The biggest problem with VA management is that management is horizontal rather than vertical.
If you are in charge of a department, the people under you are not answering to you and you have no authority over them.
All psychologists answer to the chief of psychology.
All Social workers answer to the chief of social work.
All nurses answer to the chief of nursing.
Even the MD’s do not answer to the person whose department they work...
Department heads have responsibility, but no authority. And they wonder why it is such a cluster f&*#@
In addition, there is no incentive to work hard and see patients. People learn to milk the system...
Let’s see, if I supervise Medical School Residents I get credit for their patient appointments.
President Trump is slowly moving things in the right direction at the VA. President Trump you magnificent bastard.