Fresno VA hospital hires doctors, nurses to reduce wait times

Veterans in the central San Joaquin Valley no longer have to travel four hours for knee, shoulder and hip replacement surgery.

The Veterans Affairs hospital in Fresno has hired two orthopedic doctors and is recruiting a third surgeon, as part of an effort to increase access to care and reduce waiting times for treatment, hospital officials said Monday at a media roundtable.

The VA Central California Health Care System received $20.5 million in 2014 to hire doctors, nurses and medical staff.

The hospital will add a total of 19 doctors, five nurse practitioners and physician assistants, 26 registered nurses, 19 licensed vocational nurses and 60 other staff members.

The Fresno hospital, along with VA hospitals nationwide, came under fire last year for long appointment waiting times and for veterans having to travel long distances to get care.

The Fresno hospital had the longest wait times to see specialists of any of the eight VA health systems in California. “It was clear the No. 1 reason was because we didn’t have enough providers to see patients,” said Dr. Wessel Meyer, acting director of the Fresno VA hospital.

The addition of specialists this year has improved access, Meyer said. This June, the average wait time for a specialty care appointment in Fresno was about eight days, he said. Last year, the average wait for a new appointment was 61.4 days.

So far, with the new orthopedic staff, the hospital has completed one knee and one shoulder replacement. Next year, it should increase to two total joint procedures weekly, said Dr. Prashanth Navaran, chief of surgery. Veterans have been traveling to VA hospitals in San Francisco or Palo Alto for evaluation and orthopedic surgery, Navaran said. “As you can imagine, that was quite a burden for veterans.”

The VA funding also has allowed the Fresno hospital to expand programs in cardiology and chronic pain management.

A third cardiologist has been hired and a fourth will be added next year, said Dr. Ryan Berg, chief of cardiology. Two of the doctors can do invasive cardiac procedures, such as angioplasty to open blood vessels. One of the cardiologists is an expert in advanced cardiac imaging, Berg said. With the opening of a cardiac catheterization laboratory, cardiologists should be doing diagnostic angiograms of heart arteries by September, and next year be doing balloon angioplasty and implanting pacemakers and defibrillators, Berg said.

The Fresno VA hospital also received $3.8 million to buy care in the community for veterans who could not be seen within 30 days or had to travel more than 40 miles to a VA appointment. Since November, nearly 4,000 community referrals have been made for veterans.

Last week, Congress approved the use of $3.3 billion in funds assigned to the community care program to bail out the Department of Veteran Affairs, which said a shortfall could force them to close hospitals and clinics nationwide.

Meyer said the Fresno hospital should have funds available through the end of the year to purchase local care for veterans.

One of the financial drains on the VA health system is the costly drug treatment for hepatitis C. The Fresno VA has treated 120 patients at a cost of between $60,000 and $100,000 per patient.

This story was originally published August 3, 2015 at 5:38 PM with the headline "Fresno VA hospital hires doctors, nurses to reduce wait times."