The VA is a nightmare. I have a client whom I suspect was victim of one of these wait-lists -- the VA botched a surgery on his back a few years and he started leaking spinal fluid and fell into a coma. He's had a malpractice suit against them since, which has been in limbo. He hasn't been able to get an appointment for over 3 years until just a few weeks ago, when the "VA scandal" started hitting the news. I don't think it's a coincidence.

I often call to make appointments for my clients, and will be told the next available one is... two months away. This happened recently:

  "Okay, but he says he's been told there are issues with his liver before, and he's getting a lot of blisters on his hands lately and says his urine is kind of red."
  "Just tell him to go to the ER, it's the best way for him to get seen quickly."

Cue 6 hour wait at the VA ER. There's a good chance that the problems with his liver were caused by being over-prescribed medication with very little oversight in how frequently he can have it refilled.

I know guys who are prescribed twenty (20!!!) different medications for pain, sleeping, blood pressure, etc. They all suspect a conspiracy of reaching for funding & showing good faith in caring for their patients by prescribing everything, as well as giving kick-backs to the pharmaceutical corporations. But many of them are happy about it, since they can nod out whenever they want or turn around and sell it on the street. I had one client who was apart of a group of Vietnam veterans that had a small syndicate of pill dealing. Crazy stuff.

Fortunately, the VA has taken steps to help with how frequently they can have medications refilled. Nowadays they typically mail the medications to them and need a police report to come with a claim that their medication was stolen.

That said, VA hospitals seem to be severely understaffed by doctors. Because of the bureaucracy and client load (which probably doesn't seem too bad numerical, but many of these guys need to go in frequently because of the nature of war injuries, exposure to all sorts of nasty shit, etc) I've heard the turn around is pretty fast.

The VA has been working on this by opening smaller clinics to serve smaller areas as opposed to regional VA hospitals, but many of them still have to go to the regional hospitals for various procedures like x-rays, CT scans and whatnot. So they tend to keep their medical life centralized around the regional hospitals.

In some ways, I will admit the VA is ahead of a lot of the medical field. They have a website where you can send messages to your physician, request refills, view lab results, etc. It's probably a result of the VA trying to cut down on the amount of appointments or persons in the actual hospitals just trying to get information ("I have a headache, webmd says it might be a brain tumor"), but it's lost on most technologically un-savvy older vets.