Tuesday, July 1, 2014

Saturday Morning Tea

So, the VaSpa has been in the headlights lately.  Shin is gone, everyone is wroth and righteous fury is in the air.


Lets go through the process of evaluating this.  Shitheads in Phoenix and a couple other locales fucked around with how they maintained records on the hot button issue of patient wait lists.  Dudes, this happened before in 2005.

So let me run it down for you.

Simply put, the workers and the chain of command who did this should be summarily dismissed.  They won't be.  There will be a few "resignations" to a comfortable retirement.  But the rank and file GS-4 to GS-6's who did the dirty deed day-to-day (after all Befehl ist Befehl) will be back on the job tomorrow, with a slap on the hand and some retraining that will most likely be as efficacious as the retraining that I have repeatedly taken on appointment scheduling.  (1)

The problem lies very deep in the VA.  It probably goes through to the bone.  VA is the ultimate land of Dilbert.  But it is a special kind of Dilbert, One where incompetence is desperately difficult to remove.  One where obedience and subservience are enshrined and cultivated.  Where pushing back and trying to do the right thing can land you with a poor performance report, no promotions, a dead-end job, and no bonus.(2)

Lets get this straight.  I think that the VA handing out bonuses is the most politically tone-deaf thing that I have ever heard in my life.  We get paid OK, and the bonuses the rank and file get are small.  The serious money in bonuses is at the "Senior Executive Service" level.

We do an OK job.  That's it.  We struggle like hell under a whole series of conflicting and contradictory goals.  We have to deal with Congresscritters, a unique demographic, not enough doctors and a management team that is so spineless and venal as to be laughable.

So here is my take.  Bonuses and advancement weighed against insufficient resources coupled with a serious lack of primary care providers and clinic space taken up by a swollen bureaucracy needed for the endless stream of regulations emanating from DC-land.


(1)  Just to make it clear, I don't schedule appointments for patients at the VA, I get the paperwork and records ready to do the job when the patient gets there, though I can schedule patients in a pinch.

(2)  One of the pleasures I have in working at the VA is that I am right where I want to be professionally.  I plan on retiring seven to ten years from now as a GS-6 and have no hunger to advance in the system (by then, with my military time thrown in, I will have my 20 and be in the sweet spot of 67-70 yo, when the social security check, should such a thing actually still be available, is pretty good) .

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