Table 3 Quotes from veterans grouped by theme. Italicized quotes are also reported in the text. Letters indicate specific veterans; multiple quotes were selected from some participants
Access | |
Decreased access | |
Personal barriers | “At the start, I did have to miss appointments because of my job being affected by the pandemic. I had to choose between missing work and missing appointments.”—Veteran A |
Administrative barriers | “I’d call the operator, I’d tell them my doctor’s name, they couldn’t find him, they would transfer me to the clinic, then be on hold at the clinic. Finally, the phone would hang up.”—Veteran B |
It is a problem to have to drive over there and go through the hassle of waiting outside, being screened, and all of that. Sometimes when I think about having to go in, I just want to cancel.”—Veteran C | |
Lack of physician availability | “They are not reaching out like they used to. I used to love my doctors, but they are not on top of their job anymore. They give me less appointments, they forget about me.”—Veteran D |
Waiting longer than normal to be seen | “They had to reschedule a colonoscopy 4–5 times. They had seen a few polyps last time so I really wanted to get it done but had to wait.”—Veteran E |
Unable to get care | “I was supposed to get a mammogram but haven’t heard from anyone.”—Veteran F |
“I haven’t gotten needles in 3 months, I’m having to borrow my husband’s.”—Veteran D | |
No change in access | |
“It’s no different than it was before.”—Veteran G | |
“The only difference is I have to talk to her on the phone instead of going in person.”—Veteran H | |
Satisfaction | |
Less satisfied | |
Understaffed | “Since the pandemic, when I am on the phone with [my PCP] I can tell she seems overwhelmed and overworked. I just feel rushed whenever I am in the hospital.”—Veteran A |
“From the time I called to when I spoke to a nurse, it was an hour and a half…They seem to be very behind and not very well staffed.”—Veteran I | |
“If I got sick I wouldn’t know what to do or where to go.”—Veteran J | |
Telehealth inadequate to meet care needs | “I don’t do videos.”—Veteran K |
“The biggest difficulty has to be with my mental health. I am going to group therapy and it is over the phone now. It’s hard to connect and get all that I usually do out of the program. I would participate more if it were in person.”—Veteran A | |
“I want a face to face with a doctor who will address my issues.”—Veteran I | |
“Sometimes when someone calls to say it’ll be over the phone, I say “the hell with it.””—Veteran L | |
“A lot of people aren’t getting the care they need. They need a more hands-on approach. You cannot take care of a person online.”—Veteran M | |
Expressed understanding about the changes | “It’s literally night and day, not for lack of caring on the part of the doctors and nurses.”—Veteran I |
“This is all over the world. This isn’t just Houston. I understand why I can’t see [my PCP] right now.”—Veteran F | |
“I understand why things at the VA are worse but I’m still unhappy about it.”—Veteran B | |
No change | |
“[My satisfaction] has not really changed…I know [my PCP] is busy, so I lay back until she calls me because I want those who are sick to get the treatment they need.”—Veteran N | |
“I am the type of person that I don’t really complain too much. I figure other people need help right now.”—Veteran O | |
“I’m 100% disabled. I don’t have to be anywhere, do anything. I’ve just been staying at home. Things haven’t really changed.”—Veteran P | |
VHA vs. non-VHA Care | |
Access differences | “The accessibility is the reason I changed. Compared to the VA doctor, I believe he pays me more attention. I feel like the VA doctors have been stretched too thin for years. The primary care doctor on the outside seems to care for me as an individual…I have been very satisfied with all of the VA doctors, it’s just the accessibility that has been difficult…”—Veteran Q |
“I have not had any problem with my primary care doctor or any doctor at the VA before the COVID pandemic. It is just hard to get in there…I feel like I have to see the non-VA doctor more because the VA people keep cancelling…I see doctors out of the VA more because it’s so hard to see VA doctors”—Veteran R | |
Psychosocial Effects of the Pandemic | |
Mental health | “I am extremely stressed out…Not sleeping right. Not eating right…This has been very hard…My mental health has taken a toll.”—Veteran I |
“I have a history of PTSD and anxiety. It has my anxiety at a 10 everyday when I wake up, especially the uncertainty.”—Veteran A | |
“Initially I was really depressed. I’ve been scared to be around other people…I have a lot of mental anguish.”—Veteran F | |
“It’s a lot of stress being in the house cooped up…I would like to go to the park but I can’t walk with my condition. My PTSD is giving me crazy nightmares at night and that is added stress. I lost my…brother…and I couldn’t even go to his funeral.”—Veteran R | |
“I have been depressed a lot lately, just want to be kinda to myself. I can cry at the drop of a dime. Once I get my daughter stabilized, I want to talk to my therapist.”—Veteran S | |
Anxiety about spreading or catching COVID-19 | “I suffer from anxiety attacks. It has increased since corona…I can’t be around anyone because I’m too sick.”—Veteran D |
Social isolation | “I feel like it has restricted me from seeing most of the people I am used to seeing…I stay inside and away from people.”—Veteran T |
“The only thing that has been tough is the socialization. I feel like I am almost isolated at this point. I have a care group with vets for PTSD and I was attending that and it was helpful…We used to meet once a week. That has dried up and that is sorely missed.”—Veteran U | |
“I haven’t been able to counsel men at the Christian drug rehab. I have been home a lot.”—Veteran V | |
Physical inactivity | “It has affected my activities. I used to go out to eat and I used to walk around the grocery store for exercise. I can’t do either of those now.”—Veteran Q |
Financial changes | “At the start, I did have to miss appointments because of my job being affected by the pandemic. I had to choose between missing work and missing appointments.”—Veteran A |
“I did get furloughed when it happened. My mom also stopped working. Besides our jobs, I think this has been a good thing. We have had time to focus on what is important and to become closer as a family.”—Veteran W | |