Sen. Bernie Sanders (left), I-Vt., the Senate Veterans Affairs Committee Chairman, and Robert A. McDonald, secretary of the Department of Veterans Affairs, listen to questions during a media availability after a meeting with medical students and professionals at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., about new recruitment for health care positions at VA hospitals nationwide on Oct. 13, 2014. Photo by Ariana van den Akker/Valley News
LEBANON, N.H. — Caregiver shortages that have forced veterans to wait for care from the Veterans Health Administration are early indicators of a more general problem in health care, the Cabinet secretary who oversees the 340,000-employee medical care system that serves the nation’s veterans said Monday.
“We are approaching a national train wreck,” Veterans Affairs Secretary Robert McDonald said in a speech to about 150 people at Dartmouth-Hitchcock Medical Center that was broadcast on closed circuit television at colleges in northern New England.
Nationally, the VA needs to hire 20,000 to 30,000 new medical personnel, said U.S. Sen. Bernie Sanders (I-Vt.), chairman of the Veterans Affairs Committee, who joined McDonald for the event.
“We do not have enough doctors,” Sanders said. “We do not have enough nurses.”
In White River Junction, the VA has 100 vacancies to fill, said Deborah Amdur, director of the VA Medical Center there.
The VA has already been busy hiring, Naaman Horn, a public affairs officer, said in an email: “In the last year, White River Junction VA Medical Center has brought on 56 new employees for new programs and to ensure that we have good access to care.”
McDonald stressed that the need for more caregivers extends beyond the VA. Florida needs 22,000 more doctors to serve its general population, and California needs 17,000, he said.
But the VA has a role to play in solving that problem as well, according to McDonald, who described the agency’s three-pronged mission of medical education — about 70 percent of the nation’s doctors receive some training at the VA, he said — as well as research and clinical care for veterans.
“The country needs a strong VA,” he said.
Controversy about the role and performance of the VA erupted earlier this year, fueled by reports that veterans were enduring long waits for care at a VA hospital in Phoenix and elsewhere, and that some administrators were doctoring statistics to hide the backlog.
Eventually, former VA Secretary Eric Shinseki, a retired general, resigned, and McDonald, the former chief executive at Procter & Gamble, a consumer products maker, stepped into the agency’s top job. There, he said in an interview, “the biggest surprise (was coming to understand) how essential the VA is to American medicine.”
Sanders led the way to passage of a law that provided the agency with $5 billion of additional funding for hiring and staffing.
“A couple of months ago we were able to do something unusual in Washington,” said Sanders, who got the afternoon’s biggest laugh. “We got legislation passed.”
That legislation will allow the VA to add 1,500 residency positions to train aspiring doctors, Sanders said. VA officials at the event could not say immediately how many residency positions the system has. Overall, the nation’s hospitals offer about 26,000 residencies to new doctors, and about 16,000 are filled by new graduates from medical schools.
Tina Foster, a Dartmouth-Hitchcock obstetrician and local director of the VA Quality Scholar program, used Tuesday’s event to raise the profile of those fellowships for young caregivers. Currently, the program has three doctoral fellows and two nurses.
Susan Mooney, the chief executive of Alice Peck Day Memorial Hospital and an alumni of the Quality Scholar program, said in an interview that although the VA was historically “a pretty male-centric organization,” it had offered her, as a gynecologist, an opportunity to develop the skills to lead a health care organization. One key advantage of training at the VA, she said, is that doctors don’t waste time coding and billing, so they can focus on medicine.
As a result of the legislation Sanders sponsored, the agency has some new recruiting tools. The amount of medical-school debt that can be erased for a doctor who goes to work at the VA had been doubled, to $120,000 from $60,000, Sanders said.
Pay packages have also been made more attractive, McDonald said: “We increased the pay bands to be competitive with private industry.”
In a brief interview, Sanders dismissed a critique of the VA that argues that the medical care it provides could be more efficiently delivered by paying for veterans to seek care at private hospitals. He said that the strongest resistance to that approach would come from veterans organizations: “They see the VA as their institution.”
And McDonald stressed the important role played by the agency: “There is no higher calling than caring for our veterans.”
Still, he said, that message might not be reaching enough listeners: “We need to do a better job selling the VA and what the VA does.”
The two men made a similar appeal Monday at the University of Vermont.
Rick Jurgens can be reached at rjurgens@vnews.com or 603-727-3229.
Read the story on VTDigger here: VA chief sees critical shortage in providers.
