ecoming a VA whistleblower was not on my bucket list, and it remains my most challenging leadership decision. Facing this enormous challenge, while difficult, was also the catalyst for tremendous personal growth.
Inside the classroom, it was serious business. You had to pay attention, take notes, learn the material, think for yourself, answer quizzes, participate, pass the tests, and keep the area around your desk and school neat. If you did not, the staff would hold you accountable. Each day there was time for prayer and reflection; each week, there was time for Mass and Confession. This pattern of respect, reflection, and accountability is what I followed from first through eighth grade.
I did not know it then, but this school routine instilled several values that would carry me through life. These values include truth, kindness, respect, caring, reflection, accountability, and learning. They are still a part of who I am today. These leadership characteristics sustained me during my most significant leadership challenge as a whistleblower.
This leadership model, establishing committees and training the members, clearly impacted the public’s knowledge of what VA could offer our veterans. We built a collaborative, infectious spirit that positively touched many areas within the medical center.
Our program worked well for decades. Amongst VA hospitals, the Phoenix VA was a top performer. Our quality-of-care indicators were positive and healthy, and our public relations program was listed as a model of success. But when our director retired, a trio of leadership transitions occurred. The first was lackluster, the second selfish, and the third unethical.
I waded carefully through all three, but during the latter, it dawned on me how different it would be when I gave my budget briefing. I used the public relations planning model of research, planning, implementation, and evaluation. This model allowed me to gather feedback from our stakeholders, including patients, staff, Veterans Service Organizations, and the community. Based on the “Guidelines for Measuring Relationships,” by authors Linda Childers Hon and James E. Grunig (November, 1999), we had a pulse on these relationships and the opinions and perceptions of our stakeholders.
Our latest round of surveys showed our ratings were declining, trust was waning, and there were direct correlations to those in the leadership roles. I tried to counsel them on ways to change course and get us back on track, but they ignored my advice. Then, through a comedy of errors, I learned they planned to change the leadership role of the associate chief of staff for ambulatory care. I was concerned because this leading physician was the one who had kept us on a steady course in providing excellent primary care management to our veterans. I shared my concerns with my confidant Dr. Sam Foote, who was a member at large on the Clinical Executive Board, but we couldn’t stop it. So, we waited, we watched, and we took notes.
The new leaders hired an outside consultant, whose role was to improve the performance metrics of access to care through what they called a Wildly Important Goal. The goal was to reduce the wait times for new patients to receive care to within 14 to 30 days. This “WIG” became the focus of the entire medical center. Everyone was required to take training and meet weekly to highlight how their contributions were helping us make the mark. But what concerned me was that they canceled a key product, the Saturday overtime clinics, which we had established to get new patients in quickly. This change meant additional strains on the primary care providers and ancillary staff. I fired a few more shots across the bow warning of danger, but they fell on deaf ears. And then the leaders made a move against me.
This “banishment to the basement” caught us all off-guard. But I can honestly say divine intervention came into play. Our vanpools came from varied areas of the hospital, and on the way to and from work, we would discuss what was happening and what the patients were saying and pinpointing the reverberations. One of the riders in the van was trying to manage the new waitlist for patients. Her day-to-day interactions were crucial in helping us put the pieces together. Managers said the WIG was a success, we were getting patients in within 14 days, and Phoenix was leading the way. But in reality, the list kept growing. She couldn’t keep up with the demand, and she was getting minimal help to get caught up.
It became a grueling game of Cloak & Dagger to see how they could personally get ahead, no matter the cost. And then, one day, the waitlist manager called me and said we had to go off station for lunch. We did, and she broke down in tears. She told me that one of the patients she had called that day died before we could get them an appointment. He had waited for six months for a primary care appointment that never came.
While I was still banished to the basement and fighting my case with lawyers and representatives, I became the counselor to VA whistleblower physician Dr. Sam Foote. His own data-gathering matched ours, and he knew he would have to retire to expose them. I worked with Dr. Foote to get him media training and to introduce him to investigative reporters who could write the story. I also put him in touch with Congressional members on the House Veterans Affairs Committee on Oversight and Investigations. We kept funneling information to the office of the Secretary of Veterans Affairs. The investigative reporters must verify their sources. Dr. Foote was source one, but they needed a second source to run their stories. That source came on April 9, 2014, when Congressman Jeff Miller exposed the deadly waits and delays at a Phoenix VA hospital during a public hearing.
This exposure became what is known today as the VA Wait Time Scandal. When the investigative bodies finally got on board, their review showed that 115 of the 174 VA hospitals engaged in waitlist manipulation to improve performance.
Before resigning from his post, the VA Secretary put the leaders at Phoenix on administrative leave. In doing so, he paved the way for others to come in and help clean up the mess. Those leaders were later fired for various reasons, including a lack of candor, and one became a convicted felon for ethics violations.
Once they were out of their jobs, I quickly moved on to resolving my whistleblower case. New leaders came in and learned I had been reporting the waits and delays all along through anonymous letters, submissions to investigative bodies, and other avenues. They negotiated several avenues of restitution for me, including a new job outside of the Phoenix VA. It was bittersweet move, but one that was needed.
Through it all, I learned several leadership lessons.
- Truth and transparency create an honest and ethical organization. Dynamic leaders know that when we confront the truth, we learn and grow even when it’s problematic.
- We lead better when we treat each other with care and respect. As leaders, we impact lives, and we must do so honestly and ethically.
- Learning is a vital component of leadership. As leaders, we are helping others learn through our actions, our thoughts, and our words. It is imperative to increase the positive.
- Accountability is part of the journey. Accountability is essential. After all, we need to be responsible for our decisions and grow from them.
- Reflection is critical to success. Each day in the library, I kept a journal, and it helped me look back on my thoughts and feelings so I could cut through the fog of war.
In closing, I learned that the morals and values we build along life’s journey are essential. For me, choosing a moral compass that helps organizations lead with truth, kindness, respect, continual learning, morality, reflection, and accountability is vital.
