At Miami VA, hundreds of new patients wait 90 days or more for doctor appointments

An audit released Monday found more than 8,500 new patients waited three months or longer to see a doctor at Florida’s VA hospitals and clinics.

06/09/2014 7:40 PM

06/10/2014 3:46 AM

Nearly 770 new patients at the Miami VA Healthcare System have waited more than 90 days to see a doctor, according to WFOR-CBS 4 News — some of the more than 8,500new patients that the U.S. Department of Veterans Affairs announced Monday have waited three months or longer for initial appointments at six VA hospitals and clinics in Florida.

In an audit report issued Monday, the VA said the longest waits in Florida were at the Gainesville facility, where more than 1,200 new patients have waited more than 90 days for treatment. Nationally, more than 57,000 veterans have been waiting 90 days or more for their first VA medical appointments — information that was supplied only after reports emerged that some veterans may be dying while waiting for healthcare.

The VA’s goal is for first-time patients to see a doctor in 14 days — a target that the audit deemed “not attainable” due to poor planning and veterans’ growing demand for healthcare.

Of the six VA facilities cited for further review and investigation in the region that includes Florida, three were in the Sunshine State: Gainesville, Bay Pines and Lake City.

At the Miami VA, many new patients have waited longer than three months for their first appointment with a doctor, according to CBS 4, which obtained information gathered during an internal review of the Miami VA showing there were 769 new patients waiting more than 90 days for care.

Of those, 208 were waiting to get into audiology, 197 for dermatology, 96 for a primary-care physician, 89 for physical rehabilitation, 67 for neurology and 25 for general surgery.

Shane Suzuki, a public affairs officer for the Miami VA, said in a written statement that those numbers were accurate as of May 1 — but that figures had improved during that month.

He said the numbers dropped to 122 for audiology, 13 for dermatology, seven for primary care, five for physical rehabilitation, six for neurology and 12 for general surgery.

Suzuki said a patient can wait more than 90 days for an appointment for reasons “including patient choice, clinic capacity, willingness to travel and patients not canceling previously scheduled appointments.”

He said that Miami VA administrators have taken steps to improve access, such as extending hours of operation, examining physicians’ productivity, and offering some medical specialty services at non-VA medical centers.

A May 28 email from the head of the Miami VA, Paul Russo, to his staff — and obtained by CBS 4 — appears to confirm efforts to improve access for new veterans.

“Any patient out past 90 days is being reviewed and contacted to provide sooner appointment access either internally or through non-VA care authorizations,” the memo said. It also noted the VA was approving more overtime and hiring additional staff.

Still, the Miami VA’s experience in meeting the 14-day target appears to be as unattainable as the national audit determined.

CBS 4 reported that the VA provided a breakdown of how many new patients have seen a doctor within 14 days. In total, the Miami VA has been able to provide care within 14 days to a little more than half — about 58 percent — of the new patients it has seen since October, according to the numbers.

In the area of primary care, 3,478 new patients entered the VA since October but only 1,376 of them, or approximately 40 percent, were seen within 14 days. Of the 1,841 new patients at the mental health clinic, 1,139 of them, or 62 percent, were seen at the clinic within 14 days.

For psychiatry, 756 new patients requested appointments, with 668 of them, or 88 percent, receiving one within 14 days. For psychology, there were 331 new patients, with 291 of them, or 88 percent, receiving an appointment within 14 days

For substance-abuse disorders, 225 new patients requested an appointment, with 150 of them, or 67 percent, receiving an appointment within 14 days. And for post-traumatic stress disorder counseling, there were 328 new patients at the VA since October, with 223 of them, or 68 percent, receiving an appointment within 14 days.

The audit released Monday examined 731 VA hospitals and outpatient clinics nationally, and found more than 57,000 veterans on the 90-day-plus waiting list, with an additional 64,000 apparently falling through the cracks, never getting appointments after requesting them.

The audit found that, in asking front-line staff to rate the barriers that interfere most seriously with the timely care of patients, the two most commonly cited reasons were lack of provider appointment slots and “the peculiarities of the 14-day goal.”

VA officials ordered the audit following reports in April of patients dying while waiting for healthcare, and of agency administrators keeping secret waiting lists and falsifying records to conceal the excessive wait times. The controversy led to the May 30 resignation of VA Secretary Eric Shinseki.

In a statement accompanying the audit, acting VA secretary Sloan Gibson announced a set of reforms to ensure timely access.

Among them: establishing a new patient-satisfaction measurement program to provide “real-time, robust, location-by-location information”; holding senior VA administrators accountable; removing the 14-day scheduling goal from employee performance evaluations to diminish incentives for inappropriate scheduling practices; and hiring additional clinical and patient-support staff.

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