'Whole system is corrupt': Metro-east vets complain about delays at VA hospital

News-DemocratJune 21, 2014 

The national furor over scheduling abuses and long delays in seeing physicians at VA hospitals has touched a chord among metro-east veterans, including Marine veteran Thomas "TJ" Johnson, of Highland.

Three years ago, Johnson was suffering from acute back pain stemming from his 16 years lugging a heavy rucksack in the Marines.

In the summer of 2011, at the John Cochran VA Medical Center in St. Louis, Johnson faced a choice: He could wait until March 2012 to get needed surgery at the VA hospital, or he could use his private medical insurance to have the surgery performed much sooner, but outside the VA system.

Johnson, 43, chose the latter option, even though it cost him $1,500 out of his own pocket.

"I was in such great pain, I actually jumped on it," Johnson said.

Johnson's experience with long delays at the Cochran facility reflects what other metro-east veterans are reporting in interviews for this story.

Long wait times and months-long delays in scheduling appointments for vital services at the Cochran VA hospital, the primary medical facility for metro-east veterans, have made the promise of free medical care for life a mixed blessing for these veterans.

Richard Hart, 53, of East Carondolet, said he's been trying for weeks to get an appointment to see a psychiatrist at the Cochran facility. Hart has been diagnosed with post-traumatic stress disorder linked to what he says was botched medical care at the same hospital.

"If you got a problem, you got to go through the ER," said Hart, who suffered an injury in Army basic training that kept him from pursuing a military career. "Otherwise, they schedule you for every three months."

Hart contended in a lawsuit filed at the federal courthouse in St. Louis that he suffered severe, crippling injuries as a result of an overdose of Botox that a VA physician gave him. Hart lost his lawsuit in 2012, then lost on appeal.

Nonetheless, Hart said he fears going back to the same hospital system that he has said left him with severe muscle damage, but that he must depend on anyways because he has no other option.

"The whole system is corrupt," he said. "I'm scared to death of them."

Hart's complaints echo much of the criticism leveled against the Cochran medical center in 2010, when more than 1,800 veterans were notified that they could have been exposed to hepatitis, HIV and other viruses because of improper sterilization procedures in the dental clinic.

Not all veterans are unhappy with the Cochran facility.

Janet Wiley, of Marissa, said she was, overall, pleased with the care she's received there for the multiple sclerosis that forced her to leave the Air Force after eight years.

Wiley said it took her a month to set up an appointment at Cochran when she and her husband, a master sergeant stationed at Scott, moved her from Washington, D.C.

"But once I got a hold of someone and got in with a doctor, I've had a wonderful experience," she said.

Wiley said her average wait time to see a specialist is about two weeks.

"Even when I was in the military I waited longer than that," she said.

A national firestorm erupted in late April when news media began reporting, based on a whistleblower's disclosures, that at least 40 veterans died waiting for appointments at the Phoenix VA Hospital.

Congress quickly stepped in when it was revealed that many of these deceased veterans died while on a secret waiting list.

The covert list was part of an elaborate scheme that VA managers had devised to hide the fact that up to 1,600 sick veterans had to wait months to see a physician.

What amped up the outrage meter even further were revelations that at the same time these veterans on secret lists were dying, Phoenix VA executives had been paid $10 million in performance bonuses, in large part because of their success in "reducing" veterans' wait times.

The scandal has led to the forced resignation of former Army general Eric Shinseki as the VA secretary and the appointment of Sloan D. Gibson as the new acting secretary.

One by-product of this latest VA scandal was an audit the VA released nearly two weeks ago of 731 medical facilities nationwide.

The audit showed that the St. Louis hospital had the fifth-highest average wait time in the nation for veterans to see a specialist -- 86 days.

A key discovery in the audit was that the 14-day target for waiting times that Shinseki had installed was "not obtainable," a problem made worse by the fact that hospital managers' bonuses hinged on meeting the 14-day goal.

The VA did not respond to a request from the News-Democrat to interview a representative for this article.

But Marcena Gunter, a spokeswoman for the St. Louis VA system, sent an emailed statement to the News-Democrat that said the VA St. Louis Health Care System "is committed to providing high quality health care to veterans."

The statement also noted that 96 percent of 61,000 appointments at St. Louis VA facilities are completed within 30 days.

Gunter's statement further noted that 247 of the 731 VA medical facilities will require further review. "None of the VA St. Louis Health Care sites are on this list," according to her statement.

In addition, Gunter's statement contained a list of reforms initiated by Gibson, the acting secretary, that call for launching a new patient satisfaction measurement system and ending the VA's 14-day scheduling goal from employee performance plans as to eliminate "incentives to engage in inappropriate scheduling practices or behaviors."

What's more, Gibson's reform plan calls for suspending performance awards, increasing transparency by posting key data twice each month and using high-performing facilities to help that who need improvement.

Paul Sullivan, a longtime critic of the VA medical system, said no one, especially members of Congress, should be surprised at the current crisis gripping the VA.

Plenty of advocates for veterans, including Sullivan himself, had warned over the years that big problems were brewing for the veterans' agency because of underfunding, understaffing and a loosening of restrictions regarding who could file for disability claims.

"They knew all this was coming, and they failed to prepare," said Sullivan, the former executive director of Veterans for Common Sense and managing director for veterans outreach for a Washington, D.C. law firm that focuses on VA disability benefits law.

Sullivan cited a litany of factors responsible for long delays at VA facilities.

Factors include a flood of new patients as a result of laws passed by Congress that allowed many more veterans to file claims for exposure to Agent Orange in Vietnam and for symptoms connected to post-traumatic stress disorder.

In addition, many thousands more veterans flooded the VA system because of the Great Recession of 2008-2009, an economic calamity that resulted in lost jobs and lost private health insurance, Sullivan said.

In addition, the wars in Afghanistan and Iraq have resulted in many thousands of veterans with complex medical conditions that will require lifetime care from a wide range of VA specialists, according to Sullivan.

"When the veteran's claim is approved, the veteran doesn't need one or two doctors for the rest of his or her life," Sullivan said. "The veteran may need 10 or 12 very expensive specialists. The multiple conditions make the processing of the claim more complex and time-consuming, and the cost per veteran goes way up."

None of these facts should be a surprise to anyone in Congress, Sullivan said.

"So this horrible hurricane has been parked over the VA now for more than a decade, and add on top of that one million new claims from the Iraq and Afghanistan wars, and add on top of that one million new patients," he said.

Another reform the VA needs to tackle, Sullivan said, centers on realistic evaluations of its medical facilities' quality.

"There need to be objective measures, and not self-congratulatory measures," Sullivan said.

Case in point: On Nov. 18, 2013, the VA released a list of 32 agency medical facilities named as "top performers," including the VA St. Louis Health Care System.

On the same day, though, a federal jury in St. Louis awarded $8.3 million to an Army veteran and postal worker from St. Louis who suffered severe brain damage and paralysis at John Cochran hospital because of negligence and the bungling of a routine procedure.

Contact reporter Mike Fitzgerald at mfitzgerald@bnd.com or 618-239-2533.

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