The Atlanta VA Medical Center ranks near the bottom nationally in providing timely appointments to vets needing care and has made little progress toward fixing the problem.
The massive medical center ranked 125th among the nation’s 150 major VA hospitals for the percentage of appointments delayed more than 30 days, according to an analysis by The Atlanta Journal-Constitution of data compiled by The Associated Press.
For Richard Thiede, the delays meant living in pain for weeks. Thiede has the degenerative illness commonly called Lou Gehrig’s disease, and his shoulder was in severe pain when he called the hospital on Feb 15. He said he finally got in to see a doctor for a cortisone shot on Tuesday of this week — 52 days after his initial call.
“Painful — and there’s nothing you can do about it,” said Thiede, a Marine veteran. “I took a lot of (the painkiller) Vicodin, so I slept more. You learn to sleep on your back, not your side, to deal with the pain.”
The AP’s data show that one in every 22 patient appointments in Atlanta took at least a month to fill.
In addition, Atlanta VA officials told the AJC that a national program begun months ago to alleviate wait times — which allows vets to visit a civilian physician — has had a rocky start here.
Atlanta’s sustained poor performance emerges almost a year after a nationwide scandal over long wait times at VA medical centers. At the time, Atlanta had among the longest wait times for new patients in the country. The delays prompted the resignation of the VA’s secretary and a federal investment of $16 billion to fix the problems.
‘We are not where we want to be’
Atlanta VA officials acknowledged that they have made little progress in improving wait times for medical appointments over the past year. They say the hospital and its 13 satellite centers have been inundated with 62,000 additional patient appointments, about a 10 percent increase, since October, compared to the same period the year before.
Dr. David Bower, the Atlanta VA’s chief of staff, said the patient population is growing at twice the national rate. Georgia is home to numerous military installations and the growth may reflect many soldiers coming home from service overseas, he said.
“We recognize we are not where we want to be with wait times,” Bower said, noting that the hospital meets its timeliness standard 95 percent of the time. “We have more patients coming into the system. We’ve been told more vets are moving to the South.”
Indeed, the AP found that many delay-prone facilities are in Southern states, often in areas with a strong military presence, a rural population and significant patient growth. Of the 75 clinics and hospitals with the highest percentage of patients waiting more than 30 days for care, 11 are in Georgia or southern Alabama, 12 are in Tennessee or Kentucky, and 11 are in eastern North Carolina and the Hampton Roads area of Virginia.
Bower said the Atlanta VA system, which serves all of northwest Georgia, is expanding patient capacity at its recently opened Atlanta clinic and has received approval to build another clinic in Cobb County. In addition, the Atlanta system has hired 550 people in recent months and received $10 million for an additional 100 full-time employees.
But change takes time, he said. The Cobb clinic won’t open until 2020. Hiring a single doctor can take months of recruiting and then more time to allow the doctor to fulfill obligations at his current practice.
Pay raises for medical staff
Federal VA officials have approved pay raises for some employees, intended to help retain doctors, nurses and other staff. Recruitment efforts are also being beefed up, including an incentive program that enables the VA to pay up to $120,000 of a young doctor’s student loans.
The AP examined wait times at 940 VA facilities across the country. The analysis revealed that, both nationally and in Atlanta, the percentage of delays had largely remained flat since last summer.
“VA’s chief problem – a widespread lack of accountability among failed employees – is as prevalent today as it was a year ago,” said U.S. Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans’ Affairs. “It’s simply naïve to think these issues will subside in the absence of the thorough housecleaning the department desperately needs.”
The VA failed to meet its timeliness goal, which calls for patients to be seen within 30 days, in 2.78 percent of cases nationally from Aug. 1 to Feb. 28, the AP found. That nearly 3 percent amounted to 894,000 cases.
At the Atlanta facility, 12,894 patient appointments — or 4.5 percent of the total — took longer than 30 days. That analysis looked at the period from September through February. Several of the Atlanta VA’s satellite clinics also had waits above the national average, including those in Stockbridge, Lawrenceville and Austell.
A scramble for mental health services
BriGette McCoy, an Army veteran and advocate for vets, said the long delays are particularly troublesome for those with mental health needs. When a vet is in desperate need of counseling, advocates and nonprofit groups often must scramble to find help for them through support groups and online services.
“I get those text messages from someone who is suicidal and needs help,” said McCoy, a member of the Atlanta Commission on Veterans Affairs. The delays, she added, “are weighing on us very heavily.”
Some of the veterans’ most damning criticism came for the new Choice program, a multibillion-dollar effort to alleviate wait times nationally. Essentially, the program provides a veteran with a card that allows him to seek outside care if he lives more than 40 miles from a VA facility or if his appointment is more than 30 days away.
Thiede, the Atlanta vet who is wheelchair-bound, said he tried to use the program, but his calls to the VA were never returned.
Bower, the VA official, acknowledged that the program has major glitches.
“We can do a better job at education on this,” he said. “There’s a lot of confusion.”
He said the VA will educate employees who can become the “champions” of vets, helping them to navigate the Choice program.
McCoy said she never expected the VA would quickly clean up its mess, but she is seeing some signs of hope.
“It’s a government agency,” she said. “It’s not going to be nimble.”
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