Doctor Shortage Blamed for VA Wait Times Scandal

Friday, 30 May 2014 08:17 AM

By Drew MacKenzie

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The Veterans Affairs scandal stems from an acute doctor shortage, particularly primary-care physicians, in the 150-hospital system, The New York Times says.

Falsified treatment waiting times leading to the deaths of up to 40 veterans at a Phoenix hospital — and possibly dozens of other VA hospitals nationwide — was largely the result of the current VA doctor crisis, the Times reported Friday.

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The beleaguered department revealed that it has been trying to fill 400 primary-care doctor positions. In 2013, the VA employed 5,100 such physicians, noted the Times, citing information from Veterans Affairs doctors, industry experts, and congressional officials.

The VA system has been overwhelmed by the rapid increase of the number of patients waiting for treatment, which includes aging vets from the Vietnam War and younger vets from Iraq and Afghanistan.

"The doctors are good but they are overworked, and they feel inadequate in the face of the inordinate demands made on them," said Democratic Sen. Richard Blumenthal of Connecticut and a member of the Senate Veterans Affairs Committee. "The exploding workload is suffocating them."

The doctor shortage comes to light as President Barack Obama was due to receive a report on Friday from embattled VA Secretary Eric Shinseki on the scope of the fraud and corruption at VA hospitals across the country.

The Times cited the case of Dr. Phyllis Hollenbeck, who took a job as a primary care physician at the VA medical center in Jackson, Miss., in 2008, and quickly found she was working 13-hour days.

After she reported the problem and left the hospital, an investigation found there were not enough primary care doctors at the facility, leading to extensive treatment delays for veterans and inexperienced nurse practitioners taking on the work of doctors.

"It was unethical to put us in that position," Hollenbeck said. "Your heart gets broken."

A report on the investigation into the burgeoning scandal by the VA's inspector general, released earlier this week, found that wait times for doctors were manipulated because performance reviews determined raises, bonuses, promotions, and other benefits.

Florida Republican Jeff Miller, chairman of the House Veterans Affairs Committee,  revealed that whistleblowers at several VA hospitals told his staff they would be threatened by their superiors if they failed to change wait times for doctors.

"Fear was instilled in lower-level employees by their superiors, and those superiors did not want long wait times," said Miller, who is pushing for a criminal probe into the widespread corruption scheme.

"Bonuses are tied directly to the waiting times of the veterans, and anybody that showed long wait times was less likely to receive a favorable review," he said.

Dr. Atul Grover, chief public policy officer at the Association of American Medical Colleges, told the Times there was a simple explanation for the current VA doctor shortage.

"It's just harder to attract physicians to care for more challenging patients while paying them less," he said.

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