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VA Healthcare System Failing Veterans, Study Says

Military veterans experience “excessive wait time” for medical care, leading to higher incidences of preventable hospitalizations and death, according to a scientific research council.

Drawing on the findings of recent government and scholarly studies, a report issued this week by the Institute of Medicine paints a picture of a healthcare system that is understaffed, undertrained, and inaccessible.

For instance, veterans seeking mental-health care at one site had to wait, on average, 86 days to see a psychiatrist, according to the report. And veterans living in rural areas may not have access to any psychiatrists at all, the report said.

The Institute of Medicine’s report comes a couple of weeks after the Government Accountability Office testified that Department of Veterans Affairs (VA) employees manipulated records to understate the wait times for medical appointments. In once clinic, for example, employees made it appear as though there was no wait time when, in reality, veterans experienced six- to eight-week delays for appointments, the GAO said.

Congress commissioned the study by the Institute of Medicine, which is part of the National Academies. The National Academies is a non-profit organization that often provides advice to Congress on scientific and technical issues.

While the Veterans Health Administration (VHA), the healthcare arm of the VA, requires that veterans seeking mental-health care be able to get a doctor’s appointment within 24 hours, the VHA has no “reliable and accurate method” to make that happen, the report said, citing findings from the VA Office of the Inspector General.

Image from the U.S. Marine Corps.

By: Mia Steinle
Investigator, POGO

Mia Steinle, Investigator Mia Steinle is an investigator for the Project On Government Oversight and the civil society coordinator for the U.S. Extractive Industries Transparency Initiative. Her work focuses on government management of the oil, gas, and mining industries.

Topics: Government Accountability

Related Content: Inspector General Oversight, Veterans Affairs

Authors: Mia Steinle

Submitted by Jerry at: July 2, 2014
I fault the Physicians for not standing a higher ground and voicing a need for better health care in VA-medical facilities.
Submitted by Narrative Inquiry at: June 10, 2014
Call for Stories Veterans’ Healthcare on the Home Front Narrative Inquiry in Bioethics will publish a collection of personal stories from war veterans (combat and non-combat)about meeting their health care needs. Veterans’ stories may address a variety of health care needs, and a variety of health care settings. We would like to hear about both positive and negative experiences with health care systems. The stories should give readers a sense of what it is like to try to meet health care needs as a war veteran. We want true, personal stories in a form that is interesting and easy to read. http://www.nibjournal.org/authors/documents/VeteransCall-6-30-14.pdf
Submitted by Bobbie Harrison at: May 21, 2014
I have waited as long as 9 month to get my toes nails cut, I am a diebetic we was told not to cut our own, the person that cut, was sick. kcmo va.
Submitted by Smp1 at: February 26, 2014
Medical records are inaccurate, incorrect, subjective and misleading. Comments made during Dr/Pt meetings often misconstrued within records. On my third attempt to have them amended and information corrected. Care given by most specialty clinics is substandard due to a general lack of communication between physicians and not reading clinic notes. Some physicians, within the same clinic often disagree with test results and/or findings, leaving patient totally confused, not knowing what or who to believe. We are referring to seriously, life altering, progressive, degenerative disorders! Policies and procedures can be changed without any prior notification, where clinic phones are shut off for two weeks and prescribed medications, even "C-2's" are now mailed. Even though they are requested for refill, 21 days in advance, does not mean they are received on time and on a few occasions if they were received at all! Not all medications received require signatures. Primary accused patient of "doubling up on medications, when in fact the four medications in question, could never be obtained from VA, as they were not on their list of formulary drugs, therefore were never dispensed! Neurology ceased treatment of established and documented neurological disorder, diagnosed, treated and monitored for 10 years, by physician outside VA. When neurology ceased treatment, because patient refused a repeat test that was unnecessary, he went back to his outside physician. Did the VA think the patient was going to let that neurological disorder go left untreated because the specialist they hired, was unfamiliar with the disorder (she finally admitted)and was ordering a myriad of repeated tests that would not shed any new light on this disorder? The level of care is beyond substandard, the areas focused on and worried about are minor whereas those of a serious nature are ignored. The new administration, as well as the Chiefs of these clinics have a "closed door policy, whereas they lack the courtesy to even to respond to repeated requests for an appointment to sit and discuss he various issues at hand to find a resolution that would benefit all parties concerned, especially the patient! I have never encountered such a lack of dismissal or unconcern in either government run facilities or the private sector, whereas one would think that someone in a position of authority would welcome the knowledge of knowing where their system has shortcomings that effect the care, well being, the waste of costs, the ineffectiveness that could be changed instead of presuming that a VA a patient and/or their representative is ignorant and unable to ascertain the difference between quality of care and substandard care. If they think that the indifference shown by their total lack of response is going to deter me from addressing these issues,they are in for a rude awakening.They have merely fueled my passion to go forward in the pursuit of rectifying the wrongs that have transpired...for if it has been experienced by one veteran, believe me it has and continues to happen to many.....to those that do not have a voice through an advocte to act on their behalf or perhaps the lack the knowledge of who to call or where to begin..as it is a daunting undertaking.
Submitted by ytrayze at: February 23, 2014
I have two prior honorable periods of service, and will soon have my last period of service characterized for VA benefits, The va is actually trying to tell me that if my last period is characterized as dishonorable for VA purposes, they are planning to deny me benefits for my prior honorable periods, as well. They are actually trying to cheat veterans out of their benefits illegally. (Submitted congressional inquiry, no subversion involved in BCD)
Submitted by bit smarter at: January 24, 2014
I decided to record video of my VA appointment with my phone today. This is because every time I go to the VA for care, they tell me they will do nothing because "I should know the VA" and not expect any care. Then I got home and read the story last month of veterans dying because the VA killed them (did not treat them). Basically, if you want to die, go see the VA doctors or pay for your own private doc. This is the new VA policy according to the video I have. Now I have it on tape and it is going to be released VERY publicly.
Submitted by Jacquelinr Stone at: January 3, 2014
Who served her country… (A gaping hole in the Veteran’s Administration) How could it take all day to attend to a United States Veteran’s mental health’s needs when contacted at 8:30 am, by phone, on a Friday morning, with not even a call back before close of business that day? Left to attend to her own shattered state of sanity and disheartenment, can she ask… Is it factual to emit the feelings of abandonment as the sun goes down and the anguish of the weekend, with no help, draws near? No one even stopped to ask her how she is feeling? Is she to think that someone actually dawned their overcoat, put away her file and comfortably walked to their car and thought, “I’ll take care of it on Monday”, without a care of what would happen to this veteran in need? Wow!!! That blows my mind and saddens me greatly as an American who served her country. Actually, It didn’t take all day. It took “NO” time at all. She was a waste of their time…
Submitted by TheRealTruth at: December 29, 2013
The gold standard for judging the quality of health care: Number of malpractice lawsuits. The VA has many and the US dept of justice maintains a PUBLIC database of all VA (and all federal) lawsuits. Judge for yourself: https://www.fms.treas.gov/judgefund/index.html
Submitted by greg at: December 20, 2013
I tried seeing my doctor, after waiting weeks for an appointment, I found out my doctor had retired, now I'm waiting for to be on a list to get chosen to be appointed to get a doctor. On top of that I couldn't get emergency room treatment because it couldn't get prior authorization, these people want to kill you, just for fun. please stop them.help
Submitted by pateint x at: November 16, 2013
VA is full of union workers. They feel they don't answer to anyone not even Congress, so what else can you expect for health care. Congress needs to get rid of VA and issue insurance cards to its Vets, where they can go to A real doctor and not be denied care. No one should have to deal with such a flawed system of so called health care.
Submitted by John C at: October 24, 2013
Time and time again I leave the VA Medical center feeling I have a label on my records that I'm a germ or something. I don't think my care takers are under any accountability. I feel like I have to be diligent in looking out for my self. Recently I had to stop taking my acid reflux prescription because I was having a skin reaction that wasn't diagnosed by the VA dermatologist. I was given three different topical creams that didn't work. I had to take matters into my own hands and went to Rite aid and bought Prilosec. My skin has cleared up. I also get a lot of test and x rays but never get any helpful results. sometime I feel like they rather have me dead so they can collect there bonuses.
Submitted by snowbound at: September 28, 2013
I can say basic care is good mostly, but.... try this: arm injured, complete rotator cuff tear, given scans and tests and cotazone and 9 months later they were finally going to schedule operation, I had full medical outside coverage the V.A. charged at this time. Out of work, basicly disabled, my wife wants a devorce, so I move out of state. I go to another hospital, two visits in a year, besides meds renewed and flu shoots, no help, so I gave up and went to a different hospital, because of cancelled appointments on their end and no meds for two months. We'll new hospital/primary care are fine, finally get an ortho appointment and get an 3 months pt prescription, which they would not honor. had a cortisone shot because now I had torn the other shoulder. A mericale must have happened while I was not looking; all the ortho documents say"no further action needed" yet I have past documents and history of issues. Liars, CYA staffers waiting to retire while sucking the tits dry. Oooh yeah, if you complain, these are the same animals who will be treating you. Ashamed for them and sorry for other vets. I hope they treat the fallen better, but I have my doubts.
Submitted by Smitty at: September 14, 2013
Civlian doctors who practice civilian medicine on unique soldier (non penetrating)war injuries. Treatment is non existent, or if a test is ordered, it is an X ray designed to detects bone fractures, yet is still used to look at Non Penetrating abdominal injuries. The guidelines state everything is treated, yet the primary has the final say. National studies list open abdominal surgery, for such items as Kidney, Liver, etc., at 1% morbidity. The VA on it's own website lists 30% - 35% morbidity for the same surgery. The VA system is apathetic and designed for residents to perform complex surgery which in turn creates the 30 - 35 % morbidity rate, either operative or post operative. As long as it is near impossible to be fired as a G rated employee of the Government, zero accountability care will continue in this dismal, often arrogant way. The Vietnam veterans were treated with the same pathetic care as the OEF/OIF veterans. The public is apathetic now. If for no other reason than common sense, one would think the heads of all armed forces branches would realize this is the age of computers. This is not just one Veteran complaining, but a vast majority of all Veterans complaining about indifferent, unprofessional, substandard treatment. The Vietnam Veterans did not have the advantage of the computer age. However, a computer is only a tool which needs to be properly utilized. Veterans talking among themselves does not work. Utilizing the computer age to organize not just one million Veteran march to the capital steps, but as many as it takes to stop the travesty that kills more Veterans than the wars. I am sure all Veterans, their spouses, and children, are feed up with platitudes of "yes it is broken, but.....". The Vietnam Veterans marched on Washington to no avail. Perhaps it is time to stop talking among ourselves and start getting the message out, consistently, to the public, who will be apathetic until they realize unless change occurs now, there will no longer be an all volunteer military, which would in tern lead to their son's and daughters being drafted. The draft is not something I want, the military wants, and it is definitely not wanted by the apathetic public. Their apathy will quickly vanish when it is their son or daughter fighting for the freedoms they take for granted. Then and only then will the G system be eliminated, and VA accountability be initiated with top specialists, and not a training ground for residents to practice, substandard doctors, nurses, techs etc. That is a brief outline of how change is initiated and full filled. United, In the computer age, Veterans have the power to initiate change that are in the best interest of our country, the military, and our families. Just my thoughts on how to create rapid change, and eliminate excuses.
Submitted by Charlie at: August 24, 2013
Worst care around... Real
Submitted by jjames0429 at: July 10, 2013
After requesting copies of my medical records from VA recently, to my surprise, I saw comments regarding my health conditions, to include Chronic Kidney Disease. When I inquired about it I was told it was nothing serious and it has been being monitored since 2009. How can any condition not be disclosed to the veteran patient and given an explanation of what the condition is and what the prognosis and method of treatment should be. I also discovered that DKD can be a significant contributor to heart disease which I was discovered to have in 2011. This to me seems like totally unacceptable treatment of the disease and also the veteran. How do I address this issue with someone other than the doctor who failed to disclose it to me?
Submitted by Gumpchun at: July 7, 2013
There is a lot if disinformation and old rhetoric against the VA floating around here that is false. Let's get this straight: the VA Hospitals are some fo the best in America. People are going by a few anecdotes and the some issues with mental health treatment, a separate issue than general health care, to smears a very good system. I know military doctors who are on waiting lists to get into the VA to practise because it is so good now. 25 years ago, they ran from it. Let's stop the easy bashing and recognize some of the most advanced systems and medicine is being practiced and opractices well in the VA. The Best medical Care in the US. How Veterans Affairs Transformed Itself -- And what it Means for the Rest of Us. http://www.dieteticinternship.va.gov/docs/USBusinessWeek.pdf
Submitted by BelgianwaffleIt at: April 27, 2013
The people most deserving of our populatin and government sre those who have stepped up and filled our Military needs. Some return with limbs and mind intact, but many do not! We owe them the very best care, even if it means a lifetime of repair. Get this going pronto!
Submitted by Linda belgianwaffle at: April 27, 2013
It is well past time to fill the wasted time on obstructionist in Congress, to find an appoint Heads for these agencies.
Submitted by Murf at: April 5, 2013
The problem is the corrupt people in the system who are guaranteed a paycheck no matter how poorly they perform. When a whitty , educated person comes along the lazy employees want to get rid of them. They cannot fire the lazy employees becasue they go to there union or make up false reports. The problem is that supervisors spend more time dealing with discipline and trying to get there employees to work rather than helping vets. And if your a doctor you need to "play ball" or the administration will ruin you. Get more qualified peole for our vets. They are actually paying multiple contract employees from outside agencies to sit around and text on there phones just to represent that they need funding. Its no wonder Vets are upset and the country is broke.
Submitted by ChapsBoy at: March 31, 2013
As a Veteran of the Korean conflict' I can say that at one time the VA health service was the best in the world. This really irritated the Health Care industry and so there political allies cut funding at the same time our Commander-in-Chief cut taxes and then started a war with NO WAY TO PAY FOR IT. This resulted in fewer hospitals and much greater patient load. Poor VA hospital care? Thank the radical right in congress!
Submitted by Rixar13 at: March 30, 2013
We're working on it... smile :-)
Submitted by shamrock450 at: March 30, 2013
I am a 73 year old Vietnam veteran and have been treated at the VAMC Dallas Texas, Marion Illinois, and Evansville, Indiana all told for at least 15 years, for Cardiomyopathy, COPD, Bladder Cancer (surgery),neck and back surgery, Carpal tunnel syndrome, and a Myriad of lesser problems, and I have nothing but raves for the treatment I have gotten from VA. I don't think I would be alive today were it not for the care I've gotten there. I do however know that they are seemingly shortchanged with regards to staffing and the influx of new Veterans. They (we) were created by the Government and it should be duty bound to provide the necessary timely and adequate care for us all. As for myself I can only praise the care I've gotten and in a timely, caring matter. thanks, John Hughes Anna, Texas
Submitted by Skyhawkmaintainer at: March 30, 2013
The Veterans Abyss hired the Veterans Examination Service to handle their backlog. My examination from them consisted of a 20 minute interview with a doctor, which wasn't much of an examination. When they first contacted me, they wanted me to drive across the Big Island for this, but I actually had to opportunity to decline and took the next appointment on my side of the island 2 weeks later. If you miss 2 appointments, that claim is dropped. Their slogan is "We're Veterans, We Understand!" Alright, they survived to be Veterans. I suspect (purely an opinion, which I believe I am entitled) what they understand is the more of us they get denied, the more money they get.
Submitted by Zoe at: March 30, 2013
While I don't disagree with you that the backlog is a problem, you're provided Republicans with "evidence" for their argument that the government can't do anything right, and we need to privatize the VA. Conservatives would like any excuse to marginalize government programs and disband the social safety net.
Submitted by Jan at: March 30, 2013
Yep, this happens to everyone that has to deal with the government. My fiance developed (non-psychological) problems in Iraq, he's unable to work, and has had to wait 4 years for his applications for help to be approved.
Submitted by Shaker47 at: March 30, 2013
The spinless cowards on capital hill should be prosecuted for incompetence and immoral behavior. However, in our society they are reelected and given awards. They are the canaries in our sick society. We need to take care of our volunteers, starting yesterday.
Submitted by PERUCHO at: March 30, 2013
I agree with your evaluation, but the PBS/NEWSHOUR/NYC aired a brilliant expose report yesterday( 3/29), including the interviewing of DOVA Secretary Erin Shinseki who tamely agreed with the point of view that points toward a debacle in the system, but that I have the overwhelming suspicion that he as helpless as the PRO GUN CONTROL ACTIVISTS and THE PARENTS OF THE SHOOTING VICTIMS IN THE GUN CONTROL ISSUE AND THE INJURIES AND DEFEATS INFLICTED ON US BY THE POLITICAL DESICION MAKING ESTABLISHMENT. Dear Mia is THAT BADDDDFD!!??!! ELDER PEDRO PEREZ-ORTIZ
Submitted by bullet bob at: March 30, 2013
i a vietnam vet ,the dam gav has never the va the money it need to run this and we lose a hell lot becuse of this,you be lucky if we see any get past they 65 birthday,i 64,i will but none of vet from vietnam ,we group nobody has every care above and we all dead maybe just a million left
Submitted by WolfBrother at: March 30, 2013
The fix for: The Institute of Medicine’s report comes a couple of weeks after the Government Accountability Office testified that Department of Veterans Affairs (VA) employees manipulated records to understate the wait times for medical appointments. Is to very publicly fire the first line, second line, and third line supervisors responsible. ONCE managers and supervisors get the idea that "spinning" poor care into good looking reports will cost them their jobs --- it'll stop.
Submitted by dujaa74 at: March 30, 2013
And you don't know the half of it. http://www.change.org/petitions/american-justice-or-fbi-cover-up#

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