Too few doctors and nurses for veterans in some areas
WASHINGTON — As the nation prepares to honor its veterans Nov. 12, many veterans in rural areas and some cities still face long wait times for health care because there aren’t enough doctors, nurses and support staff to provide it.
Almost 40,000 of the 335,000 positions in the Veterans Health Administration are vacant, according to the Department of Veterans Affairs, which oversees the VHA. The VHA serves about 9 million veterans.
The VHA’s turnover rate is less than half the rate for the health care industry overall.
However, a Stateline analysis of recently released federal figures shows the VHA has a severe vacancy problem in high-cost urban areas such as Los Angeles and Washington, D.C., and in largely rural states, such as Montana and Colorado.
Montana and Colorado have the highest state job vacancy rates at more than 20 percent, followed by Utah, Oklahoma and Maryland. At the other end, vacancies in Connecticut, Hawaii, Michigan, Minnesota, New Mexico and Rhode Island are less than 8 percent.
In some ways, the challenges facing the VHA are the same ones facing the health care workforce as a whole, especially in rural areas like Montana, said Kristin Mattocks, a Montana native and associate professor at the University of Massachusetts Medical School who has studied VHA efforts to improve care for veterans.
Nationally, job openings in the health care sector have nearly tripled to 1.1 million since 2010, according to Bureau of Labor Statistics data. Most of the communities with shortages of health care workers are in rural areas, according to the Health Resources and Services Administration. There are also shortages in Honolulu, Hawaii, Los Angeles and Washington, D.C.
As more doctors and other providers in the VHA and elsewhere have been retiring, there’s more pressure on the remaining doctors to absorb more patients and speed up appointments.
“Now the pressure is put on physicians, which is probably driving some folks” away, Mattocks said.
The vacancy rates, detailed in a new report required by legislation Congress approved this year, can cause long wait times for appointments, create waitlists for artificial limbs and lead to unsanitary conditions.
Most of the nearly 40,000 vacancies are for medical and dental staff such as doctors and nurses. Those professionals are hard to find and keep because VHA’s hiring process is time-consuming and the pay is lower than in the private sector.
And because there isn’t sufficient support staff, many VHA doctors say they are frustrated by having to do more paperwork and even clean offices, federal audits have shown.
In Colorado last year, the Denver Post found that the VHA postponed surgeries because it didn’t have enough anesthesiologists. Understaffing led to dirty storage rooms and canceled surgeries for anesthetized patients at the VHA’s flagship hospital in Washington, D.C.
And veterans in Connecticut had a hard time getting appointments for counseling because four key jobs were vacant earlier this year. U.S. Sen. Richard Blumenthal, a Democrat from Connecticut, in a September hearing called the vacancy figures “really staggering.”
Blumenthal added that leaders of the local Veterans of Foreign Wars chapter had complained that care was held up at a Norwich, Connecticut, clinic because the local office lacked a director, a case manager, an outreach coordinator and a counselor.