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VA secretary: Special advisory board will help fix system’s problems

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Veterans Affairs Secretary Robert McDonald vowed Friday, April 24, 2015, to fix systemic failures at the beleaguered agency.

SANTA CLARA, Calif. — The chief of the Department of Veterans Affairs vowed Friday to fix systemic failures at the beleaguered agency and lamented what he sees as a constant negative focus.

“It’s hunting season at the VA,” Secretary Robert McDonald told the Tribune-Review about attacks aimed at the veterans care agency. “Nobody wants to talk about the good things. We’re the largest medical system in the country, so when something goes wrong, it becomes news. So we’re going to fix it.”

McDonald, 61, used an appearance at the national conference of the Association of Health Care Journalists to announce an 11-member medical advisory board he said will “return the VA to pre-eminence.”

He said the Special Medical Advisory Group will play a crucial role in guiding the agency where patient appointments soared to 51 million between May 2014 and March 31, an increase of 2.4 million appointments over the same period a year earlier.

The panel of private, nonprofit and government health care leaders will address improving care delivery, research, education and training. Its chairman, Dr. Jonathan Perlin, is chief medical officer at Nashville-based Hospital Corporation of America and a former VA undersecretary for health.

At the Veterans of Foreign Wars, senior legislative associate Carlos Fuentes praised a departmental transformation under McDonald. He said officials should be cautious in comparing the VA with more profit-minded private hospitals.

“However, there are many instances where the private sector is a model for the VA and where you can find inefficiencies” by applying private hospital methods, said Fuentes, who works in Washington.

McDonald told the Trib that he has a soft spot for Pittsburgh because his wife grew up in Monroeville. The former Diane Murphy attended Gateway High School; the McDonalds’ daughter and two grandchildren live in Upper St. Clair.

He said he visits Pittsburgh “all the time.” He expressed confidence in the VA Pittsburgh Healthcare System, where a Legionnaires’ disease outbreak killed at least six veterans and sickened 16 others three years ago.

As a result of the Legionnaires’ outbreak at facilities in Oakland and O’Hara, VA officials fired the Pittsburgh system’s director, Terry Gerigk Wolf.

McDonald said it takes time to fire government employees: “You can rush to judgment, but if it doesn’t stick, it does (you) no good. It’s better to take your time.”

The VA has been crippled by years of understaffing and an influx of veterans who survive complex traumatic injuries on the battlefield, he said. VA projections show claims in 2017 will rise to 1.5 million — up from 1 million in 2009 — as retired troops age.

The department records more than 6 million annual outpatient visits overall, McDonald said.

An Army veteran, he spoke of his medical experiences and problems with pain from losing three disks in his lower back.

“When I was young, I could run marathons, long races. Now … I have trouble sleeping through the night because of my back pain,” McDonald said. “This is what happens as you age.”

The department is seeking a nearly 8 percent budget increase for 2016, in part to accommodate veterans from conflicts in Afghanistan and Iraq. Total spending under the plan would reach about $168 billion.

McDonald, a former CEO of Procter & Gamble Co., inherited a scandal-plagued agency when President Obama appointed him in July to replace Eric Shinseki. The department was mired in controversy when congressional investigators found VA employees conspired to hide months-long wait times for veterans seeking care. Dozens of veterans died while awaiting treatment at the Phoenix VA hospital.

“We’re trying to change the culture from Kremlin-esque to … transparent, open,” McDonald said.

In Pittsburgh, whistle-blowers said employees invented fake schedules and manipulated computer programs to mask delays.

“Veterans, I think, frankly have been patient for too long. The time for patience is over. They need to see results,” said U.S. Sen. Bob Casey Jr., a Scranton Democrat.

McDonald has “brought a measure of accountability, discipline and determination” but “still has a ways to go,” Casey said.

McDonald blamed some failures on a shortage of health care providers, saying the agency is short by at least 1,000 workers, including physicians. The system lacks adequate facilities to treat female veterans, he said. About 11 percent of the nation’s veterans are women, a figure expected to reach 20 percent by 2017.

“We don’t have the clinical space for female veterans,” he said, noting that some VA buildings have single-gender restrooms.

McDonald hinted that his strategy to fix the VA will draw from his business experience. The agency could save $25 million a year by shutting down unused space or vacant buildings. Congress has not granted approval because the buildings are “in somebody’s district,” he said.

Casey said lawmakers ought to take the recommendation seriously.

“We’re trying to be responsible in being productive, just like in business,” McDonald said.

Luis Fábregas is Trib Total Media’s medical editor. Reach him at 412-320-7998 and [email protected]. Staff writer Adam Smeltz contributed to this report.

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