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Old 01-07-2024, 07:29 AM
 
Location: upstate ny
174 posts, read 203,707 times
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I'm considering moving to eastern tennessee or western north carolina. I'm trying to get some feedback about the quality of care. I use the va for my primary care dr. now.
thanks
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Old 01-07-2024, 10:49 AM
 
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For whatever reason, even though i am entitled to use the VA System, i just never did until very recently.

It took a while to get the doors open, but now that i am "in" the system my experience thus far has been very good.

Having said that, the local VA Hospital/Campus etc. is large, but not all encompassing and many times they refer "complicated" procedures to an outside local provider.

And having said that, it you requite serious medical treatment...spine surgery, open heart, etc. you probably want to go to a major center like Duke, Vanderbilt, Johns Hopkins etc. and the VA will facilitate such care. The tri cities area is just too small to have higher end medical care for things which are considered of the "major" variety. Whereas specialists in the major medical centers do multiples of the special type procedures each week, the local docs might do one here and there. You want experience, even though the locals will tell you, "Oh, yes, we do that".
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Old 01-08-2024, 07:36 AM
 
Location: TN/NC
35,057 posts, read 31,258,424 times
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I've heard good things about the local VA. My girlfriend's mother at the Asheville VA also had good treatment during the end of her life.

I will say that the local healthcare system, Ballad Health, delivers lousy patient care overall. I worked for them for many years, and quality metrics have consistently declined across the board since Ballad was created in 2018. Specialists see the writing on the wall, and are bailing out to systems that are better regarded in more affluent areas. Clinical staffing levels are very low, turnover is very high, and pay/morale for employees is also extremely low.

The team I was on was nonclinical and worked from home - in saying that, the team of six I was on at 1/1/2023 fully turned over in 2023 (aside from one employee), with two different managers cycling through. This is pretty common, even for relatively cushy office positions that work from home.

While I wouldn't expect an area the size of the Tri-Cities to have a medical center on par with Duke or Vanderbilt, I've also dealt with this system from a patient's perspective with my ex-girlfriend. Even seemingly minor things are often a referral out of area, or the care is subpar. I've transitioned all my medical care outside of this area. The area's medical care should be a lot better than it is.
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Old 01-09-2024, 09:01 AM
 
Location: upstate ny
174 posts, read 203,707 times
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I've been reading a lot about eastern Tennessee health care not being great. I don't understand why so many people are retiring there.
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Old 01-09-2024, 09:29 AM
 
Location: Knoxville, TN
2,539 posts, read 1,907,042 times
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Quote:
Originally Posted by restlessyankee View Post
I've been reading a lot about eastern Tennessee health care not being great. I don't understand why so many people are retiring there.
I am retired and I live in Knoxville. A lot of doctors here are associated with the university. I have had cataract surgery, surgery for a broken patella, physical therapy and have made regular visits to a dentist and dermatologist since I have lived here. I think the care has been very good, with a wide choice of doctors and physical therapists. The situation can be very different in rural areas, where many of the hospitals are on the brink of insolvency. Also, the state did not participate in Medicaid expansion, which could impact care for some people.
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Old 01-10-2024, 02:15 AM
 
Location: TN/NC
35,057 posts, read 31,258,424 times
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Quote:
Originally Posted by restlessyankee View Post
I've been reading a lot about eastern Tennessee health care not being great. I don't understand why so many people are retiring there.
Because people seem to largely be moving here for tax or political reasons. They often don't think of practical things until they're here and have a problem.

A lot of the healthcare issues aren't generally that well-known. Most people don't know where to look for healthcare quality metrics. The mainstream local media is basically in Ballad's pocket, so there's not much in the way of investigative reporting.

My ex-girlfriend had over thirty admissions to Ballad owned hospitals over the years. While some visits were better than others, there were so many issues that Ballad was unable to treat that they were basically a glorified triage center. They wouldn't do a hip replacement on her as a complicated mid-20s autoimmune patient. The only positive thing that I can say is that they knew when they were in over their heads and sent her to Vanderbilt. Any sort of treatment for autoimmune issues in this area is barebones, at best.

I have very bad sleep apnea. My now girlfriend encouraged me to get tested for it. I made an appointment with a Ballad family care doctor (as Ballad employees, getting treated elsewhere was out-of-network on their insurance - another big issue) to get a referral for a sleep study. Weeks, then months, passed. My phone calls were never returned. I finally had to get a sleep test and CPAP done outside of Ballad, at my own expense.

I changed jobs at the first of last year. I was promptly referred by a non-Ballad provider to a non-Ballad sleep clinic in Asheville. That place prescribed an additional CPAP. I had two local durable medical equipment providers not be able to fulfill the order. Again, the order had to be fulfilled in Asheville.

This is basic stuff. The area has a population of ~500,000 - it should not be a challenge to get something as basic as a sleep study and a CPAP order fulfilled, but here we are.

A friend of mine had a weird cancer developed in/near his eyes around COVID. He was sent to Emory in Atlanta. Another friend had eye issues years ago and was sent to UVA-Charlottesville. A former professor of mine had brain cancer, and was largely treated at Duke. My girlfriend's aunt is being treated for cancer at Dana Farber in Boston. I could keep naming people that had to be treated hours away.

It would be one thing if you just needed to drive an hour or so for better care, but we're an hour and a half away from anywhere else of any consequence. The nearest major city, Charlotte, is over three hours away. Nashville and Raleigh are even further.

Yes, there are some structural issues in this area in terms of quality of care outcomes - high rates of poverty and addiction, low rates of typical insurance coverage, poor lifestyle choices, etc. - but a lot of the issues boil back down to priorities in the wrong place.

There is a woman named Dani Cook who has a large following on her public Facebook page. She does a great job of covering the healthcare issues.

Admittedly, I did see a lot of operational practices from the inside as an employee. I brought in a certain software system as my last major project before leaving the organization. I had to train staff repeatedly due to turnover. A few months after I left, a Facebook post when viral where the team I trained contacted the wrong on-call team, and the patient died. This was an issue of turnover, incompetent management, and staff not knowing what procedures to use.

Quote:
Originally Posted by JOinGA View Post
I am retired and I live in Knoxville. A lot of doctors here are associated with the university. I have had cataract surgery, surgery for a broken patella, physical therapy and have made regular visits to a dentist and dermatologist since I have lived here. I think the care has been very good, with a wide choice of doctors and physical therapists. The situation can be very different in rural areas, where many of the hospitals are on the brink of insolvency. Also, the state did not participate in Medicaid expansion, which could impact care for some people.
Knoxville has a major university medical center, more affluent, and Covenant is far more competent and better run than Ballad Health. It's not an apples to apples comparison.
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Old 02-04-2024, 07:12 AM
 
Location: upstate ny
174 posts, read 203,707 times
Reputation: 136
I'm thinking knoxville or west of there. I'm in pretty good health now with a VA hospital about an hour away
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Old 02-05-2024, 01:39 PM
 
8,079 posts, read 10,070,207 times
Reputation: 22669
Quote:
Originally Posted by restlessyankee View Post
I've been reading a lot about eastern Tennessee health care not being great. I don't understand why so many people are retiring there.
IF you are a big user of health care, with serious medical issues which are/might be complicated, then probably East Tennessee is not the right place for you.

The other drawbacks to East Tennessee are the grocery stores are poor, and the restaurants are mediocre.

So, why do people come here?

First, the Environnement is outstanding. Lower humidity than just about anywhere on the east coast, including most of New England. I know, it's hard ot believe but the statistics don't lie. The mountains are terrific, the lakes outstanding, and just miles and miles of gorgeous countryside.

Four seasons, but not wallowing in snow, nor sweltering like you do in Carolina or Central/West Tennessee.

The people are over the top great! Yes, there are a few religious zealots and a number of right-wing nut jobs, but overall, if you stay away from religion and politics the people will embrace you and welcome you in a remarkable manner.

The health care systems are decent for pedestrian treatment. You don't want to get a heart valve done, or a back operated on, but for simple stuff there is more than adequate care. The biggest issue is tha t the provides just don't do enough af anything to have the best equipment and be good at doing the more intricate procedures.

The University and the Health care system bring a great deal of variety in cultures. Ethnic, religious, etc. and it makes it nice to have a diverse population.

You can't beat the income tax situation, and the State Government actually runs a healthy surplus.

So, you hit Wegmans when you travel, you cook at home, and you run up to Johns Hopkins or go out to Vanderbilt if you need serious medical treatment. No matter where you go, there are always positives and negatives. The positives in East Tennessee by far outweigh the negatives and that is why people are flocking here.
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