MANCHESTER, N.H. — The interim director of the embattled Manchester VA Medical Center told nearly 100 veterans he's working to address allegations of substandard care at the facility but has acknowledged the culture can't be changed overnight.
Alfred Montoya, who took over in Manchester a little more than a week ago, heard from veterans Wednesday about shoddy care, being misdiagnosed and frustration over inadequate mental health services.
"We got a lot of room for improvement. We have to open our ears a little bit," he told The Associated Press after spending several hours with the veterans. "We have to listen to what our veterans are saying to make those improvements."
Secretary of Veterans Affairs David Shulkin recently removed the hospital's top two leaders and ordered a review by the VA's Office of the Medical Inspector after The Boston Globe reported on a whistleblower complaint filed by physicians. He also has ordered the VA's inspector general to launch its own investigation and plans to meet with the state's congressional delegation at the hospital on Aug. 4.
Montoya said he has launched an analysis of what services are missing from Manchester, recruited a part-time cardiologist and put in place a system to read echocardiograms remotely and this Friday will open a center that helps veterans who have problems accessing Choice, which offers veterans federally paid medical care outside the VA. They also moved quickly to set up mobile medical facilities after a pipe failure last week caused flooding on a number of floors.
"I am deeply committed to making sure we make improvements. This mission is personal," said Montoya, who spent 10 years in the Air Force.
At the town hall, the veterans said they would give Montoya a chance but doubted he would be able to change the system that many believe is responsible for the problems at the medical center.
"I came with an open mind and I feel Mr. Montoya is very compassionate and very courageous for taking on this assignment," said Craig Meriwether, a Persian Gulf veteran who complained the lack of mental health services had exasperated his depression and bipolar condition.
"He will do what is in his control," he said. "But unfortunately, the culture and the bureaucracy within the VA is above his head. He can make recommendations all day long. But if Washington doesn't support him by adding more funds or a full service VA hospital here in New Hampshire, his work will be at a turtle's pace."
On Tuesday, Shulkin said that VA investigators "have been looking into the allegations in detail since early last week, and we are close to announcing a third-party panel of medical experts who will review their final report."
A spokesman for Shulkin said Wednesday the secretary also plans to meet with the 11 staffers who described a fly-infested operating room, surgical instruments that weren't always sterilized and patients whose conditions were ignored or weren't treated properly.
One of those was staffers is Dr. Ed Kois, who said he's looking forward to the meeting.
"I think this will be a historic first step for a VA chief to reach out to the whistleblowers and hopefully will be the start of dialogue not only toward solving issues at the Manchester VA but addressing the larger issue of VA reform nationally," he said.
He and several of the other doctors, however, said they have little confidence that the inspector general's investigation will be a "separate, wholly independent review" as Shulkin put it. They want a third-party investigation from the start, not just an outside panel to review the VA's conclusions.
"I had sent a request for an investigation to the (inspector general) back in April, and they didn't even respond to my allegations at that time, so we have no faith in this," said Dr. Stewart Levenson, the hospital's chief of medicine.
Kois said: "They're investigating themselves, and getting the final report rubber stamped by an independent panel who may be well-meaning but will not have enough information to form a real, valuable opinion."
Acting VA Undersecretary of Health Dr. Poonam Alaigh visited the hospital on Tuesday and held two listening sessions with staff. Levenson said people were angry.
"People got up to talk about more problems coming to light, and we seem to have gotten canned answers," Levenson said.
In interviews with the Globe, former hospital director Danielle Ocker and former chief of staff James Schlosser acknowledged significant cuts in services but said the hospital was addressing the shortcomings and patient safety hadn't been compromised.
The whistleblowers accuse administrators of essentially dismantling the hospital's cardiology and surgical programs.
"Manchester's broken, it's as simple as that," Dr. Ed Chibaro said.