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    Working the system at expense of veteran care

    On sending email messages that explain how to 'game' the system

    Dr. McDonnell

    My friend, Allan, a loyal reader of Ophthalmology Times, recently sent me an email message with the subject line entitled: “Moral Compass.” In it, he describes his experience as an ophthalmologist working, many years ago, in a medical clinic run by the government.

    Finding himself with a lot of free time—because he was scheduled to see only two patients per hour, and not happy that so many patients were waiting up to 6 months to get an appointment—Allan adjusted his template to increase his patient volume by 50%. Two days later, Allan was reprimanded by the government official who oversaw the clinic for caring for more than the approved two patients per hour, and had his schedule cut back.

    The sharing of this anecdote was occasioned by the ongoing scandal in which, it is alleged, employees of one or more Veterans Affairs (VA) hospitals came up with a plan to violate the policy of seeing patients within 2 weeks. Rather than figure out how to meet the demand for care and comply with the policy, news reports and congressional committees indicate that staff members developed strategies to “game” the computer scheduling system to make it appear as though timely appointments were being given when such was not the case. Tragically, if true, some 40 patients at a single hospital in the Southwest are alleged to have died as the result of their being denied timely appointments. Employees at other hospitals are coming forward with similar tales, including patients dying while waiting 6 months to see a cardiologist.

    How many veterans might have suffered some irreversible vision loss as a result of delays in eye care?

    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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    • Dr. Richard Bensinger
      The VA still has issues related to Bush administration policies. As part of the effort to "support our troops" Bush ordered the withholding of significant funding for the VA system resulting in lowered hiring, an end to needed expansion of the facilities, and turning away of many veterans especially from the Viet Nam era. Obama restored the funds which made inroads in these problems but seven years of inadequate resources has a price. There is no excuse for gaming the system, but the VA has a huge backlog to catch up with thanks to the previous administration.


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