In response to Joseph Conn's “VA's Eric Shinseki puts 45 IT projects on hold":
The news that the Veterans Affairs Department canceled 45 information technology projects is surprising not because they were going badly, but because the VA actually had the gumption to make it known.
VA management is horrendous. In VA hospitals all over the country, management is overrun with do-nothing, risk-nothing bureaucrats whose sole goal is to put in their 20 years so they can retire, and/or to leave early so they can work at their other job. They make no effort to manage their employees, instead spending their time reading novels, hiding from staff and/or supervisors, and going to endless meetings, which give rise to memos, position papers and action plans that never see the light of day.
I have witnessed midlevel VA hospital employees having conversations while leaning against the walls in the hallways that extended from my arrival at work to my lunch break. I have seen employees taking to friends and family members over the phone for hours, and to express their irritation when asked to perform a task by angrily responding, "Do you mind—this is personal!" And I have asked managers why this was allowed, only to be met with sullen looks, excuses and nonanswers and, in one case, charges of being disruptive.
Registered nurses at the VA refuse to administer routine drugs, claiming that the pharmacy says they can cause an allergic reaction. I have seen IT employees who do not know the basics of setting up Microsoft Word or Outlook programs. I have spoken with telephone operators there who refuse to look up pager numbers, and laundry technicians who refuse to take clothing off a hanger rack, instead requiring that each employee in line, one at a time only, enter the office and get their own while the technician sat behind a desk with his feet up.
I have witnessed security guards asleep in the parking lot, playing cards in the basement, and absent from their posts for hours at a time.
I have seen hospital administrators leaving at noon every day, and not returning; chiefs of staff who were unavailable after 10 a.m. for a full week, and rooms with 30 desks, only two of which were occupied at 9 a.m. I have been called to a code blue at 7 a.m., on multiple occasions, where the patient was actually cold and in rigor mortis before being found (at the shift change).
I have been refused requests by VA staff, and VA RNs, on the basis of "policy." After years of asking, I have never been able to see an actual written policy backing up the refusal.
The VA simply doesn't function, because its management doesn't function. In every administrative and patient-care unit in the half-dozen or so VA hospitals I have seen, one finds that there are one or two employees who get the job done, and they do so while swimming against a deep and powerful tide of incompetence, apathy and bureaucratic limitation.
I applaud and admire the bravery Eric Shinseki has shown in openly admitting that there are problems at the VA, and I wish him the best of luck in his endeavors. Sadly though, the VA at present represents the absolute worst that government healthcare has to offer. He has a tremendous wall to climb, and the crowds will not be cheering him on.
Albert R. Davis, M.D.
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