Urologic care at the Phoenix VA Medical Center — it’s not been good!

A story in yesterday’s Washington Post suggests that US veterans seeking care for prostate cancer and other urologic conditions at the Veterans Administration (VA) Medical Center in Phoenix, AZ, received the short end on a very short stick in the 2 years after the initial patient scheduling problems came to light.

The full story can be read on line. But here are the “low points”:

  • The urology clinic was massively understaffed after the original scheduling problems were revealed in 2013.
  • Clerks were unable to schedule patients for medical care because there simply weren’t enough doctors to cope.
  • Some patients may have died as a direct consequence.
  • When patients were finally given permission to seek care from non-VA clinicians, poor communications seem to have caused many patients to receive only minimal care.

The “New” Prostate Cancer InfoLink knows that providing care to the millions of US veterans through the VA system is inevitably challenging. However, we also know that we have to do a lot better than we seem to have been doing over the past decade or so … and some of the challenges may be a direct consequence of the failure of Congress to adequately fund the VA. One can’t provide any quality of care (let alone high quality care) if you don’t have the resources to pay for skilled and motivated care providers and skilled and talented management!

Having said that, it does also appear that there are more specific problems associated with what has been going on at the VA’s facilities in Phoenix.

3 Responses

  1. I disagree that it is a matter of money that makes the VA inefficient, but the culture of the bureaucracy. I’ve been with the VA for 46 years and it has only gotten bad within the last 8 or so years. There were many more Vets been treated after WWII and Viet Nam and I never saw as many issues over my first 40 years as I see today.

    It takes 4 or 5 calls to get even the simplest issue resolved: phone calls not returned, records lost, appointments cancelled without notice, claims taking well over a year to resolve. The medical staff is good, but the administration sucks, with lack of follow up and any sense of caring for their customers.

  2. Dear John:

    I was very careful to say “may be” in my comment. However, is it possible that over the past decade the compensation of management staff at the VA has fallen relative to that in the rest of healthcare, implying that the VA has lost and/or been unable to attract the quality of personnel that they used to be able to attract and retain?

  3. I recently worked extensively to coordinate care between the private/Medicare system and the VA for a friend with terminal prostate cancer at the San Francisco VA. I have also experienced prostate cancer care provided for others at this facility.

    In the VA’s defence, and I acknowledge all of the criticisms above, the SF VA provides excellent care for prostate cancer, especially for men with advanced disease. Most of the rad/oncs and med/oncs are UCSF staff; and many of the urologists providing primary care are also UCSF faculty. I know a number of men who use the VA just to provide their drugs at a highly subsidized rate.

    VA care for prostate cancer is spotty. I would suggest that where staffed by teaching institutions, care is probably better than where not. I also am familiar with VA facilities that are quite inadequate … another factor, in my observation, may be whether the VA facility is urban or rural.

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