American Legion National Veteran Affairs and Rehabilitation Division Director Louis Celli spoke about the dangers of staff shortages among physician and medical specialists within the Veterans Health Administration (VHA) during a hearing March 22 at the Cannon House Office Building in Washington, D.C.
The hearing, hosted by the U.S. House of Representatives Committee on Veterans’ Affairs Subcommittee on Health, focused on “Healthy Hiring: Enabling VA to Recruit and Retain Quality Providers.” Celli was among several other witnesses who spoke, including U.S. Government Accountability Office Strategic Issues Director Robert Goldenkoff, Partnership for Public Service President and CEO Max Stier, and Steve Young, deputy undersecretary for Health for Operations and Management at the U.S. Department of Veteran Affairs VHA.
Celli said the Legion has been concerned about the dangers of staffing shortages among physician and medical specialists at VHA since 1998. “VA currently operates 1,233 health care centers and at one time,” he said. “In 2015, VA lost over 2,000 medical officers alone. We have got to do better.”
A full one-third of all veterans treated by the VA live in a rural area and the Legion echoes VA’s concern to increase access to quality health care for veterans living in those communities. Celli said VA medical centers in rural areas face ongoing challenges recruiting and retaining qualified medical and clinical providers due to their inability to compete with medical centers in large metropolitan areas.
“The differences between VA and nearly every other hospital in America is selectivity,” said Celli. “This is a business model that no other hospital system in the country suffers under, nor would they be able to survive if made to adhere to the regulatory guidance that VA has to follow.”
As the number of veterans residing in rural communities continue to grow, Celli said veterans will continue struggling to find timely and quality VA health care that meets the needs of the communities in which they live. “In 2015, during our SWS (System Worth Saving) site visit to the VA Medical Center in St. Cloud, Minnesota, providers were openly upset about the number of physician vacancies and how the additional workload is impacting morale at the medical centers,” he said. “One veteran told us, ‘Every time I visit the medical center, I am assigned a new primary care provider because my last provider either quit or transferred to another VA.”
Unfortunately, Celli said there are no easy solutions for VHA when it comes to effectively and efficiently recruiting and retaining staff at VA health care facilities. The American Legion believes that access to basic health care services offered by qualified primary care providers should be available locally, as often as possible, at all times, he said.
“There are too many vacancies in VHA and the recent action by (President Donald Trump) to freeze federal hiring will only add to delays in performing life-saving surgeries, patient wait times and claims backlogs,” said Celli. “All health care employees are essential and critical to the health and safety of all patients entrusted to their care.”
Celli said VA will never be in a position to compete with the private sector. VHA is going to have to start leveraging the resources they already have to attract and retain medical talent. “VA has a variety of creative solutions available to them with and without the need for additional legislative action,” he said.
Celli urged the committee members to consider the following options:
Open VA to more patients;
Make VA more competitive and allow them to accept all forms of insurance, Medicare, Medicaid, etc.;
Make VA a destination employer by offering physicians rotations in research, emergency preparedness and education areas;
Call on VA to establish a medical school; and
Instruct VA to engage in public-private partnerships with community hospitals across the country by renting wings of existing hospitals.
“The American Legion understands that fulfilling highly skilled vacancies at premiere VA hospitals around the country is challenging,” said Celli. “The American Legion calls on Congress and the American people to treat VA with fair and balanced criticism as well as praise. We all have a moral obligation to make it better, not torture it to death.“