VA Clinic Leadership 'Reform' Really Just Shifting Managers Around

Reupholstering the deck chairs on a sinking ship


Bob McDonald

According to a USA Today investigation, The Department of Veterans Affairs (VA) is solving its management crisis the way government institutions have since time immemorial: They're moving staff around rather than dumping people and replacing them.

In the wake of its massive scandal where veterans were dying while sitting on wait lists and unable to get medical care, VA Secretary Bob McDonald promised new leadership at medical centers. He is correct in a very literal sense. Two-thirds of the VA medical centers have new directors, 92 since McDonald took office. The problem? Only eight of these new directors are from outside the VA administration. Many others have been simply shifted from facility to facility.

The administration's response is essentially, "This is fine":

President Obama has echoed McDonald's pride in the VA's transformation, saying on a recent CNN forum that "we have, in fact, fired a whole bunch of people who are in charge of these facilities." In fact, the VA only moved to fire seven medical center directors. One of them quit and another retired first.

Of the 69 permanent directors installed since McDonald took over, 49 transferred from a different VA medical center, while 12 came from different jobs within the same hospital. The moves included promotions, for instance from associate director to director of a medical center.

In 22 cases, the VA moved directors from one center to another, sometimes to more complex hospitals, but at other times, to less complex facilities. In Ohio, directors in Chillicothe and Columbus simply switched places.

Some of the directors came from facilities where they faced issues ranging from low-ranking quality of care to wait-time falsification to mismanagement identified by outside investigators.

Reporter Donovan Slack notes further the specific problems and misbehaviors by a handful of these directors. But certainly they must have learned their lessons, right?

Why can't they bring in more outsiders? The VA administration claims money is an issue. Salaries for directors are about half of what they can make in the private sector, and they blame Congress for failing to raise the salary cap.

Of course, the problem with that argument is that the VA has a history of blowing money it's given, and that has increased congressional skepticism of giving them more. The VA got $15 billion in funds but that didn't improve veterans care. And over the course of a decade the agency spent millions on artwork while care languished.

A representative for the agency also noted that the hiring process is very slow and heavily favors applicants with federal experience. This system, of course, is a result of decades of self-serving government employee influence and power. It will resist reform and change, and there's very little to suggest in USA Today's reporting that it will be coming from this administration (and possibly not the next one either).

Read more here.

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  1. VA Clinic Leadership ‘Reform’ Really Just Shifting Managers Around

    +1 Post Office.

  2. Imagine that. I worked for a company once when the president hired a brilliant new VP who he had just met at a bar. The guy comes in, president puts him in charge of operations. First thing he did was shift the offices around, put customer service where accounting was, put accounting where IT was, etc, etc. That was the first of his ultra-brilliant strategy. He finally got fired when it became obvious even to the president that the guy was an idiot. In politics none of this matters, it’s other people’s money that the idiots are losing.

    1. Feng Shui management. The first sign you’ve got bad management is when they think they can fix dysfunction by moving furniture around. That’s your cue that they don’t have any real ideas.

  3. I’m surprised there’s nothing on the video of the Hillary campaign paying people to cause trouble and having illegal relationships with these groups.

    1. We can’t talk about Hillary, because Trump! You some sort of Trumpet?

      1. I know right? When is RAISIN ever going to post a non-Trump article?

  4. They’re moving staff around rather than dumping people and replacing them shuttering their evidently superfluous offices.

  5. It’s almost like government controlled monopolies are inefficient, self serving, expensive, and corrupt. Who could ever guess this would be true?

  6. In my work I get the displeasure of going into federal agencies now and again. I remember one time the figurehead had changed so I asked one of the drones about what kind of changes were to be expected. The drone laughed at me, then laughed some more. Bureaucracies cannot be changed. They have their own momentum that no figurehead can affect.

    1. They can move the office furniture around.

      1. Once you fill out the proper forms in triplicate, sure.

    2. Maybe it was just the colander on your head.

  7. “…the hiring process is very slow and heavily favors applicants with federal experience.”

    Candidate 1: I successfully implemented improvements in quality and service, while cutting costs every year.

    Candidate 2: I successfully lobbied for budget increases every year.

    That second guy as VA upper management written all over him.

  8. Reupholstering the deck chairs on a sinking ship

    Except the ship’s not sinking. In fact it just got a nice big bonus and the captain is refurnishing his suite.

    1. And they’re adding on a new wing.

  9. It’d be *nice* if they disbanded the VA and gave us freaking voucher. Then I wouldn’t be looking at a minimum of 5 hours (let’s get real, they’ll send me to Tucson – so it’ll be a whole day trip just to get there) to see a VA doctor *and* I’d have some control over the quality of care that I received.

  10. So America’s closest analog of ‘single payer’ is a disaster, with Death Panels not on org chart but as side effect of all that indifference. Right-wingers would have good comparison here, but since veterans…they love that single-payer.

  11. Just before he became the head of the VA Bob McDonald was Chairman, President, and CEO of Procter and Gamble. Under his leadership the company became moribund as revenue and profits went from growing to being flat then to declining; other financial stats and ratios followed south too. After McDonald left the P&G Board replaced him with a former Chairman and CEO who started the process of a turnaround. The company is still in the process of recovering.
    Bob may be a nice person (I don’t know as I have never met him) but he is a text book example of the Peter Principle – managers rise to the level of their incompetence. Though nowadays they seem to get promoted one last time to showcase their utter incompetence.

    1. “Hey, this guy has failed in the private sector, he knows how hard it really is out there!”

  12. Assignment Shifts!
    Say, isn’t that how the Vatican tried to deal with the problem of Pedophile Priests?

  13. The fact remains: VA is mostly very good at what it does, and patients report high levels of satisfaction with the care there, according to EXTERNAL evaluations and surveys by NEUTRAL, OBJECTIVE agencies such as the RAND Corporation and the American Customer Satisfaction Index (ACSI).

    1. I’m sure those external evaluators don’t have any selective bias when it comes to their methodology either (since most of them receive government funding for their research).

      My friends who have served and are still relatively young and healthy are okay with the system because other than free meds and checkups, they never use it. OTOH, my dad’s friends who actually need healthcare constantly complain because they can’t get proper care, relative to what their buddies who have private insurance can get.

      Of course, the ones who have died because their VA plan basically just gave them meds for pain when they could have gotten actual treatment don’t complain at all anymore. Maybe the evaluators counted them as “satisfied” on their BS report.

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