One of the nice things about my current VA becoming a teaching hospital is that they send more complicated procedures to affiliated local hospitals. I'm having my shoulder replaced Wednesday, and going to a civilian hospital for the first time in 20 years has been rather nice.
The down side was being scheduled for geriatrics to be cleared for the surgery, the upside, is getting clear after action reports within a few hours of my visits/tests on my computer that I don't need a computer degree to decipher.
Interesting times.
Best of luck to you in this venture. My insurance lady had her left shoulder replaced and is doing fine. She told me she thought her shoulder went bad from years of holding plywood and things in building projects with her husband. Her procedure was in a civilian hospital and she adapted to the new shoulder quickly.