A look at the idea of "automating inequality."
2 Years Post-Scandal, What's Really Changed At The Phoenix VA Hospital?
Two years ago, headlines about delays in care and secret waiting lists dominated newspapers and airwaves across the country. The story broke wide open after retired Veterans Affairs (VA) physician Dr. Sam Foote blew the whistle publicly with accusations of secret waiting lists and months-long delays in care.
The news was the catalyst for probes into facilities across the country, and later the resignation of then VA Secretary Eric Shinseki. Lawmakers got involved shortly thereafter, and in August of 2014, President Obama signed legislation known as the Veterans Access, Choice and Accountability Act, designed to reform the scandal-plagued agency.
The $16 billion in reforms attempted to do a lot. It gave the agency funding to hire more staff and allowed veterans to seek care outside of the VA if they lived far from a facility or waited more than 30 days for an appointment. It also gave the agency more leverage to fire employees accused of wrongdoing.
So has it helped? For Arizona Sen. John McCain, not as much as he had hoped.
"There has been some improvement," McCain said. "But there is still an enormous amount that needs to be done."
McCain said while he’s happy that veterans now have the option to see providers outside the VA, there are still hundreds of veterans contacting his office with problems.
"I think the first proof of progress will be a reduction in the number of veterans who have to contact our office," he said.
He’s also disappointed in the amount of time it’s taken to fire VA employees implicated in cases of whistleblower retaliation and other issues. A sentiment echoed by other lawmakers in response to the recent news that the Phoenix VA had proposed to fire three high level employees.
Dr. Katherine Mitchell is a Phoenix VA whistleblower who faced retaliation after bringing up issues with understaffing in the ER. She was transferred out of the Phoenix ER and now works in the VA Southwest Regional Office. While she couldn’t comment on specific personnel actions, she said any move to change management is a benefit to veterans.
"I’m still incredibly disappointed," she said
Mitchell said the hospital still has a long way to go. And while it does provide millions of high quality appointments to veterans each year, she said, "unfortunately the cracks in the system are pretty big and pretty deep. So that when someone falls through, the result is not just a delay in care. The result is often death and that’s unacceptable."
She said there are still reports of ER wait times longer than six hours and instances of the VA trying to downplay its problems. But there are some improvements to report.
"The staff is no longer being told to put people on paper lists to avoid putting them on electronic lists," said Mitchell. "There have certainly been some significant improvements in staffing."
Outpatient visits are also up. In 2015, hospital staff completed 60,000 more outpatient visits than the previous year. And as of Feb. 29, the VA reports the average wait time to complete a primary care appointment was about nine days.
"I think there’s no question that we still have things we need to improve at the facility," said Phoenix VA Director Deborah Amdur. "But I think people are very committed to doing that."
Amdur is another noticeable change at the facility and the first permanent director since the agency fired her predecessor in 2014. Amdur said she’s instituting several changes including more process audits and increasing communication with staff.
"But what’s also important is that we sit down and talk about this data together as a leadership team with all of our service chiefs in morning meetings on a very regular basis," she said.
She said changing the culture at the hospital so that employees feel safe to come forward with concerns is a priority, too.
It’s been four months since Amdur started. Whistleblowers, veteran service organizations, and members of Congress say they’re hopeful she can actually institute positive change at the troubled facility, but all of them conclude it’s still too early to tell if that will happen.