Whistleblower says Veterans Affairs cost-cutting led to denials, delays in life-saving cancer tests

Patients in a Southeast Texas Department of Veterans Affairs medical system faced denials or long delays in getting routine colonoscopies and other medical tests because of bureaucratic cost-cutting, a former top administrator told the Washington Examiner in an exclusive interview.

Dr. Richard Krugman, former associate chief of staff at the Veterans Affairs health care system based in Harlingen, Texas, said his boss implemented a policy in 2010 that colonoscopies would only be approved if the patient tested positive in three successive screenings for bloody stools.

“By the time that you do the colonoscopies on these patients, you went from a stage 1 to a stage 4 [colorectal cancer], which is basically inoperable,” said Krugman.

Now we’re hearing of VA reprisals against vets who complain about delays in treatment.

“We don’t like your attitude, so your file goes to the bottom of the stack. That’s three extra years of waiting for you, pal.”

I have long believed the VA, and other bureaucracies, cook the books, or keep two sets of books, in order the look good and increase their individual annual bonuses.

I don’t know when the bonuses for everyone scheme came into play for federal workers, but it has come as a detriment to effective government - and menace to the taxpayer.

I've been a VA contractor examining medical records of cancer patients in different VA facilities since the early 2000s. I can assure you that bleeding from the rectum is not a prerequisite for a colonoscopy at all facilities, and referrals for colonoscopies get a high priority, as this is a known weak spot in the VA system. There are good VA hospitals out there, but what I have noticed is that they are usually a reflection of the caliber of people in the local community, which is no surprise. The biggest problem I've seen is with inferior providers at some facilities, those who can hardly write in English; those who don't seem to care or ever even talk with the patient; and those who can't make up their minds about the patient’s diagnosis and tend to stall treatment by referring patients endlessly for more tests that take more time. Another issue is that the people who run the clinics at the lower levels are sometimes inferior employees who just don't give a damn and only care about their break times. They are impossible to get rid of, and the problem is especially bad at facilities located in inner-city, high-crime areas. This puts an additional burden on the medical staff and leads to earlier burn-out. I've seen a contract proposal out one such VA that would have been impossible to work, as they evidently wanted to protect the on-site VA employee. He couldn't do his job for the vets because he was too busy doing union work, which took up all of his time. Communication and leadership at the top levels is also miserable, and there is little standardization between facilities.

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

“That was done because of dollars and cents. For the VA, they have to be bleeding out of their rectum before they would authorize a colonoscopy. That was the standard of care,” he said.