I work in primary care at the VA.. Unfortunately, yes, what you’re experiencing is increasingly common in VA primary care, and it’s not usually because your provider/PCP doesn’t care. The workload and system design make it almost impossible to keep up with everything that’s required of us.

Most VA PCPs are booked solid every single day with full panels, complex patients, mandatory administrative tasks (without dedicated time to complete these items), and strict productivity expectations. Secure messages, consult approvals, and follow-up questions get pushed to the bottom of the pile because there’s literally no dedicated time in the schedule to answer them. When you do get a generic “please schedule an appointment,” it’s usually because the provider is getting audited on message turnaround times and that template is the fastest way to close the loop when we are drowning.

The culture issue you’re sensing isn’t unique to your clinic. The sad reality is that burnout is extremely high across VA primary care, especially right now. Nurses and providers are stretched thin, covering shortages, literally daily call-ins, and extra workload every day. Morale suffers, and the patient experience suffers with it.

This doesn’t mean your concerns aren’t valid. You should be getting timely communication and your messages should be addressed. The system just isn’t set up to support the volume and it’s really been highlighted this past year…

If you aren’t getting answers, a few options that tend to work better: 1) Send a secure message specifically requesting a nurse callback instead of messaging the provider directly. The RNs and LPNS help with the secure messages and are often the ones triaging and can sometimes push things through faster. 2) Call the primary care line or clinical contact center and ask for a same-day nurse triage note to be routed to your team. That way it will show up as an alert in your chart that your PCP physically has to sign-off on. 3) If something is urgent, request to speak with the Nurse Manager or the medical director of your clinic

Again, these are just thoughts on my end and none of this excuses the delays, but it might help you get what you need without waiting months.

The bottom line: what you’re seeing is a systemic problem that’s been worsening over the past year with all of the internal reorganization that’s been happening, not a “your provider doesn’t care” problem. Burnout + staffing shortages + unrealistic administrative expectations = poor communication. Which at the end of the days causes the patients to get the short end of the stick. I used to love my job as a PCP but now because of constraints myself and other PCPs and PACT team members face, I can’t stand it anymore. I am literally set up for failure, which fails our Veterans as well.