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VA's acting chief tours Baltimore medical center

The acting secretary of veterans affairs said Tuesday that the agency would add more primary care physicians to the Maryland VA Health Care System to help reduce the long waits for veterans seeking appointments with doctors.

Acting Secretary Sloan Gibson said the agency would also add $500,000 — a 40 percent increase — to help veterans facing delays seek private care.

Gibson, who replaced the embattled former Secretary Eric K. Shinseki last month, visited the Baltimore VA Medical Center a week after a nationwide audit showed that veterans in the Maryland system face the fourth-longest wait to schedule a first-time visit with a primary care doctor.

The VA health care system has been rocked in recent weeks by revelations of long waits and allegations that staff at some facilities have falsified records to hide delays. Eighteen veterans at a VA facility in Phoenix died while waiting to be seen.

"We have a lot of work to do," Gibson told reporters after meeting privately with veterans and staff. "Veterans deserve action now."

VA officials said the visit was part of a series that Gibson plans to make over the next several weeks to speak with veterans and employees directly.

He said the VA is hiring five primary care physicians to help the 37 now seeing patients in Maryland. Each will see an average of 1,200 patients a year.

Gibson said he chose Baltimore because the waits here are too long. But he commended the staff for accommodating veterans who come to the clinics without appointments.

"They keep capacity available," Gibson said. "That's a good thing. I call that a best practice. But that doesn't erase the fact that we've still got too many veterans waiting too long for care."

Veterans in Maryland were waiting an average of 80 days to see a primary care doctor for a first visit, according to the Nationwide Access Audit conducted May 15 and released last week.

That was longer than veterans in other large cities were waiting. Wait times averaged 64 days in Atlanta, 60 days in Dallas and 59 days in Boston.

Honolulu had the longest wait, at 145 days.

Most appointments in Maryland — 96 percent — were scheduled within 30 days. These included patients who were not making a first visit and those who were not seeing primary care physicians.

The VA provides care for 55,000 patients in the state. They wait an average of four days for a primary care appointment, five days for an appointment with a specialist and about 21/2 days to see a mental health professional.

The VA offers medical, surgical, rehabilitative, mental health and outpatient care. It operates the Baltimore VA Medical Center, the Perry Point VA Medical Center, the Loch Raven VA Community Living & Rehabilitation Center and six outpatient clinics.

The average wait for a new patient in Maryland to see a specialist was 44 days. The average wait for a new patient to see a mental health provider was 32 days.

Veterans made more than 693,000 outpatient visits at Maryland VA facilities last year.

VA officials say the audit found no inappropriate scheduling practices in the Maryland system.

Rep. Elijah E. Cummings, a Baltimore Democrat, said he was encouraged by the number of Maryland veterans who have chosen to stay in the VA system rather than see other doctors. Gibson said most Maryland veterans contacted by the VA have chosen to keep their appointments rather than seek care elsewhere.

The VA has $1.25 million to help Maryland veterans get care outside the system. Gibson said Tuesday that the agency would boost that by $500,000.

Officials said the Baltimore VA Medical Center would also resume Saturday hours for primary care appointments.

Bill Turenne, a spokesman for Concerned Veterans for America, said the long waits in Maryland speak "to how broken the VA health care system is."

"The notion that simply hiring five new doctors or throwing some money around will fix the problem is absurd," Turenne said. "Until ... Gibson realizes that the problem is within the bureaucratic culture of the Department of Veterans Affairs itself, he's no better than the man he replaced."

The added staff and money were the latest in a series of intended fixes Gibson has introduced. Others include a program to measure patient satisfaction, mobile medical units to see veterans, the suspension of senior-level bonuses and a hiring freeze for the VA's central office.

New auditing standards will trigger administrative procedures to determine personnel actions necessary to hold senior leadership accountable.

The agency says it will send human resources employees across the country to help add staff where necessary.

It also plans to remove a 14-day scheduling goal from employee performance contracts, with the aim of removing an incentive to engage in inappropriate scheduling practices.

A review ordered by Shinseki found that 13 percent of VA scheduling staff were told to enter dates different from the dates requested by patients.

Gibson said he is working aggressively to improve the system.

"We've seen a major erosion of that trust in recent times," Gibson said. "My commitment to all of you, to all of our veterans, my commitment to the American people and their elected representatives, is that I'll work to earn it back."

ywenger@baltsun.com

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Copyright © 2014, The Baltimore Sun
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