May 30 8:15 AM

Doctor shortage exacerbated problems at VA

VA Sec. Eric Shinseki testifies before Senate Committee May 2014
Getty Images

The Department of Veterans Affairs is embroiled in a scandal that threatens to claim the job of its secretary, retired four-star general Eric Shinseki, but the VA has faced a much more severe staffing crisis for some time. [UPDATE 11:20 a.m. EDT: Secretary of the Department of Veterans Affairs Eric Shinseki has resigned.]

The scandal revolves around the gaming of patient waitlists at an Arizona VA medical facility, but that is only what happened — why it happened, according to the New York Times, is a window on a bigger problem:

At the heart of the falsified data in Phoenix, and possibly many other veterans hospitals, is an acute shortage of doctors, particularly primary care ones, to handle a patient population swelled both by aging veterans from the Vietnam War and younger ones who served in Iraq and Afghanistan, according to congressional officials, Veterans Affairs doctors and medical industry experts.

The department says it is trying to fill 400 vacancies to add to its roster of primary care doctors, which last year numbered 5,100.

And even when the VA is fully staffed, there are still not enough doctors for the growing numbers of vets in need of help. Primary care physicians were each supposed to be responsible for 1,200 patients, but are now seeing upwards of 2,000.

Combine that with pay substantially lower than the average private-sector doctor receives, and a 20-year-old system that provided performance bonuses for personnel and facilities that cleared patients in less than two weeks and discouraged follow-up visits, and a picture emerges of a VA ripe for cooked books and inferior care.

Not that the shortfalls hadn't been noticed before. A bill that would have provided for 27 new medical facilities, roughly a 20-percent increase in VA capacity, was blocked from an up-or-down vote in February by a series of Republican procedural moves.

GOP senators attempted to use the legislation to make points about the recent budget deal and nuclear negotiations with Iran.

Bernie Sanders, I-Vt., chairman of the Senate Committee on Veterans Affairs, sponsored the February legislation. In the wake of the Arizona revelations, Senate Democrats introduced another bill that not only would fund the 27 new VA facilities, but would attempt to alleviate the backlog by providing access to other government health centers, along with short-term reimbursements for private care, and would try to fill the doctor shortage by offering scholarships and loan forgiveness to medical students in exchange for five years service in the VA system.

But that bill also stalled in the face of GOP senators insisting on a vote on a House bill that focused on making it easier to fire VA officials.

Sanders has vowed to reintroduce the Democrats' legislation June 5, but also says he is open to a compromise that brings relief to waiting vets.


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