Legislation to improve VA Healthcare - Boston Globe

In effort to fix woes in VA care, Moulton taps own experience

The Boston Globe

Ex-Marine tells of litany of gaffes

Representative Seth Moulton introduced several bills to revamp veteran health care.

By Jessica Meyers GLOBE STAFF JUNE 05, 2015

WASHINGTON – Seth Moulton had earned two medals in Iraq for his valor. He’d witnessed brutal combat in four tours with the Marines. But none of that mattered when he showed up at the Veterans Health Administration hospital in Washington, D.C., where staff could not find records.

“We’ll consider taking you as a humanitarian case,” a hospital staffer told Moulton, unaware that the would-be hernia patient was also a newly elected Massachusetts congressman.

Thus began Moulton’s frustrating experience with the Veterans Affairs health system, a personal sampling of a chronically troubled medical bureaucracy that has drawn complaints from veterans, demands for improvements from Congress, and multiple investigations.

“If it wasn’t so sad, it would have been comical,” Moulton said in an interview as he recounted his VA odyssey.

In addition to enduring missing records and computer glitches, Moulton said, he was prescribed the wrong medicine, which in his case did not imperil his health but is in the category of a medical error that can be extremely dangerous in some cases, even fatal.

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The VA refused to discuss Moulton’s case, citing patient privacy laws, even after Moulton gave the administration written and verbal authorization to do so.

Moulton’s encounter with the VA health system led to his first legislative initiative — a package of bills designed to strengthen training and recruitment of VA health care professionals.

‘I was probably getting far better care than the average patient at the VA. And yet they still sent me home without the proper medicines.”

A congressional physician tried to steer Moulton away from any Veterans Affairs hospitals when he showed up in the Capitol clinic, days before his Jan. 6 swearing-in ceremony, with a hernia that had resulted from weight lifting. The doctor didn’t know where a VA facility was located and suggested George Washington University Hospital — or anywhere else, Moulton said.

His wasn’t the only warning. Members of Moulton’s platoon told their own horror stories, which they relayed to one another through Facebook chats. Moulton had also followed news reports of fumbled service.

But the Salem Democrat wanted to see how the VA treated patients, so he put himself forth as a sort of guinea pig — arriving at the Washington DC VA Medical Center a few miles north of the Capitol without announcing he was a congressman and without remembering his VA identification card.

He checked in, sat down in the waiting room, and listened to patients compare the length of their waits. Six hours. Seven. About half an hour into his own wait, an attendant came over to the 36-year-old and said the hospital couldn’t identify him as a veteran.

The VA staff could not find any record of his checkups at the VA hospital in Boston, Moulton said.

“There was a part of me that wanted to say, ‘Just Google me,’” Moulton said, from his Capitol Hill office strewn with books about the Middle East and photos of top US generals.

He kept quiet.

Employees did manage to reach the Boston hospital. Staff there offered to fax his information.

The two Washington workers looked at each other, according to Moulton’s retelling. They looked at the fax machine.

‘“Does that thing even work?’” Moulton recalls one asking.

The other man threw up his arms.

“I doubt it.”

Employees finally did get the records transferred, although Moulton doesn’t know how. It probably didn’t hurt that a congressional physician also called the VA hospital and then showed up unrequested to monitor the exam, Moulton said. The lawmaker said he lost track of time but estimated he waited an hour or two for the preliminary exam.

The congressional physicians’ office declined to comment, despite Moulton’s authorization to discuss his medical situation.

His outpatient surgery took place at the VA hospital several days later, after his pain-filled swearing-in ceremony. The operation went smoothly, and Moulton applauded the anesthesiologist and surgeon, who came in on a day she wasn’t scheduled to work.

“It’s the doctors themselves that are trying to step beyond the bureaucracy,” he said.

Then a more serious problem became apparent.

The medical center pharmacy was supposed to supply Moulton with periodic doses of Percocet, a painkiller, to ease the post-surgical pain. Moulton took one pill and sat down for a staff meeting in his new office. Still suffering, he decided he needed another and reached for the bottle. He looked down at the pill in his fist. It was Advil, a weaker painkiller than Percocet.

Moulton called the hospital. The pharmacy was closed.

“The really sad part is, at this point, they did know I was a congressman, so I was probably getting far better care than the average patient at the VA,” Moulton said. “And yet they still sent me home without the proper medicines I needed after surgery. The system truly is broken and needs to be fixed.”

Gwendolyn Smalls, a Washington DC VA Medical Center spokeswoman, confirmed Moulton’s visit and said it takes “any allegation seriously.” She said privacy laws prevent officials from commenting further.

“Our primary concern is providing quality health care to our nation’s heroes, and Representative Seth Moulton is certainly deserving of that care,” she said.

The Department of Veterans Affairs operates the largest integrated health care system in the country and serves more than 8 million patients. Supporters point to the thousands who receive expert operations and quality medical assistance, often out-performing private organizations.

But issues within the sprawling system of 152 medical centers continue to reinforce an image of severe mismanagement. Veteran Affairs Secretary Eric Shinseki resigned in May 2014 after reports revealed employees’ attempts to cover up excessive wait times and delayed care in medical facilities from Phoenix to Fort Collins.

The Federal Bureau of Investigation launched a criminal investigation the next month into the department and the president signed legislation into law in August intended to speed up appointments and fund reforms.

Moulton’s story did not surprise the Marines from his platoon, who correspond almost every day through their Facebook group.

“Everybody has got their own [story],” said Nick Henry, 31, who served with Moulton and now lives in California. Henry suffers from recurring back pain. He needs to see a physical therapist in the system to get chiropractic care, but the first available appointment is two months away.

“Somebody described it to me once: You need to know the right handshake to get things through,” he said.

Moulton’s package of bills seeks to improve the quality of VA hospitals through stronger recruitment efforts, training scholarships, and the expansion of a student loan repayment program for health care workers. Any changes would take funding from existing programs.

These bills, a small patch in the VA’s gaping hole of bureaucratic problems, could struggle to gain traction amid the priorities of more senior members. But they establish a career focus for the new congressman and tie him to a high-profile bipartisan cause with which he is personally familiar.

Moulton used a Red Sox broadcast on Memorial Day weekend to call for improved veteran care.

He acknowledges the bills make incremental changes but considers them a starting point.

“If the VA can’t take care of Iraq and Afghanistan veterans today, it’s going to get far, far worse,” he said. “Nothing makes up for the failures.”

Moulton plans to remain a patient at the VA — all the better to monitor its risks and progress.

Jessica Meyers can be reached at jessica.meyers@globe.com. Follow her on Twitter @jessicameyers.