Nationwide, tens of thousands of veterans have been waiting three months or more to get their first VA medical appointment.
The long delays have prompted widespread outrage, triggering audits of dozens of VA medical centers and leading Veterans Affairs Secretary Eric Shinseki to resign on May 30.
The uproar began earlier this year amid news reports of veterans dying while they waited to get medical appointments and of possible cover-ups over wait times at the Phoenix VA medical clinic.
The San Diego VA Healthcare System , however, is not under investigation. Still, wait times for new patients in San Diego average 44 days.
Wait times for new VA patients in California
As of May 15, 2014, these are the VA hospitals in California with the longest average wait times for new patients seeking primary care, specialty care and mental health care.
NEW PATIENT PRIMARY CARE AVERAGE WAIT TIME:
Greater Los Angeles Healthcare System: 56.2 days
Loma Linda: 44 days
San Diego: 43.8 days
Northern California Health Care System: 43.5 days
Palo Alto: 42 days
Long Beach: 33.7 days
San Francisco: 29.7 days
Fresno: 25.5 days
NEW PATIENT SPECIALTY CARE AVERAGE WAIT TIME:
Fresno: 61.4 days
Greater Los Angeles Healthcare System: 55.1 days
Long Beach: 50.6 days
Loma Linda: 50.4 days
San Francisco: 49.7 days
San Diego: 43.7 days
Palo Alto: 42.1 days
Northern California Health Care System: 40.3 days
NEW PATIENT MENTAL HEALTH AVERAGE WAIT TIME:
Greater Los Angeles Healthcare System: 39.3 days
Long Beach: 38.1 days
San Francisco: 35.9 days
San Diego: 34.5 days
Fresno: 30.7 days
Loma Linda: 27.6 days
Palo Alto: 25.3 days
Northern California Health Care System: 22.3 days
Inside one of the clinics at the VA Medical Center in La Jolla, it’s hurry up and wait for the patients who have appointments.
Outside, ex-Marine Joel Dominguez said when he first entered the VA medical system, it took him six months to get an appointment.
Dominguez complained that’s just too long.
“And the length of time you have to wait kind of discourages you, so you lose interest in trying to solve your medical issues. So you don’t have any faith in the system, so you stop trying," Dominguez said.
San Diego VA officials say the vast majority of existing patients can get in to see their primary care doctor within two weeks.
But they acknowledge new patients usually have to wait for six weeks.
The VA’s call center in Mission Valley makes appointments for all San Diego patients. Lately, it has received more than 10,000 calls a week.
Donna Fagan, chief of health administrative services, said operators are using antiquated scheduling software that makes it difficult to find an open appointment.
“Instead of it just being a big calendar where you can see everybody’s schedule, and who’s up next, if you will, no. You have to go through every single clinic. And we have thousands of clinics in our computer," Fagan explained.
Fagan said it takes a long time to master the dodgy software. But because of low pay, schedulers don’t usually stick around long enough.
VA Medical System Chief of Staff Robert Smith pointed out San Diego’s system faces two fundamental challenges.
“Space and resources," Smith said. "And that’s been true of the VA in San Diego for a long time. We do well in terms of the care that we provide, but we also have the challenge that this has been a growing community of veterans for a long period of time.”
In 2003, the system handled 452,000 outpatient visits. In 2013, that number grew to 822,512 outpatient visits. That's an 81 percent increase over the past decade.
Smith said the VA’s budget hasn’t kept pace with the growth.
The budget, he said, is based on the number of patients treated two years prior.
“And in an environment where you’re growing by 5 percent a year, as we have been, that means our annual budget is anywhere from 5 to 7 percent behind what we might need to care for the number of veterans that we have to take care of,” Smith said.
The VA Medical Center in La Jolla and the clinics in other parts of the region also are at or near capacity, he said.
“If I bring on another primary care provider, I have to have an office to put him in. I have to have exam rooms for him to see patients. And if we’re running out of space, we have real limitations on that," Smith said.
But some improvements are coming soon.
Construction crews are putting the finishing touches on a VA clinic in Sorrento Valley that is scheduled to open later this summer.
The clinic will have four primary care teams and 22 patient exam rooms, where patients can get mental health care, regular health care, and nutrition services.
The facility should help ease some of the burden on the VA’s existing primary care doctors, each of whom care for about 1,200 patients each.
San Diego’s VA is also expected to get an extra $11 million before the end of the year. That will cover veterans who choose to go outside of the system, rather than wait months for a medical appointment at the VA.
Veteran Joel Dominguez said his significant other, who’s also an ex-Marine, hasn’t found it easy to get care for her injured back.
“She got out in 2010. And she’s still trying very hard to get these things taken care of,” Dominguez said.
The VA has expanded its clinics’ hours and has opened additional primary care clinics on Saturdays.
For example, the clinics in La Jolla, Oceanside and Mission Valley are open half days on Saturdays and some evenings during the week. Mental health appointments are now available on Saturdays, too.
Smith said it would probably take a few more months to build extra internal capacity. In the meantime, he said, VA staff members are going all out.
“I don’t know anybody that comes into this building to work that doesn’t want to provide outstanding care for veterans. And I’ve never seen a more mission-driven group of people,” Smith said.
San Diego’s VA treated 75,000 veterans last year.
