PHOENIX -- The scandal in the Phoenix Veterans Administration has been grabbing headlines nationwide recently, but a former employee said the problems began four years ago.
Dr. Sam Foote said it all began when seven physicians left the VA in 2010 and were never replaced. Within one year, his clinic went from a wait time of a few dozen veterans to more than 7,000.
The director of the Phoenix VA Health System was then replaced by Sharon Helman, but things only got worse. By 2012, the wait list had hit 13,000 veterans and one year to see a physician. That's when the VA board, including Foote, hatched a plan to catch up.
"We came up with a plan that we'd just kind of ignore the 13,000 and try to get that backlog down, thinking that these people know the system, they're getting their medications and we need to get these other people in," Foote said.
However, Foote said, at that time, the VA's intentions were still good. The multiple wait lists had yet to crop up.
"At that point, we thought we were trying to clean it up."
But how did the situation become so bleak? Foote said it extended to the physicians leaving in 2010.
"At that time, we had a severe shortage of staff, and still somewhat do, but it was pretty critical at that point," he said. "Too many patients, not enough providers."
Part of the plan was to assign each physician a list of 67 patients to cut the backlog. Foote agreed with the idea, until he spoke to Dr. Christopher Burke. Foote said the VA would need to create another list of patients who came in while the agency played catch up.
Burke's response? "We'll see about that."
Foote said he was "flabbergasted" by the response, but didn't understand what was truly happening until February 2013, when the secret list was created.
"They would type your information into the computer and rather than hit save, they would hit screen print and they would print out a paper copy, which would be taken up to the HAS office and then they would put you, at least at that time, on a paper list.
"Only when they had an appointment available in the guideline times of 10 to 14 days would they then make an appointment for you," he said.
That guideline was put in place by Helman, who made it her goal to reduce the access time for both new and old VA patients to 10 to 14 days. She even sent Foote and other physicians away for "training," though Foote essentially said it was a waste of time.
Despite Helman's goal, Foote said the problems only got worse. The VA was, technically, meeting her goal, but the numbers were fudged. Foote said Helman herself admitted that in a memo filed during an ethics exam. He quoted her:
"I have to say, I think it's unfair to call any of this a success when veterans are waiting six weeks on electronic waiting lists before they're called to schedule their first [primary care physician] appointment."
"Sure, when their appointment is created it can be 10 to 14 days out, we're making them wait six to 20 weeks prior to creating that appointment."
Helman later denied knowledge of the memo, according to Foote. He alleged Helman collected bonuses for reducing wait times.
So what's next for the embattled VA?
"I think the first step in solving a problem is admitting you have one instead of covering it up," said Foote.
He recommended the entire senior staff be removed and for the new leaders to be honest and come up with a solution that helps everyone.
It's possible the U.S. Senate may agree. Sens. John McCain and Jeff Flake have called for an investigation into the VA.
If you or someone you know has been affected by the VA scandal, Dr. Foote would like to hear from you. Please send the patient's name, the last four digits of their Social Security number, a contact phone number and a brief description of what happened, along with your name, to firstname.lastname@example.org.