The VA Needs More Doctors and Industrial Engineers

Could industrial engineers help with the VA mess?  As the demographics of our aging population collides with the supply constraints of producing additional doctors and other critical care medical professionals, the industrial engineering community needs to step in and help.  What professional better understands waiting queues, scheduling algorithms, quality control/assurance, coming up with KPI metrics and key performance measurement tools - - the very things that appear to be most challenging to the VA.  Industrial engineers don't make for very good heart surgeons, but heart surgeons don't make for very good industrial engineers.  You have to look at the entire medical system - - both doctors and engineers have a place at the table. 

Very good post on the whole VA mess.  From the article"

"First, it is important to understand just how serious the misdeeds of the Phoenix VA hospital (and apparently quite a few others) really are. The core of the scandal is what appears to have been a highly organized effort to cook the books in order to be able to report far shorter wait times for care than were actually achieved. Veterans awaiting care were kept off the formal waiting list (so that the wait-time clock did not start ticking) and handled through a series of ad hoc informal queues, which were themselves carelessly kept and badly mishandled. To work, this system appears to have required the active collusion of a large number of people at each VA facility in question, involving everything from telephone operators keeping some appointment requests out of the system to senior managers turning off audit controls on the hospital’s scheduling software to make it impossible to know who manipulated the system and how. The IG notes that some of these actions were almost certainly outright crimes. It’s not clear if what has happened at the many other VA facilities that have now been drawn into this scandal was as deep and broad, but it does look that way in at least some cases.

Second, the lengths to which VA employees were willing to go to report shorter wait times is a function of a longstanding emphasis (by Congress, successive administrations, and the veterans’ groups) on wait times as a primary performance measure, but this emphasis has not been tied (by any of them) to structural reforms that might actually enable the VA to function more efficiently. Centrally run, highly bureaucratic, public health-care systems that do not permit meaningful pricing and do not allow for competition among providers of care can really only respond to supply and demand pressures through waiting lines. It happens everywhere, but when it has happened at the VA the response has been to criticize waiting times rather than to reconsider how the system is organized."