Andy Dunn

Review of VA Portland

This review is for the Portland VA's ER, the syste...

This review is for the Portland VA's ER, the system's only urgent care facility.

When you sign up for health care from the VA, you are assigned a primary care practitioner (PCP), likely to be a nurse. If you are sick, it usually takes at least a few days to get in to see this person, who then mostly farms you out to specialty clinics. After that, and weeks of phone tag, clinic appointments are then scheduled for several months later.

Though it is not well advertised, the emergency room downtown is the only place for "emergent/urgent care" in the VA system. Your PCP might begrudgingly refer you there for urgent or weekend care, but you can go there without the referral as long as you are in the system -- and possibly even if you are not in the system, though I do not know that for sure.

The ER is located just to the left before you enter the lobby on the ground floor of the main VA building. Inside the VA lobby itself, there are usually dozens of sickly looking, mostly elderly vets sitting on chairs and staring out at the gray concrete parking lot and buildings. By contrast, inside the ER waiting room, there is usually nobody, or maybe a handful of people, glumly watching (or ignoring) the ubiquitous Fox News Channel while wearing the annoyed and confused expression common to almost all patients in the VA system.

There are over a hundred thousand vets in the Portland metro area, and though only a fraction are in the VA health system, the inoccupancy of its only urgent care facility seems perplexing -- at first.

You sign in at the desk, where two people sit serving nobody for 98 percent of the time. For the first occurrence (out of about a hundred to come) you are asked to confirm your name and numbers. You are given a wristband to wear with this info as well. There must be a horrible history of patient mix-ups underlying this, but it grows tiresome when every person asks these questions repeatedly.

The check-in person asks you why you are there and tells you to take a seat. This is when you start waiting for long, random periods of time. It is quiet, except for the outraged babble on Fox, as you wait for a half hour to three hours for your name to be called.

You are first summoned into a small closet off the waiting room where a hostile nurse will take your vitals. Woe to you if you have not had your flu shot that year, as all ailments and injuries are then squarely on your head. The pain scale you are asked to rate yourself on makes no sense, as the description for Level 8 says you are too sick to get out of bed. Since you are here, it seems your pain level could not possibly be more than 7, unless you were wheeled in barely conscious. Regardless, you get nothing for the pain.

They may send you back to the waiting room or you might get a golden ticket to finally enter the ER bay. This is like no other ER you have ever been in. Among a handful of patients, there are a dozen or more staff talking leisurely among themselves in the dark roomy space.

You are shuffled into a curtained room for another long wait to see an actual doctor, which we all recognize as the norm of the American health care system.

If you are getting a knife wound stitched or a boil lanced, I trust them to do it competently. If you show up with an immediate life threatening condition, this process would be accelerated. If you are there for urgent care, though -- such as severe flu, pinched nerve, or due to an emerging follow-up symptom which your PCP advised you to come for -- you are treated with some degree of indifference or worse.

There will be long waits for any tests and for any prescriptions and it will be hours before you leave, having received a minimal level of care and a referral back to your PCP to begin the process all over again.

Like me, you may be getting your VA healthcare for free due to the poverty wages of working full time in our tremendous economy. However, like the military institution itself, you are a name and number and nothing more.