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Editorial: A little bit of honesty at the VA, please

Jul. 5, 2014 - 06:00AM   |  
Robert McDonald
Former Procter and Gamble executive Robert McDonald, President Obama's nominee as the next Veterans Affairs secretary, listens as Obama makes a statement at the Department of Veterans Affairs on June 30. (Charles Dharapak/The Associated Press)
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The White House’s nomination of Robert McDonald as the next secretary of veterans affairs offers at least one potential reason for early cautious optimism: his 30-plus years of corporate experience with consumer products giant Procter & Gamble.

After a run of three consecutive permanent VA secretaries who came out of the military’s senior officer ranks, a shift to a more corporate style of management might be what the VA needs at this critical juncture.

Certainly, there are similarities between corporate and military management. But there are differences, too.

In the military, the commander issues an order and expects it to be obeyed without question down to the lowest E-1 — and woe to anyone who dares to color outside the lines.

In the business world, leaders usually need to rely more on gaining team-oriented consensus and inclusive buy-in from the corporate strata below them.

And within VA, those ingredients are in very short supply, according to a new and damning internal analysis of departmental culture.

The report found that the department is rife with mistrust, paranoia, retaliation and lack of accountability “across all grade levels,” severely undermining the effort to fulfill the mission to care for America’s wounded and ill veterans.

Reversing this deeply rooted dysfunction certainly will not be easy. It will take time, dedication and persistent effort.

But identifying the starting point is not that difficult at all: McDonald and his top deputies must strive to foster a workplace environment in every VA facility and across every level of the management chain that is based on one simple concept: honesty and openness.

After all, the root cause of VA’s current crisis is a near-endemic tendency to hide bad news and poor performance from top departmental officials, lest supervisors in the field miss out on their performance bonuses.

It’s a calcified culture “that tends to minimize problems or refuse to acknowledge problems at all,” in the words of the recent report.

Indeed, manipulation of appointment waiting times — geared toward hiding the fact that thousands of veterans waited far longer for care than is mandated by current VA guidelines — was the specific flashpoint that led to the resignation of McDonald’s predecessor, retired Army Gen. Eric Shinseki.

McDonald’s first order of business should be to detach all supervisor performance bonuses from arbitrary metrics that long ago escaped the bounds of reality — if indeed they were ever realistic to begin with.

In the case of the waiting-time scandal, for example, the plain fact is that there are far too many veterans seeking care and far too few health care providers to accommodate them to ever achieve the goal of ensuring all veterans are seen within 14 days of their desired appointments.

McDonald’s second order of business should be to demand a detailed accounting from every VA facility of the reality they face each and every day — coupled with ironclad guarantees that no one will be punished in any way for providing that data.

That will allow McDonald to construct and present a comprehensive picture of VA’s current and near-term patient load, and its current and near-term budget outlook — and, more importantly, an accurate picture of the yawning gap between the two.

At that point, accountability would shift to where it rightly belongs: a White House, a Congress and a public that for far too long have obfuscated, sidestepped and downplayed the true costs and challenges of caring for our nation’s veterans.

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