Former President & CEO, INTEGRIS Health

VA versus Disneyland

Published in The Journal Record
June 1, 2016

Have you ever said anything really stupid? So stupid the moment the words came out of your mouth you wished beyond hope that you could retrieve them?  I believe Secretary Robert McDonald, head of the VA health system, had such an experience.  When questioned about the continued delay in appointment times for veterans at VA facilities his comment was that it was similar to people waiting at Disneyland.   As you can imagine, these comments were received with howls of scorn.  Clearly waiting for a gondola to Space Mountain is not the same as waiting for a medical appointment after a diagnosis of cancer.

I have a little bit of a unique perspective on this subject having been a patient of a VA facility.  After my service in the US Army in Vietnam I had the occasion to use VA facilities with a non-service connected medical problem.  My observations were, at the time, that the VA nurses, doctors, employees were every bit as gentle, kind, and thoughtful as the care experienced in civilian hospitals across the country.  I also observed that care was delivered at a very deliberate and in some cases slow fashion as neither the hospital nor the physicians had the same incentive as their civilian counterparts to move patients rapidly through the medical process.

While my observations are several decades old I cannot help but reflect they might be somewhat instructive in today’s environment. Add to that an incentive system that does not encourage speed and a population that historically has not demanded rapid treatment to the usual bureaucratic entanglements and continued controversy over budgets maybe we should not be surprised the VA is having difficulty in reducing wait times.  There may simply be too many veterans with too many problems for the existing manpower and facilities of the VA.

While we must be vigilant to assure our wounded warriors receive appropriate care, simply getting angry and condemning the system seems self-defeating. I would encourage our political leaders to continue to move significant portions of veterans’ care to the civilian system which has some significant unused capacity.  It may be time to examine the principle that the VA system is responsible for organizing, financing, and delivering medical care.  Perhaps the delivery component could be managed differently, with greater speed, and similar compassion.

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