Boise VA Director Responds To Audit Of Medical Care

Jun 12, 2014

Boise VA Medical Center Director David Wood
Credit Boise VA Medical Center

In the U.S. Department of Veterans Affairs' medical scandal that's forced patients to wait for care, a new audit shows Boise’s VA Medical Center scored well in some areas, and not so well in others.

The FBI has opened a criminal investigation into the Department of Veterans Affairs. The move comes as Congress takes steps to help thousands of military veterans who've been dealing with long wait times for VA medical care.

A VA audit this week showed more than 57,000 new patients had to wait at least three months for initial appointments. In Boise, the percentage of new patients waiting more than a month to see a doctor was higher than the national average.

Boise VA Director David Wood says that number is a little bit misleading because it includes all appointments. "Some veterans actually want their follow-up appointments scheduled over 30 days,” says Wood. “It includes follow-up appointments, initial appointments, everything. Some appointments, it’s clinically necessary to have them [scheduled] over 30  days, but there are other statistics that were in that same report that show Boise in very good standing.

"If you look at primary care and how quickly we can get an existing patient in, it’s less than a day," Wood says. "For mental health its very good statistics. Even for our specialty clinics, the whole picture looks much better than that over 30 day number.”

Wood says 27,000 to 28,000 veterans come to Boise for medical care each year. He says every year for the past 10, the number of veterans seeking medical care has increased in Boise.

Here is a transcript of our interview with Wood. It has been edited for clarity. 

Any idea why Boise was different?

"I don’t really understand where the data came from, so we’re digging into that, trying to understand what they were looking at. We do know they were looking at all appointments, however, so that would be follow-up appointments, etc."

The wait time for new patients is greater than established patients at the Boise VA. Some established patients are seen almost immediately. What’s the difference?

"If you’re an existing patient, then you have a relationship with that provider and you’re in the system and so it’s easier for us to see you in a timely manner. If you’re a new patient, it takes a while to assign you a provider, schedule and appointment, and get all of that pre-work done that needs to occur. So it takes a little bit longer for getting new patients into the system. But once that relationship is established, than we’re pretty good at providing access to our veterans."

The average wait for a specialist in Boise was 52 days. Why is that number so high?

"We’ve had an extended vacancy in ophthalmology. We have a wait list in that area, and have had a wait list for some time. So that has really driven the average up for our specialty-care areas. In most specialty-care areas, the access is really good. But because of a couple of areas, it has driven that average down. Now we have been, and will be, accelerating the number of patients that we send into the community to receive that care. So those numbers will come down. And we’re in the process of recruiting another ophthalmologist and another optometrist."

Is it hard to get specialists to come to Boise?

"It can be, depending on the specialist. So for ophthalmology, it has been very difficult to recruit a specialist."

The audit found that the systemic scheduling problems by employees at other VA’s doesn’t exist in Boise. As a person who’s familiar with the VA system, what do you think has gone wrong at other hospitals?

"I can’t really speak to what exactly has gone wrong at other hospitals. I think overall there has been confusion about the policies related to scheduling. They are a little bit complicated. So I think it’s easy for employees to get confused about that. What we do at the Boise VA is we do audits on a daily basis and on a yearly basis for employees who do scheduling and if there are issues that crop up, then we address them right away."

The audit noted that the Boise VA seems to be doing pretty well in scheduling patients. There are a few issues. Will the audit change the way you run the VA here?

"We’re in the process of contacting veterans who have been waiting and asking them if they want to receive that care in the community. So that’s a short term solution to this. I think the long-term solution is being discussed and debated in Congress and talked about nationally. But I believe it will create some real change in the VA that will lead to better access for veterans across the country."

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