December 26, 2008, Roseburg, Oregon – Lack of adequate funding has led to lack of adequate staffing which in turn has decreased the quality of care and level of services at the Veterans Affairs hospital in Roseburg. The Roseburg facility is labeled a hospital but has not been adequately funded. Last year the budget was about three quarters of a million short. I have been told that there is a much larger shortfall this year.
Even with well respected physicians like Theodore A DaCosta picking up the slack, working short staffed has led to significant problems. Numerous resignations have been occurring over the last several months. Many physicians have resigned their leadership positions and many nurses have left. The morale is quite low. A group of hospital employees formed an organization health committee which identified numerous areas of opportunity for change. But no significant results so far.
If you are a veteran in an ambulance, do not be surprised if your ambulance is told to go to Mercy Medical Center instead of the VA. Review of the last two months statistics from logs in the Emergency Department reveal an approximately 60 to 70 percent chance of diversion. Unfortunately you the veteran may be responsible for a significant portion of the bill due to this diversion.
Veterans deserve to be informed about the kind of care and the services available at the VA Roseburg. Surgical services have been diminished and gastroenterology coverage is at times sporadic. This has led to increased transfers. If you are hospitalized, your care during the day hours may be on par with the local community hospital. However, at night many of the services that are standard of care at community hospitals are significantly delayed at the Roseburg VA. For example, lab studies are drawn and sent to the Mercy lab at night. X-ray services are on call after day tour hours. Frequently there is only one physician at night providing care for the hospital, emergency department, psychiatric unit, and long term care unit. Many would argue that this is not safe.
There are a number of excellent physicians, nurses, and caring staff at the Roseburg VA. Employees have been frustrated in their attempts to make the VA Roseburg a better place. The combination of lack of funds and low employee morale significantly reduces effective recruiting efforts. Unfortunately, the VA regional leadership (VISN) is unwilling or unable to provide the funding required to adequately support this facility as a hospital.
If funding remains inadequate, maybe it is time to close the hospital aspects of VA Roseburg (inpatient beds, ICU, and Emergency Department) and convert to a completely ambulatory care center. The problem with this solution is that veterans would be more financially responsible for their hospital care unless they travel to Portland (which frequently is full). Maybe it is time to combine the VA hospitals with the private sector and have a system of universal health care coverage where everyone receives the same benefits as is the case with most every other industrialized country in the world.
Before more of these employees choose to work elsewhere, further reducing the quality of care … write your legislators or the VA director and let them know your thoughts. Veterans deserve better.
Charles S. Ross was director of the Emergency Department at the Roseburg Veterans Affairs Medical Center from November 2007 to July 31, 2008. He has been a practicing physician in Oregon for 31 years and a Roseburg resident for 11 years. He is board certified in emergency medicine and family practice. He now provides locum tenens coverage at the Roseburg VA, Three Rivers Community Hospital in Grants Pass and Bay Area Hospital in Coos Bay in addition to working part time at Evergreen Urgent Care in Roseburg.
