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Report: Cancer Care Waits Appear to be Longer at VA Centers

Jul 23, 2014

According to an emerging report, a 75-day wait for excision of a potentially cancerous tumor is allegedly considered meeting the standard of care at the Veterans Affairs (VA).

In fact, the VA Medical Center in Dallas, Texas, told CNN that one veteran’s 75-day wait to have a potentially malignant tumor removed "meets the standard of care" at the VA. The man, who fought in Vietnam and was exposed to Agent Orange received a pathology report on August 8, 2012 that revealed that the growth on his neck was “concerning for cancer.” The recommendation was for “total excision” of the mass.

After a two and a-half month wait, the tumor was finally removed. The man died at age 63 ten months later, according to CNN. "I really don't think it's appropriate that our vets have to wait for months," said Dr. Karl Bilimoria, who worked at three VA medical centers and is now a cancer surgeon at Northwestern University. "That's just the way the VA works, and it's sort of been this way for years,” he added.

Even worse, the VA allegedly sent the patient to an external specialist for surgery that was the wrong procedure; he was sent back to the VA, costing him even more time. His wife said she left what she described as “desperate” telephone message that were not returned by the VA, despite that the VA indicates calls are answered in a timely manner. His wife also said that, after her husband’s death, the VA telephoned her to ask her to make an appointment for her husband. When she advised the VA he had died, "The lady said, 'I guess I really need to update my computer,'" his wife told CNN.

In 2011, Dr. Bilimoria and his colleagues published the results of a study they conducted on wait times for eight common cancers at VA medical centers. They found that the wait times from cancer diagnosis to surgery were longer at VA centers for all cancer types compared to wait times for the same cancers at non-VA community hospitals, according to CNN. Looking specifically at liver and colon cancers, VA wait times for surgery were as much as two times as long.

The VA responded to CNN in a statement indicating that, "No Veteran should ever have to wait to receive the care they have earned through their service and sacrifice. We must work together to fix the unacceptable, systemic problems in accessing VA healthcare." Meanwhile, Dr. Bilimoria and his team shared their study results with key personnel at the VA for three years. Although many of the VA staff were infuriated over the excessive waits, no changes were made. "We clearly haven't seen any major initiatives," Dr. Bilimoria said.

Last October, a colleague of Dr. Bilimoria at Northwestern sent an email to the head of oncology for the VA nationwide. Dr. Michael Kelley responded, in part, writing, "Timeliness of care is of interest, but would not be at the top of my list,” CNN reported. Dr. Kelley also indicated that if delays occur at the VA, "it does not appear to result in worse survival" for veterans, CNN reported. Yet, in a statement to CNN, Dr. Kelley wrote, "No Veteran should have to wait for needed cancer care. It is not appropriate or acceptable for a Veteran to wait for months for cancer surgery. I strongly believe that timeliness in the delivery of care is a top priority, which is why I've been actively engaged in the improvement of VA's quality and timeliness of care."

A VA official attempted to explain what Dr. Kelley meant in his email to Dr. Bilimoria's colleagues, indicating that it was that he did not believe the Northwestern research was the highest priority and questioned the findings, according to CNN.

Although the VA indicates that it commissioned an independent review of cancer care that revealed "in nearly all respects, the quality of VA care equaled or exceeded that of non-VA care." Other studies have revealed different findings. One study found that the mortality rate at the VA following pancreatic cancer surgery is 2 and a-half times higher than at large academic health centers and that the complication rate was 58 percent greater among VA patients, according to CNN.

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