thedrifter
05-09-07, 06:14 AM
Surgeon says VA hospital has 18-month backlog
By: WILLIAM FINN BENNETT - Staff Writer
A shortage of surgeons, nurses and auxiliary staff has created a backlog of 500 patients awaiting orthopedic surgery at the Veterans Affairs Medical Center in La Jolla, a surgeon who works at the hospital said Tuesday.
In some cases, those patients must wait as long as a year and a half for their surgeries, orthopedic surgeon Mark Murphy said, in response to questions from the North County Times. He added that 227 of the patients are waiting for joint-replacement surgery.
"We are at the point where we really need the help," Murphy said. "It's like the Alamo, waiting for Santa Anna to come over the hill and holding him off as long as you can."
The backlog problem at the VA hospital in La Jolla came to light Saturday during a meeting U.S. Rep. Darrell Issa held by phone from Baghdad with about 3,000 constituents from his 49th Congressional District.
Murphy participated in that meeting and registered his complaint about the backlog, asking Issa for his help in securing more funding for the hospital.
A hospital official acknowledged the backlog for orthopedic surgeries Tuesday, but said hospital officials are taking a number of steps to address the problem, including increasing the hours of operation for operating rooms and transferring some elective surgeries to the San Diego Naval Medical Center, the official said. He said the backlog of people needing joint-replacement surgery stands at 165 patients not the 227 patients claimed by Murphy.
Murphy stressed that the patients on the waiting list are those in need of elective, nonemergency surgeries. But that doesn't necessarily mean the wait is not difficult, he added.
When a person needs joint-replacement surgery, "it means you have a chronic painful condition," Murphy said.
The hospital's chief of surgical service, Erik Owens, said he could not immediately confirm the number of patients who are in line for orthopedic surgery, but he acknowledged that some patients were waiting as long as 18 months for elective surgeries.
"By the end of the calendar year, we hope to have things down to ... under six months," Owens said. "That's our goal and we hope to see it even better than that."
He said the hospital is working hard on solving the problem and is looking at three key tentative solutions:
- increasing the hours that operating rooms are used for surgeries -- currently, half of the six operating rooms used for orthopedic surgeries function from 7 a.m. to 3:30 p.m. and the other half from 7 a.m. to 7:30 p.m.;
- transferring some of the hospital's elective surgeries to San Diego Naval Medical Center; and
- identifying veterans who are also eligible for treatment through their branch of service and informing them of their options.
"Initial research says we may identify as having dual eligibility 10 percent to 20 percent of those on the waiting list," Owens said.
VA hospital officials are working with officials at the Naval Medical Center to see if transferring surgeries will be possible, Owens said.
Murphy said the prolonged wait times have existed for years. About three years ago, hospital officials began taking steps to streamline operations, he said, adding that he believes the wait times would have dropped dramatically if not for one thing.
In 2004, the VA changed its rules and began to allow returning service personnel from the wars in Iraq and Afghanistan automatic eligibility into the VA health care system for an initial two-year period, Murphy said.
Veterans hospitals across the nation were immediately flooded with new patients, he said.
"When that shortcut happened, Veterans Affairs didn't increase staffing of doctors, nurses and support -- so our waiting lists started to grow and grow," he said.
Any progress the hospital had been making with its streamlining was eaten up by the influx of new patients, Murphy said.
Most of the patients waiting for elective joint replacement are older veterans from earlier wars, he said. But the surge in new patients from the wars in Afghanistan and Iraq is taxing the whole system and pushing elective surgeries further back in the line, he said.
"In effect, waiting times haven't improved at all because of increased demand," Murphy said
Owens said he "respectfully" disagrees with Murphy.
Iraq and Afghanistan war veterans are not having much effect on patient loads at the local VA hospital, Owens said. Rather, he said, more and more veterans are seeking to enter the VA health care system as they lose other types of health insurance.
Besides, he said, increasing staffing is not the first step in solving the problem. The first step is increasing the number of operating rooms or the amount of time they are operating. Once that goal is reached, then it would be time to consider increasing the hours of existing staff or hiring more doctors, nurses and others.
UC Berkeley professor of health policy John Ellwood said Tuesday that the issues faced by the VA hospital in La Jolla are a question of national priorities.
"I think we have been unwilling as a society to increase the resources of the Veterans (Affairs Department)," he said. "That is a value choice on the part of society."
-- Contact staff writer William Finn Bennett at (760) 740-5426 or wbennett@nctimes.com.
Ellie
By: WILLIAM FINN BENNETT - Staff Writer
A shortage of surgeons, nurses and auxiliary staff has created a backlog of 500 patients awaiting orthopedic surgery at the Veterans Affairs Medical Center in La Jolla, a surgeon who works at the hospital said Tuesday.
In some cases, those patients must wait as long as a year and a half for their surgeries, orthopedic surgeon Mark Murphy said, in response to questions from the North County Times. He added that 227 of the patients are waiting for joint-replacement surgery.
"We are at the point where we really need the help," Murphy said. "It's like the Alamo, waiting for Santa Anna to come over the hill and holding him off as long as you can."
The backlog problem at the VA hospital in La Jolla came to light Saturday during a meeting U.S. Rep. Darrell Issa held by phone from Baghdad with about 3,000 constituents from his 49th Congressional District.
Murphy participated in that meeting and registered his complaint about the backlog, asking Issa for his help in securing more funding for the hospital.
A hospital official acknowledged the backlog for orthopedic surgeries Tuesday, but said hospital officials are taking a number of steps to address the problem, including increasing the hours of operation for operating rooms and transferring some elective surgeries to the San Diego Naval Medical Center, the official said. He said the backlog of people needing joint-replacement surgery stands at 165 patients not the 227 patients claimed by Murphy.
Murphy stressed that the patients on the waiting list are those in need of elective, nonemergency surgeries. But that doesn't necessarily mean the wait is not difficult, he added.
When a person needs joint-replacement surgery, "it means you have a chronic painful condition," Murphy said.
The hospital's chief of surgical service, Erik Owens, said he could not immediately confirm the number of patients who are in line for orthopedic surgery, but he acknowledged that some patients were waiting as long as 18 months for elective surgeries.
"By the end of the calendar year, we hope to have things down to ... under six months," Owens said. "That's our goal and we hope to see it even better than that."
He said the hospital is working hard on solving the problem and is looking at three key tentative solutions:
- increasing the hours that operating rooms are used for surgeries -- currently, half of the six operating rooms used for orthopedic surgeries function from 7 a.m. to 3:30 p.m. and the other half from 7 a.m. to 7:30 p.m.;
- transferring some of the hospital's elective surgeries to San Diego Naval Medical Center; and
- identifying veterans who are also eligible for treatment through their branch of service and informing them of their options.
"Initial research says we may identify as having dual eligibility 10 percent to 20 percent of those on the waiting list," Owens said.
VA hospital officials are working with officials at the Naval Medical Center to see if transferring surgeries will be possible, Owens said.
Murphy said the prolonged wait times have existed for years. About three years ago, hospital officials began taking steps to streamline operations, he said, adding that he believes the wait times would have dropped dramatically if not for one thing.
In 2004, the VA changed its rules and began to allow returning service personnel from the wars in Iraq and Afghanistan automatic eligibility into the VA health care system for an initial two-year period, Murphy said.
Veterans hospitals across the nation were immediately flooded with new patients, he said.
"When that shortcut happened, Veterans Affairs didn't increase staffing of doctors, nurses and support -- so our waiting lists started to grow and grow," he said.
Any progress the hospital had been making with its streamlining was eaten up by the influx of new patients, Murphy said.
Most of the patients waiting for elective joint replacement are older veterans from earlier wars, he said. But the surge in new patients from the wars in Afghanistan and Iraq is taxing the whole system and pushing elective surgeries further back in the line, he said.
"In effect, waiting times haven't improved at all because of increased demand," Murphy said
Owens said he "respectfully" disagrees with Murphy.
Iraq and Afghanistan war veterans are not having much effect on patient loads at the local VA hospital, Owens said. Rather, he said, more and more veterans are seeking to enter the VA health care system as they lose other types of health insurance.
Besides, he said, increasing staffing is not the first step in solving the problem. The first step is increasing the number of operating rooms or the amount of time they are operating. Once that goal is reached, then it would be time to consider increasing the hours of existing staff or hiring more doctors, nurses and others.
UC Berkeley professor of health policy John Ellwood said Tuesday that the issues faced by the VA hospital in La Jolla are a question of national priorities.
"I think we have been unwilling as a society to increase the resources of the Veterans (Affairs Department)," he said. "That is a value choice on the part of society."
-- Contact staff writer William Finn Bennett at (760) 740-5426 or wbennett@nctimes.com.
Ellie