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Vets died before initial VA visits in ABQ

ALBUQUERQUE, N.M. — A new effort to contact hundreds of veterans who enrolled for VA medical care in Albuquerque over the past decade but hadn’t had an initial appointment found 21 cases in which the veteran had died.

Dr. Meghan B. Gerety, chief of the VA Integrated Care Service and former chief of staff at the Albuquerque VA medical center, said Tuesday that officials don’t know yet whether the waits had any role in their deaths.

“We are looking at every single one of those (cases) to make sure the wait for care was or was not related to their death,” Gerety said.

Meanwhile, a national audit released this week may not have provided an accurate picture of average wait times for veterans to see doctors at the Albuquerque VA Medical Center.

Dr. James Robbins, the interim medical director, told the Journal on Tuesday there is evidence of an “improper use” of the VA appointment scheduling process in Albuquerque, “and that does affect these numbers.”

Asked how the national VA numbers released for New Mexico can be trusted, in light of that practice, Robbins said, “That’s a good question.”

The audit report stated that more than 1,000 new patients at the Albuquerque VA medical center had been waiting three months or more for an initial appointment.

That number was based on the VA’s electronic wait list from mid-May. Since then, the number of veterans waiting has been cut nearly in half to 546, VA officials said Tuesday.

New Mexico ranked near the middle in the national comparison of average patient waits for primary care appointments at 731 VA medical centers surveyed.

The longest average wait reported was 145 days at the VA medical center in Honolulu. The shortest was less than a day at the VA medical center in Detroit.

The New Mexico results showed average waits for new patients for primary care appointments at 46 days and established patients at about eight days.

Those waits were based on data from the VA’s computer database, Robbins said.

Robbins, who is on loan from the regional VA offices in Phoenix until a new director is appointed, said VA officials here are looking beyond the numbers and instituting changes to make the medical care for New Mexico veterans more transparent and more responsive.

“We know we have a problem with wait times,” he told the Journal.

The Journal reported last month that the VA launched an internal inquiry into the scheduling practices at the Albuquerque medical center last fall.

The investigation focused on whether employees were directed by supervisors to enter appointment information into the VA computer system so patient wait times appeared shorter than they actually were.

The national VA at the time had a 14-day target for patients to be seen and had promised performance bonuses to VA managers who met that goal.

Those bonuses have now been canceled under a national VA directive and the 14-day goal abandoned as impractical.

The national audit report released this week measured waits within 30 days and in excess of 30 days, instead of 14 days.

New Mexico, in that regard, showed only about 8 percent of 45,093 appointments as of May 15 were scheduled beyond 30 days.

The new audit results were challenged by at least one member of New Mexico’s congressional delegation this week.

Rep. Michelle Lujan Grisham, D-New Mexico, issued a statement this week saying she was “very skeptical of the audit report because it relies on information provided by the VA that does not match what we’ve been hearing from constituents, at my town hall or in news reports from around the country.”

VA officials reiterated on Tuesday that there was no secret waiting list of patients at the Albuquerque VA medical center – as has been alleged at the VA medical center in Phoenix.

However, the Journal has reported that up to 3,000 New Mexico veterans who needed a primary care physician were assigned to a physician administrator who doesn’t treat patients – and that the veterans weren’t told of the practice.

For nearly a year, the patients were monitored and their prescriptions refilled, Robbins said. They were referred to a treating physician if they had an urgent need. But they had no primary care doctor assigned.

Those patients weren’t placed on the medical center’s official electronic waiting list – the same list considered during the recent VA audit.

“It was a way of trying to cover those patients while we were recruiting for additional physicians,” Robbins said.

Gerety said the VA has used alternative methods of staffing when confronted by physician shortages in the past. That included hiring so-called locum tenens physicians who fill a temporary gap and stay several months to six months.

Asked why the temporary physicians weren’t hired for the 3,000 veterans who were assigned to the physician administrator, Gerety said, “We were optimistic that we would be able to recruit more quickly than we were able to.”

Hiring a physician can take months, VA officials said.

As part of the new push to reduce waits and provide better access, the VA in Albuquerque is hiring two additional physicians and support staffs.

Among changes instituted locally, VA schedulers are being reassigned to a different supervisor and will undergo new training, according to VA associate director Pamela S. Crowell.

And the VA last weekend held a special walk-in clinic for veterans seeking care.

Robbins said the VA’s Office of Inspector General apparently is finishing up a criminal investigation into the allegations in Albuquerque that records were deliberately falsified.

Dick Westphal, who served with the U.S. Navy during World War II, told the Journal on Tuesday he’s had no problems getting in to see his primary care physician or specialists at the Albuquerque VA medical center.

“I was with one of the private insurers previously and the service here is 10 times better than what I had,” he said.

Westphal, who lives in the East Mountains, said he’s getting tired of the focus on lengthy waits for veterans to see doctors.

“To me that’s not a big deal,” he told the Journal on Tuesday. “But I don’t like falsifying records, and if that was done they should be punished one way or another.”