By Sen. Thom Tillis

Last year, Americans were shocked to learn about the widespread systematic failures of the VA, with many veterans being forced to wait months to see health care providers. One VA center in Phoenix, Arizona, was so criminally mismanaged that at least 40 veterans died as a result. Soon after, a nationwide audit was released that revealed North Carolina VA facilities had some of the worst wait times in the nation.

Unfortunately, one year later, many of the same institutional problems plaguing the VA system persist. A recent Associated Press investigation found that North Carolina facilities continue to suffer from unacceptable wait times.

As a representative of North Carolina’s nearly 800,000 veterans and a member of the Senate Veterans’ Affairs Committee, one of my top priorities is ensuring that we honor our commitment to the brave men and women who have served our nation.

Earlier this month, I embarked on a fact-finding mission, visiting VA Medical Centers in Fayetteville, Durham, and Salisbury to meet with facility leaders and veterans to receive firsthand updates on wait times and other challenges facing our state’s VA centers.

I know from my years of consulting businesses in the private sector that one of the keys to managing complex and bureaucratic organizations is to constantly apply new ideas and practices to help them remain viable in the midst of emerging challenges.

After visiting North Carolina’s VA medical centers and reviewing the compelling testimony and research of Duke Hospital’s Office of Veterans Affairs, I sent the Secretary of Veterans Affairs, Robert McDonald, a series of recommendations to apply best business practices to the VA system in order to help ensure that our veterans have access to timely and quality care.

Some of my recommendations to Secretary McDonald include:

• Controlling the ever-growing size and scope of the VA bureaucracy. It is a shame that a state with vast medical and military resources like North Carolina is often unable to make use of those resources because the Veterans Integrated Services Network level discourages rapid response to a shifting environment. We need to significantly overhaul unnecessary layers of bureaucracy and give more flexibility to VA professionals on the ground who actually understand what the patients in their care need.

• Keeping VA clinics open longer. Many VA clinics currently close between 4 p.m. and 4:30 p.m.  each day, which are unusual hours for medical clinics in the United States. Figures provided by Duke University show that by keeping standard 8 a.m. to 5 p.m. hours, an additional 5 million veterans could be seen by health care professionals across the nation each year. 

• Addressing recruiting and retention issues for physician assistants and nurse practitioners. The private sector is rapidly moving toward making physician assistants and nurse practitioners a more visible part of its medical workforce to better meet patient needs, and the VA should do the same.

• Implementing a new credentialing system to get new health care providers into the VA system faster. North Carolina is home to some of the best medical schools and hospitals in the world, and yet our medical professionals are required to undergo duplicate educational and licensing background checks from the VA.

• Exploring the expanded use of urgent care. This will help keep patients out of the emergency room, which in turn will lead to more efficient and effective care.

• Promoting the use of private and military facilities by VA providers to better meet veterans’ needs. This can often be more cost-effective than simply outsourcing the care through non-VA care service, and will require enhanced cooperation between the VA and military hospitals with underutilized space, such as Fort Bragg.

I strongly encourage Secretary McDonald to consider my recommendations and work toward applying sound and proven business principles to the VA system. Fixing such a broken bureaucracy of the VA’s magnitude will not be quick, nor easy, but we owe it to our brave veterans to make the changes needed to provide them with optimal care. My commitment to all North Carolinians is to continue to work with my colleagues on both sides of the aisle in pursuit of common-sense solutions that make the VA more efficient and ensure that our veterans have access to the quality health care they need and deserve.

Tillis is a Republican U.S. senator from North Carolina.