At Overton Brooks,16 percent of medical positions unfilled
In mid-July, 16 percent of Overton Brooks VA Medical Center’s medical positions were unfilled, according to data provide by the Veterans Health Administration through a Freedom of Information Act request.
Of those positions — 205 in all — 33 positions for physicians were vacant and 70 nursing positions were unfilled.
Hospital spokesman Shannon Arledge disputed the data, saying the hospital’s human resource department confirmed 134 vacancies Thursday and only 80 were related to the direct patient care.
The hospital, Arledge said, is not understaffed and services are being provided. “We are still meeting the needs of veterans here at Overton Brooks,” he said.
The data showing a shortage of VA critical intake employees in Shreveport and elsewhere — 41,000 total — reveals a national trend. As of July 15, one in six jobs for critical intake workers, doctors, nurses and assistants were vacant at VA hospitals and clinics serving the nation’s veterans.
The unfilled positions were partly due to complex hiring procedures and poor recruitment, according to critics of the nation’s network of 139 hospitals and clinics treating veterans.
At nine of the nation’s regional Veteran Affairs health care systems, one in three jobs went unfilled leaving veterans waiting weeks to get care. Those facilities are located in Fayetteville, North Carolina; West Texas Healthcare System in Big Spring, Texas; Roseburg, Oregon; Long Beach, California; Walla Walla, Washington; Memphis; Reno; Togus, Maine, and Montgomery, Alabama.
USA Today, Gannett’s flagship publication, obtained the data and analyzed the national numbers. The information offered the first look at how serious staffing issues are at some VA hospitals and clinics. It also shows that at many locations, unfilled jobs are driving up appointment wait times.
The analysis found that even a 1 percent increase in job vacancies contributes to more appointments being pushed past a month-long wait. Some of the highest vacancy rates are for psychologists. In 13 regional healthcare systems, 40 to 64 percent of psychologist positions are vacant. Nationally, about 21 percent of such positions are vacant.
“It is unacceptable,” said Sen. Jon Tester, D-Montana, a member of the Senate Veterans Affairs committee. “This is a problem under bright sunlight now, and it needs to be fixed.”
In Shreveport, there was a 16.5 percent vacancy rating, according to the data provided. Thirty-three of Overton Brook’s 167 physician positions were open in mid-July and 70 of the 420 nursing positions were unfilled.
Arledge said some of the positions included in the data requested from the VHA may have been eliminated for cost-saving measures but are still included in the database. “It is definitely not an attempt to reduce care at all,” he said.
All of the vacancies for a single position may not be isolated to one department, Arledge said. The data provided through the FOIA request may contain positions that are not necessarily related to direct patient care, such as a medical support assistant and shouldn’t be considered.
In Shreveport, veterans waited an average of 9.2 days for primary care and 6 days for specialty care. And according to the VHA data, 5.9 percent of appointment had more than 30-day waits as of mid-July.
Again, Arledge provided different numbers than what the VHA reported.
He said the average wait time for primary care as of July 1 was 15 days. As of Aug. 1, the wait time had been reduced to an average of 7 days, he said. Appointments for mental health average four days and there’s a five-day average for specialty care.
“That just goes to show the strides that we’re making the improvements that we’re continually looking at in order to provide the best patient care available for the veterans,” he said.
State Rep. Barbara Norton said she toured Overton Brooks on June 12 to see a new hospital wing and learn about new services to reduce hospital wait times.
Norton said she is always concerned veterans and other citizens are able to receive the services they’re entitled to receive.
“I am told by our director, David LaCerte, that we have doctors over there and they are communicating on a daily basis and reporting to DHH and at this particular time we’re able to provide the services we are suppose to be providing,” she said.
Norton said she’ll do another walk-through and speak with hospital staff again to ensure veterans are receiving their services.
Norton hosted a community meeting several months ago where veterans voiced their concerns about their ability to access services and treatment at Overton Brooks. They also complained about having to drive to New Orleans for VA appeal hearings. They no longer have to make the long trek south because video conferencing equipment has been installed at the local VA hospital, she said.
One of the veterans who attended the meeting was Major Cook, who suffers from back and liver problems. Cook also receives care for mental health at Overton Brooks. Cook said he’s unhappy with the care he and his wife, Irene, have received.
“If I had the money I sure wouldn’t go there,” said Cook, who spent two years and one month in Vietnam.
The data show more than 5,100 additional physicians are needed across the VA system. Spokesman for some hospitals told USA Today they have a difficult time recruiting medical professionals because of their locations. Tester has proposed a bill to increase the number of medical residencies by 1,500 in the hopes those doctors stay on.
On the House side, Rep. Dan Benishek, R-Michigan, a surgeon who worked part-time as a contractor at a VA facility for 20 years, also has proposed legislation to streamline hiring and improve accountability.
Over the past 30 years, the VA Inspector General's office has repeatedly said the agency should have a national recruitment plan to attract and retain physicians. It still doesn’t exist, he said.
“When you have to recruit 41,000 people — there has to be a coordinated plan,” Benishek said. “And when you ask them, there’s nobody in charge. You hear ‘that’s not my job.’ No one’s held responsible.”
The Choice Act passed last August also created 10,000 new medical positions to fill, making vacancy figures appear worse, a spokesman said.
VA leadership says hiring in the past year matched the 9 percent attrition rate, and actually added new employees. The agency hired an additional 1,000 physicians and 2,700 nurses between in a 13-month period ending on May 1.
But critics say the agency’s hiring practices have mired regional facilities in red tape.
“The whole hiring process is ridiculous,” said Laurie Butler, who temporarily served as acting chief of Human Resources in Phoenix before retiring last year.
Arledge said jobs are posted on www.usajobs.gov. Candidates are vetted and backgrounds checks are given, he said.
According to Phoenix VA spokeswoman Jean Schaefer, the process to hire one person for a clinical position can involve up to 18 steps — from getting approval for the job posting to running credential checks — and can take from four to eight months to complete. By that time, candidates have often accepted a job elsewhere, others said.
“Depending on the position it make take longer than the average position or job that someone may be applying for outside of the government,” he said.
Overton Brooks is actively recruiting for 31 positions. He said 19 of those 31 positions have actively closed or selections or offers are currently being made.
“They still may show up in a database of some sort because the person has not come on board yet,” he said.
Contributing: Dennis Wagner, The Arizona Republic; Mark Barrett, Asheville Citizen-Times
By the Numbers
Shannon Arledger, Overton Brooks spokesman, disputes the numbers provided by the U.S. Veteran Health Administration, the nation’s veteran health system, through a Freedom of Information Act.
According to Arledger, Overton Brooks hired 16 physicians and 51 nurses since Oct. 1, 2014.
•A 127 patients in direct care patient positions have been hired.
•There’s a 9 percent turnover rate for nurses
•Medical officers have a 10 percent turnover rate