VA secretary again expresses regret that his Disney comment caused uproar
By DONOVAN SLACK | USA Today | Published: June 10, 2016
WASHINGTON (Tribune News Service) — Veterans Affairs Secretary Bob McDonald said Thursday that he regrets the way people interpreted his comparing veterans' wait times for medical appointments to lines at Disney theme parks and said he wants the public to know that he takes seriously the challenges veterans face in accessing health care.
“If any veteran or any person in the American public in any way thinks that we’re not serious or any of the VA employees aren’t serious about getting the veterans the health care they deserve, I regret that,” McDonald said after a meeting with the USA TODAY Editorial Board Thursday. “Since I have been secretary, we have been working extremely hard on access to care.”
He said the agency has hired 2,000 doctors and 3,000 nurses, added 4 million square feet of space, extended clinic hours and upped the number of appointments last year by 1.6 million. McDonald explained that he believes measuring how long veterans wait for appointments is important but not the most important factor in evaluating performance. He said organizations in the private sector judge success based on customer satisfaction, and he wants the VA to do the same.
“Really what we’re trying to provide is an experience for the veterans that will cause them to say we’re the best customer service organization in the federal government,” he said. “That’s our vision.”
Some Republican lawmakers, including Missouri Sen. Roy Blunt and Iowa Sen. Joni Ernst, called for his resignation after he said last month that “days to an appointment is really not what we should be measuring . . . When you go to Disney, do they measure the number of hours you wait in line? What’s important? What’s important is: what’s your satisfaction with the experience?”
Ernst called the comments “dishonorable” and Blunt said they were “preposterous” given how long veterans are waiting. As of June 1, more than 500,000 veterans were waiting longer than 30 days for appointments. That number is 150,000 higher than when McDonald took over in 2014.
VA Deputy Secretary Sloan Gibson, who joined McDonald in the USA TODAY Editorial Board meeting, said that’s because more veterans have been seeking care at the VA. He said a third of those veterans are waiting for less urgent care, such as optometry or podiatry appointments. But about 70,000 are waiting for more essential care, such as cardiology, oncology or urology.
McDonald said the VA has conducted two nationwide stand-downs, where the most urgent cases have been addressed, and he said a third is scheduled.
“We’re constantly looking at that list, triaging that list and making sure those who urgently need care get dealt with,” he said.
Some of those veterans may have been waiting much longer than the list suggests. After the wait-time scandal in 2014 — when at least 40 veterans died awaiting care at the Phoenix VA — the VA stopped releasing data showing how long veterans wait between scheduling an appointment and being seen.
Instead, the agency only releases data showing the time between their "desired" appointment date and when they are seen. That measure, however, is subject to manipulation by schedulers and so is unreliable, the GAO and VA Inspector General have concluded.
Fudging those dates was a key way that VA employees falsified wait times leading up to the crisis in 2014, and the GAO recently concluded schedulers have continued to input the wrong dates, hiding how long veterans are waiting.
But McDonald and Gibson said they will not go back to releasing the other data. They said the data is not useful, particularly in cases where doctors have said veterans should return for appointments in six months, for example. In addition, Gibson claimed the media would blow it out of proportion.
He said that when the crisis first broke in 2014 and the VA released an internal audit flagging 111 medical centers for further investigation of potential wait time manipulation, media outlets incorrectly reported that manipulation or falsification actually occurred at all of them.
“We were absolutely so careful to ensure that nobody got the impression that those audit results reflected falsification of data, and yet that is precisely what got reported, and it’s been reported so many times now that it’s a fact,” he said.
In reality, a USA TODAY analysis of 70 wait-time investigations completed as of April this year found that employees at 40 VA facilities in 19 states and Puerto Rico regularly manipulated veteran wait times, and supervisors in at least seven cases instructed them to do it. In most cases, investigators blamed inadequate training and not deliberate fraud.
Gibson said that media reports suggesting it was more widespread or malicious have misled the public.
“Here’s the real tragedy in all of that: When veterans read that kind of crap, they decide they’re not going to come to VA for care, because they won’t get timely care, or they’re going to be cared for by some lazy, corrupt bureaucrat who doesn’t care a whit,” Gibson said. “You go visit people that work at VA in their work environment to find out whether or not they care. They care.”
He worries that giving out more wait time data would lead to similar false impressions.
McDonald said the agency intends in the coming months to release the satisfaction data that he believes is a more important measure of success.
Publicly available data shows less than half of veterans — 48% — report always getting an appointment for urgent care when they need it, according to a third quarter 2015 survey. Some 58% get routine care when they need it. Survey data show VA scores on those measures are 6 percentage points lower than the private health care sector.
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