V.A. doctors see half as many as private practice

Remedy sought for long waits for vets to get government care


WASHINGTON – Doctors in the Veterans Affairs system see an average of 10 patients a day — about half as many as physicians in private practice — despite a wait list for appointments, and members of Congress want to know why.

V.A. leaders are working on an answer. They are assessing provider capacity and developing new productivity standards that take into account the tie and intensity of medical services, agency leaders told a congressional panel Monday.

“The difference between this estimated capacity and our current work load represents the amount of additional care we could potentially absorb to address veterans waiting for care,” said Thomas Lynch, assistant deputy secretary for health for clinical operations.

House Veterans Affairs Chairman Jeff Miller said that work should have been done long ago and that he doesn’t know whether he can trust the department’s data after recent investigations revealed what he called a systemic lack of integrity.

“How can Congress, the American taxpayer and our nation’s veterans and their families have any confidence?” he asked. “If there were actions that V.A. could have taken to increase access to care for patients, why were those actions not taken long before now?”

A 2012 study commissioned by the nonprofit Physicians Foundation showed that doctors who own their own practices see about 22 patients per day and others employed in the private sector see about 18 per day.

Dr. Lynch apologized for the problems that began to come to light in Phoenix, where agency workers are accused of falsifying paperwork to conceal long wait times for appointments that sometimes exceeded a year.

“This is a breach of trust. It is irresponsible. It is indefensible. It is unacceptable,” Dr. Lynch said. He said the practices are not consistent with the V.A.’s values and that the agency is working to fix them.

Agency patients are typically older and have more complex medical issues that require longer appointments. And in some cases, he said, facilities don’t have enough exam rooms or enough support staff to allow them to see more patients.

The hearing came as outrage over the V.A.’s problems intensified because of new accusations that the agency downplayed whistle-blowers’ concerns about improper handling of surgical equipment, the hiring of unqualified practitioners, neglect of psychiatric patients, and about violations of agency policies regarding the rescheduling of cancelled appointments. The U.S. Office of Special Counsel raised the concerns Monday in a letter to President Obama.

Lawmakers have been trying to legislate a fix but so far have not been able to agree.

The Block News Alliance consists of The Blade and the Pittsburgh Post-Gazette. Tracie Mauriello is a reporter for the Post-Gazette.

Contact Tracie Mauriello at: tmauriello@post-gazette.com, 703-996-9292, or on Twitter @pgPoliTweets.