When I had a good provider with the VA he would hold up his lanyard that states, One VA, and say what a bunch of bullshit. Which is 100% true. When I was in one region, they looked at my chart, saw I had chronic back pain and offered a civilian chiropractor with acupuncture. I didn't even ask, they just offered it up. Where I am at now, the provider says he can only authorize a chiropractor for acute pain that the regional director sets what is authorized and what isn't.
I have fired so many VA doctors it isn't even funny anymore. When they can't even read labs, spout BS that was disproven decades ago, I give them the boot and get a new one. I am hoping I run out and they just authorize me civilian care. TriCare isn't much better.
There are definitely incompetent doctors all over America, not just VA. Finding one you trust is key, and continuing to push until you get what you need is necessary.
My experience with community care has been essentially I just choose whoever I want, and the VA sends approval to them to see me. It’s never been difficult and I’ve always been able to choose exactly who I wanted from the area.
Tricare is somewhat more restrictive, but still allows for the same flexibility if they can’t get you in timely or don’t have the right specialist.
Shit, my best doctor through the VA so far wasn’t even a doctor, he was just a physicians assistant who “temporarily” took over the spot for 3 years, lol. The dude would listen open-minded, and then research things right in front of me if he didn’t know 100%, and was very receptive to me semi-leading my own treatments.
I’ve heard of issues similar to yours, concerning getting approval to seek outside care, but at the 3 different regions I’ve been a part of, I’ve always been able to find what I needed, eventually. Sometimes it takes some additional prodding, but I do get it.