I am starting to see an increased number of VA connected Veterans utilizing civilian doctors through their private health insurance for a variety of reasons.Recently, I had the opportunity to be involved in one Veteran’s experience navigating the world of civilian medical doctors. Seeing a civilian doctor is something that is almost second hand nature to those who have not served. Most of us have been seen by a civilian doctor since a young age and learned how to work with a doctor as an independent living skill. Therefore, we have an awareness of when to call a doctor, either for a regular check up or when ill. This basic understanding runs deeper than just scheduling. Civilians have a natural grasp of the process, the doctors’ intentions, and the regular follow ups. Based on my observations of this individual and reports of other Veterans, I would like to offer the following tips to effectively navigate the world of civilian medicine:
TAKE CHARGE OF YOUR HEALTH
Regular check ups are not scheduled for you and sent by notice in the mail. You need an appointment; you call yourself. If you are supposed to follow up, you are responsible to set that appointment. If treating your ailment requires regular intervals of treatment, again, it is not standard practice to send notice in the mail. Yup, you have to make sure you stay on top of it.
TAKING CHARGE COMES WITH CHOICES
It is a lot easier when you’re given an order and it is expected that you follow. When you are in charge of your health (civilian medicine), you have choices. I work with many Veterans who are prescribed medication and afraid to refuse or make it known that they don’t want to take it. Many Veterans are told they need certain testing and they do so because they were told they “have to”. Civilian doctors’ recommendations are just that - recommendations. Refusal of medication or testing comes with no consequences outside of the impact it may have on your health. Requests for exploration of different medications are widely accepted. Second opinion? You get to have those too. Civilian doctors know that it’s just part of the profession. Patients may seek a second opinion and not compromise their relationship with their primary physician. Seeking a second opinion is often a smart idea when dealing with major illness because it GIVES YOU OPTIONS, which allows you to choose what’s right for you rather than just being told what is right for you. It’s always YOUR body in the world of the civilian physician.
DON’T CONFUSE A THOROUGH DOC AS NOT LISTENING
Civilian physicians have much more freedom in their approach to their patients. Go in for a pain in your back and they may draw to test basic blood work. They may discuss potential causes which, to the patient, may seem unrelated. Fairly routine. Underlying causes are also something to consider. Something they can consider. If you feel you are not being heard, you can ask them to take another look, answer your questions, and review your concerns. You are paying them for a service. Collaborate with them rather than follow them. They aren’t a superior giving orders. If you feel you are still not being heard? There are lots of fish in the sea as they say. Go to another doctor. There are plenty and you get to choose who you see.
“If I get treatment and it works, I lose my rating”
When using the VA as a mental health provider, Veterans have been warned that they may not be candidates for certain treatment (i.e., EMDR) because of the fear that losing their VA rating may compromise their ability to progress in treatment. Yes, the general understanding is that your VA disability benefits can be reduced if you get healthier. My research has not yielded any statistics regarding the rate of benefit reduction. My position is: If a Veteran is seeing me (with the exception of being court ordered) then their level of discomfort has reached a point where they want to make progress. A civilian practitioner is usually not connected to the VA or your benefits; hence, the overriding position is to improve your health and quality of life. Feeling better may not be a bad thing.
SOMETHING DOESN’T SOUND RIGHT? DON’T DROP THE ISSUE
Doctors are human. The Veteran who prompted my desire to provide these tips was scheduled for a review of his medical testing with a doctor other than the doctor who initially examined them. This Veteran had been scheduled to see an alternate doctor to accommodate the Veteran’s limited schedule. But when the alternate doctor called to say the Veteran had to see his original doctor, the Veteran accepted this and scheduled an appointment a month out to see the original doctor. Didn’t make sense, but the Veteran did as they were told. Upon prompting, the Veteran called back and explained their confusion. The office acknowledged that the Veteran was correct! Who’d a thunk it. They rescheduled to an earlier appointment with another doctor and things moved forward. Question, question, question. It goes back to taking charge. Trust that you know what you need for your own health