Veterans’ medical chief cites progress

Kim Smith

Friday, July 23, 1999 | 11:21 a.m.

Veterans Administration health care facilities in Clark County have made significant improvements since March when members of the inspector general's office visited clinics, the VA medical center director said Thursday.

The inspector general's report, which was made public Tuesday, slammed the VA facilities here for making patients wait for service, letting expensive equipment go unused and for not hiring enough doctors.

Patients no longer have to wait nearly as long to get into the VA's speciality clinics because some procedures have changed and additional staff has been hired, medical director Ramon Reevey said.

"We're not where we want to be yet, and I don't know if we ever will be, but we've been making tremendous strides," Reevey said.

Sen. Harry Reid, D-Nev., had asked the Department of Veterans Affairs inspector general's office to look into the type of service veterans were receiving in Southern Nevada after receiving hundreds of complaints. Reid also requested an investigation of auditing practices.

The inspector general found new patients had to wait inordinately long to get into specialty clinics because of staff shortages and an enrollment rate of 500 new veterans per month.

Since that time, several new doctors and technicians have joined the staff, Reevey said.

Instead of waiting 146 days to visit the VA's neurology department, patients only had to wait an average of 17 days in May, Reevey said. The wait for gastroenterology appointments fell from 257 days to 63 days, and the wait for a cardiology appointment dropped from 90 days to 14 days.

The waiting period also has diminished because primary care physicians have been asked to eliminate as many possible ailments as they can before referring patients to a specialist, Reevey said.

In addition, specialists are being asked to refer their patients back to their primary care physicians as soon as their problems have been resolved.

Reid had complained about a prostate patient having to wait seven months for a biopsy, but that happened more than two years ago, Reevey said. At the time, all prostate patients were being sent to a urologist before they could see other specialists. That procedure has since changed.

"Now no patient has to wait more than 30 days, and if we can't get them in, we will send them to someone in the private sector," Reevey said.

Reevey said the staffing situation is not unusual.

"It's a Las Vegas problem," Reevey said. "The community hospitals are having problems filling their positions, too."

Unfortunately, the VA must stick to federal pay schedules and many doctors would rather open up private practices than work for the government, Reevey said.

"There will always be turnover, we will never have all of our positions filled and we will always have people in the pipeline, coming and going," Reevey said.

Although some received the news about the inspector general's visit as though "death had coming knocking at the door," Reevey said he welcomed the inspection.

"They were also able to weed out some of the other allegations that were made," Reevey said.

Allegations were made that U.S. Airforce was overcharging the VA for services provided to veterans at the Mike O'Callaghan Federal Hospital, Reevey said. The investigators found that to be false.

In addition, some felt that the VA was allowing "hundreds of thousands of dollars" in equipment to go unused, Reevey said.

However, after looking at 15 pieces of equipment, valued at more than $600,000, Reevey said only one piece of equipment was found unused. A $20,000 speech pathology item hadn't been used because a speech pathologist had yet to be hired.

Reevey said he believes health care for veterans in Las Vegas has improved a great deal since he took over five years ago. Back then there was no in-patient care and the VA had a clinic one-third the size of the current Addeliar D. Guy III Ambulatory Care Center.

The fact that the inspector general's office has started a new program where investigators will visit VA facilities on a regular basis doesn't give him "heartburn," Reevey said. The inspector general's office has the same goals as the VA, but it is just more objective, he said.

Tom Williams, executive assistant to Inspector General Richard J. Griffin, said the combined assessment program began in January.

Instead of sending health care specialists, auditors and investigators into VA facilities whenever problems arose in their given field, a team comprised of members from each field will make regular visits to the facilities, Williams said.

After the inspection, the 20-25 member team will report its findings to the facilities' director and make recommendations for corrective measures, Williams said.

It was just such a team that visited the VA's facilities in Las Vegas and Henderson in March, Williams said.

"We reported our findings to the Veterans Health Administration, which has a direct line of authority over the facilities," Williams said. "In this case, (Reevey) concurred with all of our recommendations and that was reported to the Veterans Health Administration. After a follow-up visit, another report will be submitted."

Williams said he is not sure when the follow-up visit will be made.