I have been using VA exclusively for my medical care since January after returning from overseas, and I have had extremely mixed results. Sometimes everything flows together and works just like its supposed to. Other times, not so much. There do seem to be a fair share of people working there just for the paycheck, if you know what I mean. They're not personally engaged with what they're doing or the patients. Then, there are the ones who really care - pretty much like any other hospital or clinic. My current Primary Care Provider (PCP) is a totally by-the-book doctor, who does what the book says and not a bit over. I sort of figure on demanding a different PCP here pretty quick, because she has proven to be less than fully engaged in my health care. When I went in for my first visit with her, she began flipping through the lab results and told me that I was good to go! BP good, A1C (blood sugar) good, cholesterol good, clean bill of health, etc. Then an hour after I got home she called me to tell me that I may have prostate cancer (fortunately, the follow-up test was within 'normal' specs)! I have noticed that when my doc writes a referral, that specialty clinic will make exactly one (1) attempt to contact me (or say that they did, anyway), and that's it. No follow-ups will be attempted, if they are unable to reach you the first time. No email, no text, nothing. Fortunately, I haven't yet had the occasion to sample their emergency care - or lack thereof. The main VA medical center in Houston is 50 miles away, so it's unlikely that an ambulance would take me there.