There’s an old saying often quoted by executive coaches, bots on Twitter, entrepreneurship circles and dinner tables around the world and while I hate to repeat it, it bears repeating because in my book when it comes to caring for those who’ve worn the scars for the nation, we have a sincere obligation and responsibility. Goes like this, “madness is repeating something over and over and expecting different results.”

Previously, I wrote about how the Portland Veterans Affairs (VA) Medical Center (PVAMC), on the Portland, Oregon hilltop needs to seriously and urgently start taking care of Oregon/SW Washington Veterans’ better in the Pharmacy Department and how we don’t need more security guards, but what we urgently need is a better VA Medical Center pharmacy intake procedure and friendly Pharmacy staff (though one was courteous and heard me out, today).

Thursday, I once again visited the crown jewel to refill on my meds–unusual because the emergency room doesn’t refill meds, this is done at the primary care level–however, I would run out tomorrow, Friday, and I would not be able to wait for 2 weeks until I was seen. To my surprise the Pharmacy Operation is still running business as usual. This is unacceptable and from experience on the military side, from Privates to Generals, we are all held account for lack or lack thereof, and the VA Medical Centers–where tens of millions of American Veterans’ go for their primary, secondary or emergency healthcare– shouldn’t be exempt.

Issue 1: unless Veterans’ or their spouses can read tiny print its nearly impossible to know what the anachronistic 20” TV is for. Nearly everyone in line had no idea what line to get in, or which line was for what, so Veterans’ just got in line to only be yelled out and counseled to take a number moments after and then told, “it will be 45 - 60 minutes.” I had been in/out of meetings all morning and I was wearing my blazer and someone thought I was a greeter (apparently they’ve had them in the past?).


1 - Replace the tiny black/white monitor with a large (pref 40”) flat screen and increase the font.

2 - Run a continuous script or large white/black type above the flat screen, “if your last name has not appeared below, please take a check-in number and provide to drop-off window to initiate service, thank you..”

3 - Eliminate the #1, #2, #3, #4 etc decals above the windows as this adds to the confusion.

4 - Add green/red lights to each window that are activated by the Pharmacy staff behind their respective window and use them.

5 - Implement a 15 (maybe 20) minute rule: if Veterans’ don’t get their meds within 15 minutes of dropping off their prescription, its free.

6 - Meds submitted through the emergency room are automatically entered into the system, no number, no waiting 45 minutes.

7 - Relocate the current PVAMC staffer inside the pharmacy (who doesn’t work in the Pharmacy Dept, oddly) with a Pharmacy General Manager (GM). He/she should have an open door policy and make themselves avail to Veterans’ should the need arise. If the staff is doing splendid, than the GM should have nothing to worry about.

Issue 2: no one should have to leave their Eastern or Southern Oregon home at 2:00 am to make a 9:00 am doctors appointment that lasts approximately 15 minutes and then have to wait 6 hours for meds, only to find out that the meds is for a 30 day supply. In the words of the retired former military intelligence analyst with the U.S. Army, “what in the F___ is this S___.”


1 - Effective immediately, modify the policy so that Veterans’ can visit their nearby Community Based Outpatient Clinic (CBOC) and get their meds there, especially if the CBOC is just a short commute. In this case, from Hermiston to Tri-Cities.

Now I know many of you are shaking your head, “well the doctors really need to visit w/ the patient to determine change of health condition, med dosage etc.,” and my answer is yes, of course, but we shouldn’t mandate a Veteran to make a 5 hour drive to do this and sacrifice an entire day. This is service?

I heard the argument, “well narcotics shouldn’t be prescribed for any more than 30 days” and I heard, “some Veterans’ might be taking advantage of the system and abusing their meds when they don’t need them anymore.”

Today, yet again I was warned, “the VA Center across the river in Vancouver runs a tight ship, nothing like this mess here.” Well so much for coordination, integration and synchronization.

It’s clear that Oregon and SW Washington Veterans’ that go for their primary, secondary or emergency healthcare need bold, decisive and innovative leadership at the Portland VA Medical Center this year, today, not until the next Presidential election or new VA Secretary. Please. Everyone. Get. On. The. Same. Sheet. Of. Music. Thank you.

Originally posted on Posterous

David Molina is an Army Veteran that served from 2000 to 2008, and in support of Operation Iraqi/Enduring Freedom from March 2007 to June 2008 as a Summary Court Martial Officer/S-3 Plans, Training and Operations Officer-in-Charge at the Joint Personal Effects Depot at Aberdeen Proving Ground in Maryland. He receives his healthcare through the VA.