[tired&retired]

Common sense is missing...

[PistolPaknMama]

Who would the Head Nurse report to if not the MD who is the dept head?

[proxy_user]

There are many companies that are also organized like this.

You can imagine how well this works. Anyone trying to do anything has to beg other departments to participate in his project. Why should they? They’ve got their own projects.

[Grampa Dave]

You are correct re the power structure. It is designed to protect the left wing inefficient employees.

Years ago, most VA hospitals were staffed with liberals and run by liberals. They had paper goals that often were not aimed at better care. If a VA head or his department head met or exceeded those bs goals, they often got cash bonuses and promotions while patients suffered. It is probably even worse for the vets now.

[Sequoyah101]

I see the same thing in companies. The result is that functionally nobody is accountable to anyone.

One large client asked what we thought was the root cause of their performance problems.... everybody is a general or an officer... no non-coms and no enlisted people.... everybody participates but hardly anyone is committed or accountable.

I saw a neat Navy training video called “The Chiefs” from the 70s. The Chiefs were large, competent, in charge and accountable for the most part.

I say to thank the likes of business consultants like McKinsey and Booz, Allen and Hamilton for the mess we are in in the business place now. Their flattening and right sizing from the 90s was just plain BS. CEOs then actually hired these outfits to come in and tell them how to run their companies. The pattern was to bring in a very personable senior person, a firm partner, as project lead to smooze the management and a legion of MBA youngsters to bill lots of hours, thus the reputation of the firms for being sweatshops. The more attractive young girls they could bring in to the project the better. Huge amounts of staff time were spent telling these children how we did our jobs and then they would write reports to tell us how we did our jobs.

Wonderful.

[Organic Panic]

Government run.

[The Great RJ]

Simply stated the VA is a bloated government bureaucracy with unions and corrupt administrators that make any change all but impossible. A perfect example is the paying of “bonuses” to high officials. At the Phoenix VA administrators knowingly committed fraud to get their bonuses by manipulating the waiting list numbers. There is ample evidence of this fraud for a federal grand jury to issue indictments against these VA officials and bring them to trial. Yet nothing is happening. There is no FBI investigation, no grand jury indictments, no outright firing of these corrupt officials and only a half hearted effort by Obama for political damage control. The VA officials face nothing more than a reprimand and will simply retire on cushy VA pensions as if nothing happened. Look at Lois Lerner at the IRS...same thing at the VA.

[amigatec]

The Nurses fall under Chief of Nursing, both Primary care and the Floor Nurses.
The Doctors fall under Chief of Staff. Same as nurses both Primary care and floor Dr.s.
The people in Pharmacy fall Chief of Pharmacy.

Etc, etc.....

So at the Big Table you have a BUNCH of GS-13’s.