San Francisco Chronicle – New patients seeking care at the San Francisco VA Medical Center are waiting an average of 29.7 days for their first appointment with a primary care specialist – more than twice the goal of the Department of Veterans Affairs but still shorter than many VA centers in California and the rest of the country.
A nationwide report released Monday by the VA in the aftermath of a patient-scheduling scandal shed light on the depth of the problems inside the agency. It said more than 57,000 new patients have been waiting at least 90 days for their initial appointments, a total that represents about 90 percent of all new patients. Nearly 64,000 other patients who have been enrolled in the system for a decade had not been seen, the report said.
The audit, reviewed more than 730 VA hospitals and large outpatient clinics, also found that 13 percent of VA schedulers across the country said they had been instructed by “supervisors or others” to falsify appointment dates to make waiting times appear shorter.
It found few problems, however, in Bay Area veterans medical centers and clinics – the San Francisco and Palo Alto medical centers, and the Oakland VA outpatient clinic. Despite average wait times for service members that were longer than the federal agency’s targeted goal, no concerns were raised in the Bay Area facilities that would lead to further review, said Judi Cheary, public affairs director for the San Francisco VA hospital.
- 57,000 new patients have been waiting at least 90 days for their initial appointments
- Nearly 64,000 other patients who have been enrolled in the system for a decade had not been seen
“We’ve been working hard to make sure our veterans get access to care,” Cheary said. “We’ll never stop working on the wait times. Our ultimate goal is to get veterans appointments as quickly as we can.”
At the VA Palo Alto Healthcare System, it takes an average of 42 days to get new patients in to see a health care provider, far exceeding a VA directive that veterans be seen no more than 14 days after treatment is sought – a goal the audit said was unattainable.
Hospital officials there said patients have given the hospital high satisfaction scores for access.
“While our access numbers haven’t always been meeting national benchmarks, we’re taking pride in the fact our patients feel they’re being seen when they need to seen.” said Dr. Stephen Ezeji-Okoye, deputy chief of staff at the VA Palo Alto Healthcare System.
In Livermore and Yuba City (Sutter County), VA outpatient clinics will be reviewed further.
In the Livermore clinic, which is part of the Palo Alto system, one employee in the review said he or she had been “instructed to schedule a patient in a way not consistent with the VA or our guidelines,” said Ezeji-Okoye. Ezeji-Okoye said he did not think the problem was systemic, and said the Palo Alto system is requiring employees with access to scheduling to undergo new training.
U.S. Rep. Jackie Speier, D-Hillsborough, said her office has received few complaints from veterans about timely access to care. Still, she plans to schedule two local town hall meetings in July.
“We just need to do a deep dive. While these figures appear to be very good and show responsiveness, let’s make sure that everything is operating effectively,” she said. “If veterans have criticisms or complaints, this is the time to air them.”
Meanwhile, Amy Fairweather, director of policy for Swords to Plowshares, a Bay Area nonprofit that helps veterans with housing, employment training and services, said the national report shows the troubles with the VA system are “more pervasive than we knew.”
“They promised to meet these metrics and then they’re incentivized to meet these metrics to get (a) bonus,” she said, referring to the scheme to falsify scheduling dates.
But Fairweather said her clients have not complained about the local facilities. She said sometimes the veterans have to wait for appointments, especially to see specialists, but overall the care is considered to be timely and of good quality.
“The VA is an enormous bureaucracy. However, the VA medical centers have a good deal of autonomy in running themselves,” she said. “You will find different outcomes. In the Bay Area, the VAs are partners with Stanford and UCSF, which are premier teaching centers, and this is actually a place where people want to be.”
Ron Galvan, of San Leandro, chairman for veteran affairs and rehabilitation for the American Legion in California, said he has sought care at the Oakland VA outpatient clinic for the past decade.
“If I make an appointment, I get it pretty quickly. I haven’t had any problems,” said Galvan, 75, who served in the Air Force.
The report came in the wake of a whistle-blower claim that veterans were dying while waiting for care in Phoenix. The revelations have led to a political outcry over inadequate veteran patient care at VA centers and clinics around the country. Veterans Affairs Secretary Eric Shinseki resigned May 30 amid the scandal.
Waiting for care
Veterans Affairs medical centers have come under criticism for long wait times for care. These are the VA hospitals in California with the longest average wait times as of May 15 for new patients seeking primary care, specialty care and mental health care, according to audit results released Monday.
New patient primary care average wait time
- Greater Los Angeles Healthcare System: 56.2 days
- Loma Linda: 44 days
- San Diego: 43.8 days
- VA Northern California Health Care System: 43.5 days
- Palo Alto: 42 days
- Long Beach: 33.7 days
- San Francisco: 29.7 days
- Fresno: 25.5 days
New patient specialty care average wait time
- Fresno: 61.4 days
- Greater Los Angeles Healthcare System: 55.1 days
- Long Beach: 50.6 days
- Loma Linda: 50.4 days
- San Francisco: 49.7 days
- San Diego: 43.7 days
- Palo Alto: 42.1 days
- VA Northern California Health Care System: 40.3 days
New patient mental health average wait time
- Greater Los Angeles Healthcare System: 39.3 days
- Long Beach: 38.1 days
- San Francisco: 35.9 days
- San Diego: 34.5 days
- Fresno: 30.7 days
- Loma Linda: 27.6 days
- Palo Alto: 25.3 days
- VA Northern California Health Care System: 22.3 days
Source: San Francisco Chronicle, June 9, 2014, by Victoria Colliver; feature image from San Francisco VA