he could be politically correct. Instead he was to spend 3 years at indoctrination- concentration camps far from any city or village. Despite being told he could eventually rejoin his family, he was instead forced to live and work in a newly instituted economic zone far from his home in Hue. It was 17 years before his whole family was united again.
When the opportunity arose, Tony chose to risk it all to be free from communist Hanoi’s near total control of the people. He fled, and after spending 7 days at sea, safely reached a refugee camp in Thailand and on to Seattle- penniless. During that post war period it is believed that hundreds of thousands perished attempting to do the same thing.
Upon arriving in Washington State, a relative suggested he assume at least one American name and put out flyers everywhere offering to clean homes, wash cars, and mow lawns to make money to live. Eventually Tony was able to attend the University of Washington where he earned a degree in engineering and then went to work for Boeing - Seattle and the US Patent Trade Mark Office in the other Washington. He now lives in a large beautiful home on the shores of Puget Sound and he is an ecstatic grandfather.
Though, he still struggles with the English language, that has not stopped him from working on projects like the Joint American and South Vietnamese War memorial. Tony and the Vietnamese community are deeply grateful to the sacrifices made by American born veterans for the defense of their homeland and show it at every opportunity. Active duty soldiers are also highly regarded. I was very pleasantly surprised by how many Vietnamese-Americans showed up at various events wearing the diverse uniforms of this country.
How did I meet Tony and his fellow veterans? It was during the counter anti-war protests taking place at Fort Lewis. Sean Penn and his same like-minded friends were trying to demoralize the troops leaving for deployment in Iraq by protesting at the gates along Interstate–5. In a last minute effort by American born veterans to organize and counter-protest the misguided; Vietnamese born veterans showed up en masse to support their fellow vets.
Later I was to find out that the Vietnamese community in Seattle-Tacoma area always invite veterans and active duty soldiers to their ceremonies, whether New Year’s Tet or their Memorial Day. They have consistently shown special honor to those vets who served in Vietnam during the war and I don’t believe that the Seattle-Tacoma communities are the only ones either.
It’s one thing to have someone who doesn’t have a clue what a veteran has sacrificed say “Thank you, for your service,” and something very different when it is a person who lost family and/or spent time in a concentration camp say “Thank you for your service to my homeland.” In this day of political correctness, the Vietnamese are not, they are strongly patriotic to their homeland and as much to their adopted home. They stand with the proper hand position every time the flag passes.
What does Tony’s story teach us today? to value hard work and education. He would also add that the freedoms and prosperity we have achieved in this country are delicate and must be diligently protected. With the current Congress and president, it is a lesson we should take to heart.
Thom Stoddert, former VA Rating Specialist
Bio Here
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