One major problem with VA management is that there is no vertical lines of authority.
You can be in charge of a unit but none of the employees in the unit answer to you.
Psychologists answer to the chief psychologist in the hospital.
Nurses answer to the chief nurse in the hospital.
Social workers answer to the chief social worker in the hospital.
Psychiatrists answer to the chief psychiatrist..
Physician’s Assistants answer to the chief PA for the hospital...
All horizontal lines of authority and it sucks... no authority in a management position.
Biggest problem with the VA as well as all federal departments is the cumulative effect of two generations of affirmative hiring and promoting.
They need to set up a cost accounting/management reporting system for the VA so they can tell which employees are working and which ones are slacking. The majority are slacking.
I used to do this for large hospitals back prior to the switch to DRG reimbursement. It used to be cost reimbursement prior to that. You would compute weighted average daily admissions and compute cost per unit figures for each department.
Union, union, union. Death lists were a sign that your care is based on limited choices. I paid to go to a good VA in NC, but I think the system is overwhelmed with 30 year olds coming to the ER for congestion, migraines, things they should be seeing a pcp for. My really wonderful PA had to retire for serious medical condition, so I quit going.
The VA clinic in Lewisburg WV was housed with some other govt agencies, but had to close for months and months due to air quality. At the time, WV was a union slavery state.
It’s too much trouble to reapply, so I am not planning on going back.
Air quality... btw.. the other agencies were open in the very same building. I called B Sanders office because he was the VA head at the time.
They told me, they didnt want to provide me with bad care, to which I replied.. no care is bad care.