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VA clinic swamped, some say

December 30, 1998|By BRENDAN KIRBY

When Nelson LeHardy's lungs were congested in September he called the Hagerstown Veterans Affairs Outpatient Clinic, only to be told he would have to wait three or four weeks for treatment.

LeHardy, 48, who lost a leg in the Vietnam War, said he felt he needed immediate treatment. He had come down with pneumonia several years ago and has had problems ever since, he said.

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After being told he would have to schedule an appointment for three or four weeks in the future, LeHardy said he went down to the clinic off Pennsylvania Avenue. In the end, he said, he got to see a doctor when another patient failed to show up for an appointment.

"A clinic means you should be able to walk in there anytime and be looked at by a nurse of a doctor," he said.

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The outpatient clinic, which is on the third floor of the Western Maryland Hospital Center, opened in May with much promise for veterans. Previously, they had to drive to the VA Medical Center east of Martinsburg, W.Va., for even basic health care services.

But seven months later, a steady increase in the number of patients combined with a reduction in the number of doctors at the clinic have left some veterans in a frustrating situation: Not sick enough to go to the hospital but sick enough to need immediate attention, some say, they have had to wait days before they could see a doctor at the clinic.

"It was not an emergency, but three or four weeks with pneumonia or a problem I was having, I could have died," LeHardy said.

Veterans Affairs officials said the clinic always has encouraged patients to set up appointments. Katherine Smits, the clinic's coordinator, said doctors will see walk-ins if appointment slots are available.

Smits said a nurse will look at veterans who come in with pressing needs and try to fit them in if it is vital they see a doctor that day.

She said veterans should call to make appointments before they show up.

"We have been extremely busy. Our doctors have been all scheduled," she said.

Carl E. Brumage, 74, a disabled veteran, went to the clinic in November with severe back and shoulder pain.

"They wouldn't give me an appointment until (the next) Monday," he said. "By that time, it almost quit hurting."

William Walters, commander of the Hagerstown chapter of Disabled American Veterans, wrote a letter in October to the Martinsburg VA Medical Center, which runs the Hagerstown clinic.

Walters, 54, a Vietnam veteran who has been paralyzed since he was shot in the neck in 1967, said he waited about a month before VA officials responded.

"Nothing's really improved," he said.

George M. Moore Jr., director of the VA Medical Center, said he has instructed clinic staff to schedule more blocks of time to accommodate walk-in patients.

Initially, doctors from the VA center rotated shifts in Hagerstown so patients could continue to see the same physicians they saw in Martinsburg, Moore said. But officials quickly discovered flaws, he said.

"People don't get sick on the same day," he said.

So Moore said officials staffed one full-time doctor and another half-time doctor, cutting back the number of doctors per day from 2 1/2 to 1 1/2.

To save overtime costs, Smits said the clinic probably will cut back its hours on Wednesdays after the New Year. Instead of being open from 8 a.m. to 8 p.m., the clinic likely will open later in the day, she said.

The volume of patients was smaller than initially anticipated and the clinic was treating far fewer patients per doctor than the VA Medical Center in Martinsburg, Moore said.

"It wasn't a very good use of taxpayer dollars," he said.

At the same time, however, Moore said the clinic has added services.

A social worker, pharmacist and nutritionist work in Hagerstown part of the week and tests to monitor blood-thinning drugs can be conducted at the clinic. In addition, the clinic runs a drug and alcohol abuse program on Wednesdays.

If the average number of daily patients - which Moore pegged at between 16 and 18 - increases sufficiently, the clinic will add another doctor, he said.

"We're constantly looking at this thing," he said.

Not all veterans have complained about the service at the clinic.

Ray S. Linebaugh, secretary of the Washington County Joint Veterans Council, said he has gone to the clinic about five times without an appointment.

"I haven't had a bit of trouble," he said.

But Walters said the clinic needs more staff now.

"They just can't take care of the veterans' needs," he said. "They're just, basically, understaffed for what they are trying to do."

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