Report: Fresno VA wait times short for primary care, long for specialists

The Fresno BeeJune 9, 2014 

Among California veterans, those in Fresno waited the shortest time to get an initial appointment with a primary care doctor but the longest to see a specialist, according to a report released Monday by the Department of Veterans Affairs.

The report said the average wait time for new primary-care patients at California VA hospitals ranged from about 25 days in Fresno to about 56 days in Los Angeles.

Fresno veterans waited the longest for specialty care, an average of 61 days for new patients. The shortest wait for specialty care was 40 days at the Northern California Health Care System based in Sacramento.

While Fresno had the best primary care appointment time, it remained more than twice the standard set for an appointment. VA guidelines say veterans should be seen within 14 days of their desired date for a primary care appointment. The department has now said meeting that goal was unattainable given existing resources and growing demand.

The VA report is part of a national audit ordered after a whistleblower claimed veterans were dying while waiting for care in Phoenix. The California hospitals were among 700 VA hospitals and large outpatient clinics that were reviewed.

Rep. Jim Costa, D-Fresno, said the Fresno VA is "a good hospital" but there are areas that can improve, including the wait time for new patients to see specialists.

Costa said he will vote later this week for the Veterans Access to Care Act of 2014. The legislation would allow veterans to receive care from a non-VA health care facility if the veteran lives 40 miles from a VA medical facility or has waited longer than the wait-time goals for a medical appointment.

Rep. David Valadao, R-Hanford, also supports the legislation and intends to vote for it, said Anna Vetter, the congressman's communications director. Both Costa and Valadao were original co-sponsors of the legislation.

Wessel Meyer, the acting director of Fresno's VA hospital, said it struggles to recruit specialists, which is reflective of a doctor shortage in the community. "There are certain positions where we have vacancies for more than a year or a year or two for that matter," he said.

The Fresno VA has had the ability to refer patients to doctors in the community if it's the veterans' preference and the wait time is too long, but the law could "pave the way to make it easier for us to use these different venues," Meyer said.

However, Meyer, an internist and chief medical officer at the hospital, said his preference is for veterans to be seen at the VA hospital, which compiles medical records, making it easier and safer to coordinate primary, specialty and mental health care for the patients, he said.

Alan Fry, commander of American Legion Post 147 in Clovis, said it was difficult to judge the Fresno VA appointment wait times. "Without comparing it to private industry, I don't know."

It's not known how long patients in the community wait for appointments. California has timely access rules that health maintenance organizations must follow for patients who have that form of private insurance. Under the law enacted in 2010, patients must be treated within 10 business days of requesting an appointment, and by specialists within 15.

But nationwide, a 2014 survey of five specialties in 15 metropolitan areas -- including Los Angeles and San Diego -- found the cumulative wait time for an appointment was 92.3 days. The survey was by Merritt Hawkins, a national physician recruiting firm.

There was promising news in the VA report: established patients in Fresno and in the other VA hospitals in the state were seen quickly.

In Fresno, established veterans were able to get primary-care appointments in less than a day and specialty appointments in 12 days. Established mental health patients had a wait of less than a day for an appointment, but new patients had an average wait of 31 days.

Meyer said the Fresno VA's short wait times for primary care are the result of an "open access" system that sets aside slots daily for veterans.

"We do have challenges," he said, but "we have good processes in place to really improve where we have extra challenges."

The Associated Press contributed to this report. The reporter can be reached at (559) 441-6310, or @beehealthwriter on Twitter.

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