Pity the Docs Who Work for the VA


The VA is still in trouble.   Is that a surprise to anyone?  As the NY Times reports, the number of veterans on waiting lists of one month or more is now 50 percent higher than it was during the height of last year’s problems. Even better, the department is also facing a nearly $3 billion budget shortfall.  So, what’s the plan? Well, “the agency is considering furloughs, hiring freezes and other significant moves to reduce the gap”.

Wasn’t the government supposed to fix this?  Yes.

Since the waiting-list scandal broke last year, the department has broadly expanded access to care. Its doctors and nurses have handled 2.7 million more appointments than in any previous year, while authorizing 900,000 additional patients to see outside physicians. In all, agency officials say, they have increased capacity by more than seven million patient visits per year — double what they originally thought they needed to fix shortcomings.

But what was not foreseen, department leaders say, was just how much physician workloads and demand from veterans would continue to soar — by one-fifth, in fact, at some major veterans hospitals over just the past year.

So, the way to fix this was overworking the doctors and nurses more and more.  If you know the doctor lingo at all then here is a number to chew on.  The docs had to increase their RVUs by about 20%.  That’s a lot. The bottom line is that the number of new patients seeking treatment has increased more and more and these types of patient have lots of problems.  When they finally get in to see the doctor they “have a lot of catching up to do” (Animal House reference). With less and less funding you have then have a recipe for disaster.

How about the doctors, who work at the VA, speaking up?  You rarely see it because they are afraid:

Last year’s waiting-list crisis led to complaints that the department was divided by an acrimonious and retaliatory culture, where whistle-blowers were punished and constructive criticism was stifled.

In summary, we have another VA tsunami coming.  Pity the patients who are going to the VA.  Pity the nurses who have to slave over them.  And, lastly, pity the doctors working there or who are thinking about working there. These poor bastards are going to drown.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Pity the Docs Who Work for the VA

  1. Dan
    June 29, 2015 at 11:30 pm

    my favorite VA experience was being called by a nursing assistant because my patients temp was only 74 degrees (no other vitals taken)… He was noted as “sleeping comfortably” in every nursing assessment for the prior 12 hours…

    With further cut-backs, I can only imagine that care will get worse….

  2. Pat
    June 23, 2015 at 11:30 am

    The VA model is our future. Start laughing.

    • kurt
      June 24, 2015 at 2:30 pm

      Respectfully Pat,

      No its not. They’ll be no MD’s in primary care anymore to abuse. They’ll just
      leave it to the LELT’s. By that time, all the LELT’s will have prescribing privileges and
      no longer need a “supervising” doc. There won’t be any pri care docs left. Kurt

      • Pat
        June 25, 2015 at 1:46 am

        Kurt, of course you’re right. It’ll be a LELT-powered VA. Fun fun.

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