Army Standardizes Ptsd Diagnosis, Treatment

[JarHed]

On the one hand I can understand that whether it's the VA or psych docs in general, there is a need to have a 'standard' or ruler by which to judge the severity of ones mental disorders. It's the same way that actuaries make decisions on how say insurance companies handle claims of a certain type. That's fine to a point but to use it as a blanket method of determining and giving treatment to all it just doesn't work. It doesn't simply because everyone is different. We may all share similar problems related to PTSD; depression, insomnia, anxiety,ect, but how each of us will react to treatment is usually different. It takes a good psychologist to see that and tailor their treatment to each individual as is needed.

 

[Sarg]

Jar, one of the problems with the VA (or was, I haven't been in one in two years) is the turnover. They get a guy in, he just about learns the ropes, meds available, treatments available, ect., he gets an offer from XYZ hospital for a hundred grand more and splits. I went through three shrinks until I got one that went ten years. The one that lasted ten years was, "UM Hum, UM Hum, here take these. Didn't work? Take these.". I was a walking goddamn chemical experiment.

As far as assessing severity for claims purposes, well I've got real problems there. They use contractors who have experience mainly in deciding private civil disability claims. There's a huge difference in assessing whether a clerk messed his back up as opposed to establishing a severity of PTSD. Totally apples and oranges. But these contractors contribute heavily to political campaigns and hire past VA Secretaries to get the contracts. Nice set up, huh?

In fact, I'm getting growing heartburn over the whole VHS. You remember us Nam Vets clamoring for the VA to privatize so we could get timely, decent health care? It was back in the late seventies, early eighties. "Oh no! Was the push back, only the VA can treat Veteran injuries!!!", NOW, they're fee basing everything out and don't do a damn thing anymore. Check the blood pressure, inspect feet and PCP to fee basis.

I go back to my tired. old slogan...privatize, send em' home with pink slips, bulldoze, issue plastic cards to see the PCP or specialist of our choice. Senator McCain has been repeating the same mantra for as long as I. Naw, better to throw a billion dollar retreat in Vegas.

Sarg

 

[JarHed]

better to throw a billion dollar retreat in Vegas.

Now that would get my vote. Hey I'm with you man. Just saying I understand how they think of us all. Mooooo or Baaaaaaa, as in cows or sheep and lots of them.

Like all gov't departments it's broken.

I'm glad I've got a great psychologist, she not run of the mill as I hear here so much. If she left the VA, I'd go to her privately. So, after more than 40 years of bs, I got one good one. Not bad odds for the VA. Like anything anymore just too much politics and no one that really wants to get anything done.

 

[vikingr12]

I am not sure I believe in privatization when the president of United Healthcare got a bonus of 8 million bucks last year. You can buy a lot of tennis shoes with that. Not many private companies can claim a 20% admin cost for health care. That does not include cost for providers like doctors and nurses. Privatization is corrupt at best and the reason our health care costs are going up so fast. We did try it a while ago and it failed due to its corrupt practices.

The balance has to be in providing good health care at a good cost. Contracting things out definitely does not work. We need full -time people who care. Isn't that the problem with even private health care? Yes, it is.

I hate the VA mostly because it has been so misunderstood by the people who fund it, the Congress, over the years. It's always last on the appropriations list and then they cut it anyway. And the issue of Best Practice comes in too. The VA is a bureacracy and it is the core of its problem. Good ideas like Best Practice are never really paid attention to since they end up being treated like something you have to do to satisfy the Suits. The VA, like many large institutions, is in desperate need of Best Practice. Some new people have no idea what HIPAA is all about. ("Now is your left testicle still hanging too low?" she asked the patient in the full waiting room. I hate that.)

Standardization (as opposed to Best Practice) is something bad when it comes to health care, especially our PTSD problem. I HAD to go to the VA because I was just plain desperate and was told they had no one that had that specialty. I know what then the plan became: put someone, anyone into the position even if he doesn't know anything about PTSD. Standardize the system? BS. Send me to a hospital that DOES have that expertise, even if it is in Tennessee and I am in California. That's all.

But it's hard having any good health care system when the US is ranked 37th in the world for its health care system. Not the insurance system. The health care system. That's doctor care, nurse care, equipment, wait time for surgery, quality and cost of drugs. What's the best? France. And it's compulsury. Denmark has a better health care system than we do. Surpised? So was I.

What the VA is on the path to do will take some time but I don't think they have it when we have so many new patients coming in and the VA still has old ideas about paying their obligations. It's frustrating. I am like Sarge. I stay away until the problem gets better. If I die in the meantime then I guess that's the price I paid for enjoying all that "adventure."

Yeah, right. We are in between a rock and hard on. Nurse! Pour me another one.

 

[Wagon]

I think I'm on about standardization in general..... What is everyone going to do different now? How do you triage? Perhaps they should replicate well thought out battlefield processes and ditch the bullshit. Certainly someone is looking at job functions, tasks etc.... maybe..... kind of....huh?

But what exactly are they doing by standardizing if everyone is different?

Hopefully it is not a rouse to provide cheaper, mass produced care based on a percentage of "success" rates so as to claim a statistical victory.

 

[docboob#49]

I spent 25 years working on Max security psych unit and, although I knew I suffered from PTSD,(Dustoff medic who did 2 tours in Nam) I thought I could handle it. I handled it ok until MS forced me to stop working. Went to the VA and was presented with their 3 "cookie cutter" treatment programs. All the programs required talking about Vietnam which is something I am unable to do.

Is there any help out there for someone who doesn't fit into the VAs cookie cutters?

 

[JarHed]

Hey Bob

Welcome to the forums. Lots a 'nam vets here too. I'm one also. Sounds like you're having a rough go of it. Therapy is still the best way to go. Keep looking till you find the psysch person that will give you the help you need. Guess I've been blessed with a really great psychologist. I went though the PE therapy, prolonged exposure, I hadn't talked about any of my experiences in 40 years. I didn't know if I could or not. It was tough but I'm better now for the work I did with it and her. Hope you find what you need. Try to find something that 'fits' you.

JarHed

 

[Sarg]

Bob, Nam Vet here also, look in your phone book for a Vet Center near you. Vet Centers are an entire different animal than the VA. You can do one on one's, group, what ever fits you. I didn't want to go to group meetings at first but then I just listened and then I opened up a little as the trust grew and now I'm the loudmouth of the group.

You meet some excellent Brothers and Sisters who care about each other and help when we can.

I kept it bottled up and well lubricated with alcohol and all that does is eat you from the inside out. Don't do that to yourself.

Sarg

 

[Jimmy1]

Bob, I am not a Nam vet, but in a way we are all tarred with the same brush.

If you read through the articles you will see there is heaps of help here and there is always someone online to give you an ear to talk to.

Cheers