I have worked for the VA for over 25 years. The medical care the Vets receive from the Docs and nurses is pretty damn good. The problem with the VA is the bureaucracy in Washington and from Washington down the line to the local management level.
Washington gives them unrealistic standards given the resources made available. Bonuses are “performanced based” and this puts pressure on these managers to “fake the numbers.” This is not happening at the lower management levels. No low level manager would do this of his own accord. If a low level manager, such as a chief of service i.e. chief of pharmacy, chief of medicine, chief of surgury etc., did this you can be assured that he was told to do this. If a low level manager did this it also shows a lack of professional standards. He should be fired and his superiors that made him do this should be fired. If any crossed a legal line they should be prosecuted and jailed and or fined.
In defense of the VA the actual care givers, the doctors, nurses, pharmacists, dieticians etc. really do great work. I personally know many that have given many hours of their work without compensation, as I also have. They did this because it was necessary to provide good patient care. You do not read about this in the newspapers or hear it on television. I worked many years in an anticoagulation clinic. This was very rewarding work. We worked closely with the patient managing their therapy on a one on one basis. They were grateful and this is good.
The rot in management comes from the top down. However, I must add that low and mid level managers with rare exceptions are ethical and worthy of praise. At one time I was one of those and know what it is like. It is an ugly job trying to do what should be done with limited resources. That is the reason I left management and went back to being a staff pharmacist.
My personal standard is what is called the “Grandmother Rule.” If you would not do this if it was your grandmother, it is wrong. If you would do it, it is right.
In the VA the bad guys are not those giving the hands on care it is those above them.
Which is why, I post these on my site as “Obama vs The U.S. Military”