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VA clinic rated dismal Too few doctors is top issue
Employees of the Evansville Veterans Affairs Outpatient Clinic have given the institution, administered by the Marion, Ill., veterans hospital, a dismal review on job satisfaction, management quality and institutional "culture." In an all-employee survey last spring and in on-site interviews this fall, employees gave "filling physician vacancies" priority while citing a long list of deficiencies portrayed as compromising the quality of patient care at the Walnut Centre facility. nterviews with 46 staff members at the Evansville VA outpatient center were conducted Oct. 24 and 25 as a follow-up to a written survey of all employees last spring. A report was not released, but a summary of survey and interview results was obtained by the Courier & Press. Notable about the survey, said local veterans official Mark Acker, was that there were no surprises. "These are the issues we've been talking about for the last two years," said Acker, the Vanderburgh County Veterans Council's service officer. "This only confirms what we've been saying all along about the clinic." Acker also obtained a summary of the survey. Part of the physician understaffing issue is lack of a full-time psychiatrist, Acker said. "So a veteran with mental problems goes (into the Evansville clinic) to see a doctor and he talks to one on TV. ... They've put in this $25,000 TV system so psychiatric patients can talk to a psychiatrist via closed-circuit in Marion. It's not the way you do business when you're talking to people with mental problems who need close personal contact." Employees in Evansville generally portrayed medical staff as "dedicated," "knowledgeable" and "hard-working." But a "priorities for employees" section of the survey cited the "poor reputation of (the Veterans Affairs health care) in the community as contributing to the difficulty (in) recruiting physicians." The large patient load per physician, or "panel size" - estimated at 1,800 patients per month against a national VA average of 1,200 - was scored by a large proportion of employees as difficult to manage. Among other perceived deficiencies, employees also cited: - A poor institutional relationship with administration of the Veterans Affairs Hospital in Marion. High work demand, "fear of retribution," lack of "responsiveness" and "positive feedback" and short-circuiting any autonomy at the Evansville clinic. - Forcing sick patients to make a 180-mile round trip to the Marion hospital for treatments once routinely administered at the local clinic. - Inadequate space and need for a new building. On a five-point scale from "not at all satisfied" to "very satisfied," among the largest spreads between Evansville's clinic and the Veterans Health Administration average were in supervision, senior management and promotion opportunity. In Evansville, supervision and senior management were in the "not very satisfied" range, but in the "somewhat satisfied" range nationally. Promotion opportunity was in the "not at all satisfied" range in Evansville, compared with "not very satisfied" nationally. Becca Shinneman, spokeswoman for the Marion facility and for its director, Robert Morrel, said the survey was "still being reviewed" and declined to discuss it. Acker said he believed Morrel asked the Veterans Health Administration to conduct the survey. "We're victims of budget-cutting and people wanting to look good on paper," said Acker. He noted demand on veterans' health care is increasing with return of wounded from the Iraq war. "And," he added, "it's only the beginning." Acker, then-Veterans Council Commander Robert Ahrens and other area veterans went public 13 months ago about grievances with the local VA clinic and dissatisfaction with Morrel's leadership. Shortly thereafter, Evansville Mayor Jonathan Weinzapfel wrote Secretary of Veterans Affairs R. James Nicholson that any facilities needs could be filled by the just-remodeled Walker Building on the Downtown campus of the former Welborn Hospital. Two months later, Nicholson wrote Weinzapfel that his agency "will be glad to consider all prospective offers." But Jeff Jones, spokesman for St. Mary's Medical Center, which owns the Walker Building, said St. Mary's was notified in September that the building had been "taken off the list for the VA clinic." A contingent of local veterans organization leaders have continually complained about the quality and availability of medical services. Overloading a dwindling staff of Evansville VA physicians with patients, stripping the local clinic of services and making staff changes without explanation have ravaged morale at the clinic, veterans leaders say, and amount to the government's failure to keep faith with the men and women who have served in the nation's military. The Evansville Courier & Press
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