Whether he’s recruiting new employees or giving out his cell phone number, Veterans Affairs Secretary Bob McDonald is reshaping how things work at the VA.
When it comes to fixing the well-publicized problems in the Department of Veterans Affairs (VA), Secretary Robert McDonald wants to hear from everyone. And he means “everyone,” which is why he gives out his personal cell phone number.
It’s hard to think of the head of a major government organization being so accessible, but that’s part of McDonald’s goal to fix the VA. He wants to change attitudes and perceptions, and gave out his cell phone number (513-509-8454) during his first national press conference last September.
And yes, he does answer phone calls and text messages when he can. McDonald estimates he’s received roughly 900 calls and texts as of last November’s media roundtable with veteran service organizations, including Paralyzed Veterans of America (PVA), in Washington, D.C.
By the way, if he does answer, call him Bob. He doesn’t want to be called Robert or secretary. Bob wants an organization where everyone is known by their first name.
“We are trying to reduce the formality, the hierarchy,” Bob says. “We are trying to create a flatter organization so there is less distance between the veteran and the headquarters. When I go out to meet with people, I meet with everybody.”
The Veteran Is The Customer
Meeting with people has been one of Bob’s main activities since taking over the embattled VA late last July.
He’s crisscrossed the nation multiple times meeting with veterans, VA employees, the whistle blowers, union representatives, the media, members of Congress and plenty others.
“I want everybody in the tent working toward the same objectives and I find the best way to do it is to be inclusive,” Bob says.
Veterans Affairs Secretary Bob McDonald, center, says it’s important he hears from everyone about problems.
Changing the culture in the VA is one of Bob’s main objectives and he’s doing that by drawing on his past as former CEO of Proctor and Gamble.
Referring to an organizational pyramid, the West Point graduate explains that some companies put customers and customer service at the bottom while people such as the CEO are at the top. Bob says really good companies place customers and customer service much higher, and at the VA, the customer is the veteran.
“My job is to make everybody else’s job here [at the VA] to serve that customer,” he says.
He wants VA employees to recommit themselves to the mission of caring for the veteran. Bob says to remind employees their mission, they’ll be wearing a button with the acronym “I C.A.R.E.” (Commitment, Advocacy, Respect, Excellence).
“Basically, if you are an employee of the VA and you are not committed to that mission then you don’t stand to those values and those values don’t inform you how to behave every day then we don’t want you here,” he says.
Some of those unwanted people have already been removed from the VA and others could soon follow.
Part of changing the culture in the VA has involved investigating those responsible for the problems that first surfaced almost a year ago. Disciplinary action has been brought against 41 people so far and more than 100 investigations were ongoing as of the media roundtable last November.
The Department of Justice and the FBI are involved in the investigations, but Bob says the VA has to wait for those to be completed before it can take action. He notes that some investigations could lead to criminal charges, which would take priority.
When an investigation doesn’t lead to criminal charges, the files are turned over to the VA and it takes disciplinary action, which can include firing someone.
Among those fired is the head of the Phoenix VA Health Care System. The Phoenix VA was at the center of the scandal that involved long wait times for appointments and secret waiting lists.
Bob says the new Veterans’ Access, Choice, and Accountability Act of 2014 helps speed up the process of dismissing people by reducing appeal times in half. However, he adds, being quick isn’t the biggest priority for him.
“What’s important is making sure the end result is the separation of the person. So speed is important, but thoroughness and the ability for that proposal to stick is really what is important,” he says.
Responsibility For Care
Providing quicker disciplinary action is certainly a big part of the VA reform bill, but it’s the part of the law that deals with access to care and choice that has drawn the most attention.
Signed into law by President Barack Obama last August, the law provides $5 billion to hire more doctors and nurses and grants veterans the ability to access care outside the VA using a “choice card.”
The cards are provided to veterans who live more than 40 miles away from the closest VA health care facility or have to wait more than 30 days from their preferred appointment date or the date chosen to be medically necessary by their physician.
Choice cards went into effect Nov. 5 and Bob says they have “worked painstakingly” with many groups to “figure out the right way to do this.” He says they understand not everyone who receives a card is going to understand how they work.
Bob says information is key to this aspect of the law. There’s information sent with the card to explain why a veteran is getting it, but he says calling a toll-free phone number (866-606-8198) with trained experts can answer any questions.
Calling the number during the roundtable to demonstrate how it works, Bob says clarity is his concern. He says someone choosing to go outside the VA for care is a “big, big issue” and he or she has to take responsibility for the quality of that care.
“We will make sure people don’t go out, get a bill, and figure out we don’t reimburse them,” he says. “Or they [don’t] go to someone that is a fly-by-night that is not certified as being capable.”
Going outside the VA for care is indeed a “big, big issue,” especially when it comes to spinal-cord injury and disease (SCI/D).
PVA is steadfast in its belief that getting care from trained SCI/D experts at VA spinal-cord injury centers is the only option for its members. Hiring more of those experts is another key part of the VA reform bill and Bob is recruiting them.
Bob says he’s visited almost a dozen medical schools trying to recruit the best doctors. He never seems to stop looking for more either, including when he travels.
During a flight to Phoenix, Bob says he met an Air Force veteran whose daughter was in medical school, but didn’t want to work for the VA because of the bad press. Bob gave her a call and arranged to speak at her school.
His recruitment efforts aren’t just about doctors either. When asked about provisions for hiring nurses in the VA reform bill, Bob says he’s been speaking at nursing schools, too, including Johns Hopkins University.
He notes the VA has a “fantastic program” of tuition reimbursement for nurses, but it’s not as strong as the one for doctors. Bob wants to strengthen that program to help nurses get more education and stay at the VA.
“It is very hard to get nurses to want to go on and get a PhD and to teach. It is very unusual,” he says. “So I am working with [Johns] Hopkins and some other schools about what can we do to perhaps fund nurses going on to get a PhD to teach and then also work in the VA.”
Bob believes VA nurses, doctors and other VA employees are the key to fixing the problems there.
“We’ve got great people and just have to unleash them. I think right now they have felt to be prisoners of a system they could not change,” he says. “So, I am convinced we are going to come out of this process stronger and better than ever before.”