Backlog at Palo Alto VA Hospital Has Vets Waiting

Patient logs show that many veterans have to wait 6 months or longer for dental prosthetics

It’s been held up as the crown jewel in a broken veteran health care system, but the NBC Bay Area Investigative Unit has uncovered problems within Palo Alto’s Veterans Administration Medical Facility. Dental clinic insiders have come forward with evidence of prolonged delays, staffing shortages and long wait times

The VA hospital at Palo Alto serves as the primary care facility for veterans across Northern California. The hospital has been trumpeted by officials, including VA Secretary Robert McDonald, as an example of a clinic where veterans don’t have to wait for care.

"They deserve the best treatment that we can give them," former VA dental lab technician George Geddis told NBC Bay Area.

For six years, Geddis worked in the dental laboratory at Palo Alto, making dentures, implants and other dental prosthesis.

During his time there from 2007 to 2013, Geddis said he witnessed an increased backlog in dental cases.

"It got progressively worse. When I left, it was the worst I had ever seen it. It was pretty bad," Geddis said. 

Under VA guidelines, dental care is reserved for special veterans. In order to qualify, a veteran must be a former prisoner of war, or 100 percent disabled, or meet specific need-based criteria.

However, these are the veterans Geddis said he witnessed experiencing inordinately long waits to receive implants and dentures.

"The longest one I’ve seen is about 3 years," Geddis recounted. 

Frustrated with the growing number of patients left untreated, Geddis decided to retire late last year.

"One gentleman in particular, he didn’t have his dentures, and he was telling me that he was so tired of drinking his food,” Geddis said.

Geddis wasn’t the only employee troubled by the long waits. 

"The waiting period for veterans to get some sort of prosthesis is just unreal," a current employee told NBC Bay Area.

The insider asked to be disguised for fear of retaliation, but said the problem still persists. 

"Nothing has changed," the VA employee said. 

The NBC Bay Area Investigative Unit obtained redacted copies of patient logs for dental prosthesis showing just how deep the problem runs. 

The documents which NBC Bay Area reviewed in June and July of 2014 revealed 375 finished and incomplete cases of dental prosthetics, all sitting on the shelves in the Palo Alto VA’s dental laboratory. Thirty percent (113) of those dental cases looked at by NBC Bay Area were dated six months or older, including several which dated back to 2011. 

Chief of Dental services Dr. Avantika Nath acknowledges that long wait times due to low staffing levels was an issue prior to her arrival in 2012. 

"I am aware that some patients have waited up to two years for implants," Nath told NBC Bay Area.

However, Nath insists that she has made significant progress towards reducing that backlog since she took the helm at the dental clinic two years ago. Nath said she addressed these problems by hiring more dental specialists and by contracting with two outside labs to do some of the prosthesis work. Nath concedes that the staff in the VA’s own dental lab has been cut in half, from four to two employees in recent years.

"The support staff shortages all have been addressed," Nath said. Now, Dr. Nath said the maximum wait for any patient waiting for dental prosthesis is two months.

Still, evidence uncovered by NBC Bay Area shows that backlog persists. And several veterans we spoke with, waiting for treatment, said the same.

"They need to move quicker on these problems," Vietnam veteran Michael Smerkowitz told NBC Bay Area

Smerkowitz says he’s waited nearly two years and counting to get permanent implants.

"I think people should be ashamed of themselves letting this happen. There’s just no excuse for this," Smerkowitz said. "When you have teeth missing from your mouth you feel very self-conscious about smiling. You have to be careful about what kind of food you eat because it actually hurts."

NBC Bay Area showed Nath the records The Investigative Unit obtained. The records demonstrate how long some veterans have had to wait. 

"I cannot agree with your data you have presented," Nath disputed. "We make every attempt over here to reach the patient if his denture is sitting in the lab. If the patient has not come in, there has to be another reason, that’s all I’m saying."

Dr. Nath promised to investigate why so many prosthesis continue to sit in the dental laboratory. 

"We have improved the staffing and we are going to make it even better, but if there is such a factor, it just needs to be investigated," Nath said.

"When are [they] going to take care of this problem? We’ve all waited long enough," Smerkowitz said.

The inspector general is now investigating this backlog to see why it has taken so long for these veterans to receive dentures and other dental treatment.

During his visit in August, McDonald recognized that dental waits is an issue for Palo Alto. In an interview with NBC Bay Area’s Investigative Team, the VA Secretary admitted there has been a problem with long wait times in the dental clinic.

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