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Care to Rely On

Reprinted from PN/Paraplegia News November 2015

Department of Veterans Affairs Secretary Bob McDonald's first year in office

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This November is slightly over a year since Department of Veterans Affairs (VA) Secretary Robert McDonald took office.

McDonald took his position as the head of the nation’s largest health delivery system on July 29, 2014. The Senate voted 97-0 to confirm McDonald whose previous management experience had primarily been in the civilian sector where he established an outstanding record.  

It was the first time a VA secretary had been appointed who didn’t have a substantial background in the military or veteran sector at either the state or national level. The new secretary has been watched closely to see what he was going to do to fix a seriously broken system.  

I, as a seriously injured veteran, hoped that as we approached Thanksgiving the secretary would be a much-needed gift to us that was long overdue and we could be thankful for President Barack Obama taking action that would help us. Initially, it looked like McDonald was the gift we had been waiting for.  

Congress gave him authority they hadn’t given any prior secretary. He has the authority to remove senior managers from office on the spot and the time they have for appeal has been significantly reduced. The same action is under review by Congress for employees who are further down the management chain than were targeted in the first bill. In my opinion, both actions are appropriate.  

I also believe McDonald has been too cautious in taking action which targets senior managers who are guilty of faulty patient scheduling, appointment delays, manipulation of records to cover such actions and any of the above which resulted in a veteran’s death. During the past year, a total of six senior executives have departed — three were the focus of termination and three were voluntary departures. I would not call this aggressive action.  

One of the local unions which represents VA employees at the central office in Washington, D.C., stated in a July 24 story in the Washington Post that it was unaware of any departures or removals in the central office during the new secretary’s tenure.

Having been involved with veterans issues since the mid-1970s, a significant number of times which were in Washington, D.C., I believe this is where a lot of bad management originates from and where a lot of the bad managers reside.

The secretary has a little over a year remaining to leave a record which he will be remembered for in making the VA a smooth functioning system. He’s not using the limited time he has to do those things which he needs to do. Many veterans in rural locations have to endure poor care by physicians and hospital managers in primary care hospitals who have no knowledge of VA handbook 1176.01 and paralyzed veterans end up with violations of the 72-hour transfer requirement to a spinal-cord injury (SCI) center.

I had a VA physician where I live get in an argument with me when I asked to be transferred to an SCI center in compliance with VA requirements and tell me I was wrong. I had to have a doctor in a SCI center tell him he was wrong. My reward was removal to a small isolation room with no bathroom and insufficient room for my aide to help me.

The doctor told me on the following day he was going on a fishing trip the next week and I could either discharge myself or wait until Monday and start over with a new physician. I don’t call that patient care.

These instances are not unique. We tend to focus on the big hospitals and don’t look at the smaller ones where the abuse is even more rampant. The past practice of transferring bad physicians and bad managers to other locations instead of removing them is demoralizing to both needy veterans and dedicated lower-level VA employees.

Mr. Secretary, if you read this, please by next Thanksgiving, give us something we can be thankful for. Those of us of the Vietnam era are just beginning to hit the VA hospitals in huge numbers. We need assurance that we can rely on them to take care of us. We don’t have that now. 

 

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