Dr. Jorge Gonzalez is known for his passion for concierge-level patient care. It is why patients follow him wherever he goes. It’s also why new patients seek him out. When Mike Radke was recruited to work for Dr. G, he didn’t really know how critical his role would be. Mike was given the responsibility as the liaison between the patient, the insurance companies and the pharmacies. This role was an effort to help patients get the care Dr. G knew they needed. It’s a fight unfit for those battling with neurological conditions just trying to find a path to wellness. They needed help.
That help came in the form of a 24-year veteran of the United States Air Force. Mike was given marching orders by Dr. G to go make sense of an impossible world of paperwork and forms standing in the way of the care his patients needed. Mike said, “We are different here at Dr. G’s office, because we really are about patient care and not the dollars. Dr. G employs me to help facilitate the process to get patients, like the veterans, the medication and care they need.” He added, “It’s a full-time job just trying to navigate the system with them. Imagine if they were trying to navigate it alone. We fully believe we are in this together. Whether Dr. G is praying in his office to help patients fight their medical battles or entrusting me to do what I’m skilled to fight the battles with the insurance companies with them—it really is the highest level of care.”
Almost immediately in his new role, Mike noticed a more troubling trend in veteran care. Mike said, “Due to some changes in legislation a few years ago, veterans could seek care outside the Veterans Administration medical unit and come into Dr. G’s office to receive needed specialized care.” Mike continued, “As a veteran, who suffered numerous injuries and disabilities from combat, I really appreciated the newfound freedom.” The move was a nice step; however, as good as the move had been, Mike noticed getting the insurance companies to approve recommended prescriptions and treatments for these patients was next to impossible.
Mike said “Dr. G would diagnose the veteran patient and then prescribe the treatment the patient needed; however, that’s when the mess really started. The prescription was denied; mountains of paperwork and coding ensued, trying to find the path of least resistance to get the patients the help needed.” Mike went on, “For veterans, it is next to impossible to get the right treatments through the system. When disapproved, it then requires a custom authorization created by the same insurance company, who denied it the first time.”
Mike continued, “I was giving the medication briefing for a patient with migraines. Come to find out, the patient was also a combat veteran. We started realizing how much we had in common, even the timeframe of different operations. In the process, I found out he also suffered from migraines caused by undocumented head injuries in the service. As so many veterans know, you need someone who believes you and is willing to listen in order to get the right treatment.” Mike emphasized, “In the service, if it’s not written it didn’t happen. Documentation is a problem. You are so busy and so focused on the battle you are in, caring for yourself becomes the last thing you are thinking about. You are concerned with your comrades first. The military has a bit of a demented or dark sense of humor. It’s common to say demeaning sorts of comments in regard to health and injuries–so you certainly aren’t recording them all. But, just because they weren’t recorded, it doesn’t mean they didn’t happen.”
That’s where Dr. G is different. He truly listens to the causative circumstances explained by the patients and uses that information to diagnose the problems. It’s a nice feeling just to be heard, much less to get the right diagnosis and recommended treatment. It’s unbelievable what some veterans go through just trying to find a doctor who will listen to them. With Dr. G they were heard; he wanted to prescribe the proper medicine to bring relief to the veteran patient, but it would take an exorbitant amount of work to get it approved. Mike said he works through rigorous amounts of coding, submitting and resubmitting the paperwork to get what is needed. Then he added, “There are so many legislative guidelines that have actually become closer to brick walls between veterans getting the proper treatment and the proper amount of quality care needed.”
“So, as I explained it to Dr. G,” Mike said, “I was given the power to go do something about it. It really came down to someone needing to say something. I’m sure lobbyists are talking in Washington D.C., but we never hear it. It really questions the benefit of those conversations in D.C. if I don’t see any needed changes here in Tulsa, OK. This individual with the migraines said he wanted to do something about it as well. Since he and I had that common bond from a battlefield to a chance meeting in the doctor’s office, I could completely understand his plight.” Mike added.
Mike continued, “So, we worked together. I armed him with the information to take this battle up the chain. We discussed the quality and quantity of care in the VA vs a civilian workforce. We selected the medication for migraines, so that we could show individual results as an example of this study. The veterans aren’t a part of these normal drug studies. So, when a medication has the ability to relieve the veteran of something that is chronic and debilitating—it’s just crazy we can’t get it approved.” Mike added, “Migraine sufferers are really the only ones who understand just how life altering they can be. We are incredibly lucky to have a doctor in Tulsa, who specializes in the care of these monsters—and he wants to provide that needed care to the veterans. So, we really wanted to help get this case heard.”
It is obvious veterans want care beyond what the VA system can afford them. If we can’t get the quality of care we need, what was the point in creating the legislation to allow the veterans to step away from the VA in the first place?” quipped Mike. “It was definitely a double-edged sword.” said Mike. “We knew our office had to be sharper than the legislation to push this level of care to the needed level for veterans. It wasn’t going to stop with the freedom to explore other care. It had to be armed with folks like me, empowered by doctors like Dr. G, taking on the system to get that needed care approved and paid for by the system. The VA have traditional medicines but unfortunately those medicines are often dictated by a federal budget and not by the need of the patient.” he said. “Their physicians care changed but the company that approves the payment of the insurance and the treatments allowed didn’t.” Mike ended.
Mike’s plight was just the beginning. “I had a chance meeting with someone I was able to help bridge that gap. I helped sharpen their sword or figuratively put a bigger round in their gun.” Mike went on, “I fear we are now in a situation where we are just at the tip of the iceberg with different types of care needed for veterans based on the last 20 years of conflicts.” Mike added, “With operations and conflicts such as Desert Shield/Storm, Kosovo, Afghanistan and Iraq, those individuals are either retiring or getting older and now their service-connected signs and symptoms need more attention, specialized attention. Now that they can get specialized care outside of the VA—the way they are going to pay for it should be two steps ahead of them and right now it’s five steps behind.” Mike closed, “Veterans need Dr. G and our office to help get us the care we need and the help to navigate the war for coverage. It’s a sword this office is honored to take up in the fight. We never leave anyone behind, and we’ll never quit fighting the good fight.”
Dr. G operates a concierge neurology practice off of 68th and Yale. He’s also launching 3 new research study for migraine sufferers, Alzheimer’s/dementia, and seizures in 2019. If you or someone you love suffers from any of these afflictions and want to be part of the study, just reach out at firstname.lastname@example.org.
Community Spirit with Dr. Gonzalez’s office reached out and received a great response from Congressman Kevin Hern’s office. We’re looking forward to watching all of these amazing hearts work together to see what they can do for veterans:
“Congressman Hern is the son a of 22-year Air Force veteran, so he had a first-hand look growing up at the many sacrifices that military members and their families make every single day for our country. Because of this experience, the Congressman has a special place in his heart for helping our veterans.
While we may sometimes disagree on the methods, both sides of the aisle seem to agree that our veterans deserve the best care we have to offer. I believe the thousands of dedicated individuals working on behalf of veterans in our federal system, along with members of Congress from both parties, are always willing to listen to new ideas about providing the best service to our veterans.
Our office, like many, has a full-time staffer focused solely on providing answers to veterans about their benefits, making inquiries on their behalf, and helping them navigate the federal process. We can’t promise outcomes, but we certainly take enormous pride in being able to assist our veterans in any way that we can.”
-Robert Aery, District Director for Congressman Kevin Hern