by Dan Gorman
I’m a combat veteran who receives medical services from the VA here in Manhattan. For a long time, I avoided going because I felt that I wasn’t injured enough to warrant care, or at least not in the same way or degree that some of our more traumatized brethren are. But after battling frequent migraines and a bad back for the last ten years, I decided to reengage and see if there were any treatments that may help.
My first impression was that, by and large, the folks at the VA do greatly care about their patients and clients. Of course there are outliers, but the overall care is there. Following that, I quickly realized that this is a large, sluggish system that is working on old models of providing services and is woefully underequipped to be responsive and flexible—two traits the veteran community deserves.
As it turned out, I have a host of issues with my back and nerve damage caused by a previously undiagnosed bulging disc in my C6-C7 vertebrae. Treatment right now includes physical therapy and pain management appointments. The PT was straightforward to get into right away and I’m actively doing that now. Pain management, however, is another story. The earliest appointment I could get is February. Which seems right around the corner—only this appointment was made in early December. Yes, over two months to wait for shots that will likely decrease my chronic pain and allow me to function more fully on a daily basis. The reason for the delay? That clinic’s only open certain days a week due to staffing, and the need far outstrips their availability.
Now I’ll be the first to admit that my issues are minor and the wait is inconvenient, but survivable. But what about those with more serious issues, such as mental health crises and chronic illnesses that require a fully staffed primary health care team? If understaffing is affecting me, it’s absolutely affecting others in perhaps far more adverse ways.
This is the real danger of a hiring freeze. Lack of resources is not a problem solved by “draining the swamp” or completely changing policies midcourse. If this freeze continues even three months from today, we will lose an entire graduating cohort of medical professionals that could have chosen to serve the nation by serving veterans.
There is more than enough statistical and anecdotal evidence that VA hospitals do not have enough nurses, pharmacists, doctors or psychiatrists on staff. Social Workers on Patient Aligned Care Teams, one of which every veteran is assigned upon registering, have a minimum caseload of 2,500 patients at any given time. The HUD-VASH department, which does herculean work with state and federal agencies on interventions for veteran homelessness, is so consistently understaffed that many are part-time employees. Put “Veterans Affairs” in the search bar at usajobs.gov and you will see a consistent need for healthcare professionals across the board.
This is not to say staffing is the only problem. There are structural issues at the institutional level that need to be fixed by this administration. Compartmentalization of services, on overhaul of the benefits eligibility process, better relations with city and state services and instilling self-determination and resiliency among the veteran population all need to be addressed. No one denies this.
But preventing badly needed human capital from the equation does nothing to ameliorate the fact that we are consistently asking this department to do less with more for an ever-expanding population. We should absolutely hold the VA accountable, but it is unconscionable to complain that the “swamp” needs to go without a plan to grow trees in its place.