Two longtime Roseburg Veterans Affairs Medical Center employees say a vindictive management style has led to rapid turnover and diminished care at the hospital.
The director of women’s care, Marcia Hall, has been at the Roseburg VA for 17 years. In the past half dozen years, morale has plummeted, she said.
“It’s almost as if the system has been hijacked,” she said.
VA doctor Steven Blum said the culture has become “toxic.”
“It’s abusive to work there,” he said.
Top VA administrators across the country have come under scrutiny in recent months. Early on, the focus was on long waiting times for veterans seeking care. The charges — made by veterans, lawmakers and even VA employees — have grown to include wide-ranging allegations about mismanagement and poisonous workplaces.
At the Roseburg VA, Hall and Blum say managers bully subordinates and punish those who question them. Douglas County Veterans Forum spokesman Jim Little said Hall and Blum’s stories are “shocking” and suggested leadership needs to change.
“The credibility and trust in the VA management at this point is zero,” Little said.
VA spokeswoman Carrie Boothe said Hall and Blum are wrong. She said the VA has a caring culture and one that encourages employees to excel.
“We have a culture of caring individuals within our system who are working hard to provide the best care for our veterans,” she said in an email. “The VA philosophy is to empower individuals and provide opportunity to excel.”
Nationwide, shady record-keeping and long waits for patient care created a scandal that forced the resignation in May of VA Secretary Eric Shinseki and uncovered a management culture that a White House adviser described as “corrosive.”
Hall is on medical leave for a condition she wouldn’t divulge and hasn’t decided whether she will return.
She said she has been punished for speaking up about mental health staffing shortages, a lack of psychiatric beds for women and the need for coordinators to help organize mammograms and maternity care.
Blum said he has been targeted for talking about high turnover in the nursing staff and the hiring of less-qualified, less-experienced nurses.
Hall said she was routinely asked to falsify reports that reflected negatively on capacity to serve veterans.
“So when the inspector general or the head of the Governmental Accounting Office says we cannot rely on VA data, I would concur with that. The data is not accurate,” she said.
Hall described two specific cases in which she witnessed records being hidden to clear up a backlog of patients waiting for treatment.
Hall said that in 2008 she discovered a stack of hundreds of mammograms that had been ordered but never completed.
Hall said an administrator “told me they wanted those mammograms hidden” before a VA inspector toured the hospital.
“So here’s this stack and it’s scary. I’m a breast cancer survivor. I know the implications of this,” she said. “It can be for some of those women a life-threatening issue.”
When she refused to hide them, she was told “there would be consequences.”
The alleged consequences weren’t spelled out and Hall kept her job, but she said she was subsequently frozen out of meetings and email exchanges in which decisions were made affecting women’s health services.
“I was not on the ‘A team’ at that point,” she said.
Hall said that in 2011 she was on a committee ordered to deal with 10,000 backlogged orders for specialty care appointments, which the VA calls “consults.”
“There were several individuals on the committee, physicians and myself, who said we can’t just get rid of these. We have to at least look at them or ask the provider,” she said.
“Some of us were not invited back. I will tell you over the next year those thousands of consults went away.”
She said administrators closed many of the requests for care without notifying either the doctors or the patients.
Boothe said the Roseburg VA’s upper management has never asked that records be hidden and that consults “were not closed administratively without extensive review.”
“When a consult is closed, an automated alert is sent to the primary care provider so that they are aware of the results of the consult. There was no known impact to patient care. There were no removal of team members during this time, to our knowledge,” Boothe said.
Hall said supervisors became openly hostile as she continued voicing her concerns.
“I’ve been blocked from going into meetings. Physically blocked. I have been asked to leave meetings when I’m supposed to be giving my reports. I’ve been not allowed to talk and raise issues of concern for my program. That’s my job. I’m a middle manager of women’s health,” she said.
Hall said she was assigned to mediation with a supervisor who she said yelled at her and bodily barred her from meetings. During mediation, she said her former boss “pulls out a Bible and holds it up like he’s exorcising me.”
She said he interrupted her attempts to speak by reading Bible verses about hellfire and brimstone.
“I felt like he thought I was a witch,” she said.
That supervisor has since transferred to another VA facility.
Blum said he suspects a manager retaliated against him for his complaints about nursing staff levels by calling VA police to report he had been playing with a Nerf gun.
The toy shoots foam darts and does not resemble a real gun.
“Another doctor who was kind of a joking guy brought a couple of these in and so people were playing with them. I played with it. I didn’t shoot people. I wasn’t near patients,” he said.
The next day he said the chief of police arrived.
“He comes in this meeting. We were all kind of just sitting there. He said, ‘I want witness statements from everyone who was here yesterday,’” he said.
An August 2013 police report Blum provided a copy of states police found “investigation disclosed no crime had occurred.” The report does not name the person who complained to police.
“(Blum) created laughter and a jovial atmosphere for the meeting. None of the staff members felt threatened or in harm’s way,” police concluded.
Blum said he finds the incident funny now, but he was worried about the investigation at the time.
“I didn’t sleep that week,” he said.
He said Nerf guns were being sold in the VA’s canteen at the time.
“In a normal place, that manager probably would be fired for filing a police report that was a joke,” he said.
Blum said he believes calling the police was intended to have a chilling effect.
“It was very public, and I might be psychoanalyzing it too much, but within five minutes of the police coming to talk to me the whole hospital knew about it,” he said. “I think the message was here’s a doctor who’s saying that things are not right and we’re sending the police after him.”
Hall and Blum say experiences like theirs explain high turnover at the VA. They dispute the administration’s argument that the VA has difficulty recruiting health care professionals to Roseburg. They said the hospital does not have trouble attracting new doctors and nurses. It just can’t keep them.
“We’ve had over 50 providers, nurse practitioners and physicians, in the last two years, leave this health care system. That in and of itself is a red flag,” Hall said. “What you see is a migration outward of people who have ethical compasses and who speak out.”
Boothe said 57 nurses and doctors have left in the past five years, not two. She said the VA has difficulty recruiting and retaining professionals in a rural environment.
Little said trust in the VA has been “severely damaged.”
“The physicians who have spoken out are highly respected, and I commend their courage and integrity, bravely telling the truth. As a naval officer our creed was always tell the truth regardless of the consequences, even if it meant at your personal peril. It is my hope there are no retaliatory actions against Dr. Hall or Dr. Blum.”
Blum said yelling at employees is common.
Three or four years ago he said a nurse manager yelled at him so loudly that one of the other nurses called the VA police to report it.
He said he knows several employees who have sought psychiatric help for job-related stress and depression and more who have simply left.
Boothe said if bullying behaviors are identified, “they are addressed immediately.” She said privacy laws prevent her from discussing specific employee complaints.
Blum points to the results of a recent employee survey that suggest many of those who work at the Roseburg VA are unhappy.
The 76 employees who gave written responses to a survey question on morale paint a grim picture of what it’s like to work at the VA.
“This VA breeds paranoia and discontent,” said one respondent. Another said it is “governed by fear.”
Workers described the work environment as “terrible” and “hostile.” Some said they had witnessed or experienced bullying and harassment. One said employees are treated like “interchangeable widgets.” Another called the question itself “a sick joke.”
“I have worked at several hospitals. I have never seen management treat their employees with such disrespect,” said one respondent.
Only a handful of the answers struck a neutral or modestly hopeful tone.
“I believe that upper management wants to improve this. However, old systems are difficult to break,” said one.
“We can do better to recognize the value of employees and the good work they do,” said another.
Boothe said they are taking those comments seriously.
“Based on survey responses, we have initiated several workgroups and committees whose primary focus is to improve the work environment across the organization,” she said.
Not everyone is unhappy at the VA.
Psychologist Jack Finney said he feels morale is good in the mental health clinic where he works.
Finney has worked for the VA for 23 years and said he’s never seen any bullying behavior by supervisors but has heard several credible reports of bullying.
He said most of the morale problems he has seen have to do with bureaucratic mandates. Doctors spend too much time filling out paperwork, he said.
“By the time a provider goes through the mandated questions and assessments, sometimes they don’t have time to do what the patient really wants,” he said.
• You can reach reporter Carisa Cegavske at 541-957-4213 or firstname.lastname@example.org.