VA is looking for a few good doctors and nurses

Joe Davidson
Columnist August 28, 2014

One of the first steps to rebuilding confidence in the scandal-plagued Department of Veterans Affairs is getting enough of the right people to do the job.

VA Secretary Robert A. McDonald is trying to do that by launching a new recruitment effort to boost the number of medical professionals.

Joe Davidson writes the Federal Diary, a column about the federal workplace that celebrated its 80th birthday in November 2012. View Archive

“We need the best doctors and nurses serving veterans, and that is why I will be out recruiting, leveraging the existing relationships and affiliations VA has with many academic institutions, and talking directly to medical professionals about joining us to fulfill our exceptional mission of caring for those who ‘shall have borne the battle,’ ” he said in remarks planned for an appearance Friday at Duke University’s School of Medicine.

Working against him is an agency image that has been battered by a series of congressional hearings and reports about employees gaming the system to make it appear vets were getting care much sooner that they really did.

Working for him is a new law providing $5 billion to hire additional health care professionals. The recruitment program will include:

●Developing a VA Nursing Academic Partnership (VANAP) with nursing schools and facilities focusing on psychiatric and mental health care.

●Encouraging recently discharged military health professionals to joinVA

●Expanding a pilot program for combat medics in VA facilities.

●Expanding a loan repayment program as an incentive for health-care professionals to join the agency.

●Possibly increasing salaries of VA health professionals to make them more competitive with those in private practice and at universities.

McDonald doesn’t have a specific number of new hires in mind yet, but the need is great. Just at the Phoenix VA hospital, which was the epicenter of the scandal, about 1,000 additional staffers are needed, he said during an interview.

His recruiting pitch centers on several points, among them: Serving veterans is the “highest calling;” VA is on the cutting edge of science and innovation; and VA has “the best patients in the world.”

At the same time, the agency continues to reel from the scandal over the ma­nipu­la­tion and cover-up of long wait times, which resulted at least in part from unrealistic productivity goals pushed on employees.

The goal of providing service to veterans within 14 days certainly does not sound unreasonable, but it was unrealistic in many cases because the agency didn’t have the staff to meet demand that quickly.

“Inadequate forecasting was partly responsible for severe shortages of personnel at some locations,” McDonald told the American Legion convention Tuesday. “And so recruiting is job one right now. I intend to be out in front and hands-on in that effort.”

In that speech, he recalled two medical school students who represent the promise and the problems with VA.

“On one end of the spectrum is an Air Force lieutenant about to graduate medical school who tells her father, ‘I wouldn’t want to work for VA — have you heard all the bad stories about it?’ On the other end is Nancy, about to graduate medical school as a neurologist, who told me on the plane back from Memphis, ‘practicing medicine at VA is my dream job.’ The only difference between hiring a great doctor and being short-handed is misunderstanding what serving veterans is about.”

Actually, both those students have a fair understanding of what VA is about.

There are too many “bad stories” about VA health care, as documented in a report released Tuesday by the department's inspector general. In one ridiculous case, staff in Phoenix attempted to schedule an appointment with a patient three months after he died.

Yet stories like that too frequently overshadow the dedicated work of VA employees. During a Senate hearing in May, all seven representatives of veterans service organizations said the problem with VA health care was one of access — not quality.

That should not be forgotten.

There are many fine VA staffers, but increasing their number won’t be without issues.

McDonald will have to convince people like the Air Force lieutenant that VA is the place to be. He tried to do that by personally calling the officer, whom he heard about from her father. He doesn’t know if he changed her mind about VA, but he hopes to visit her medical school on a recruiting trip.

Another problem is not related to the scandal, except to the extent that word describes the agency’s bureaucracy.

“The current system of hiring is a nightmare,” said Samuel V. Spagnolo, president of the National Association of Veterans Affairs Physicians and Dentists, who welcomed McDonald’s initiative.

The department’s hiring process can be so long and difficult, Spagnolo added, that job candidates sometimes find employment elsewhere while waiting for VA to act.

McDonald has heard that complaint before.

“We’ve got to get it fixed,” he said.

It might be worth their wait if the pay were better.

McDonald said VA pay is “relatively uncompetitive now” but did not know how much the pay needs to increase.

“It's a lot,” he said.

Twitter: @JoeDavidsonWP

Previous columns by Joe Davidson are available at wapo.st/JoeDavidson.

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