A Losing Battle at the VA

Embattled VA Secretary Eric Shinseki resigned this Friday, May 30, in the wake of a growing scandal over some VA managers publishing misleading statistics about veterans’ wait times for medical care.

“I can’t explain the lack of integrity among some of the leaders of our health care facilities,” said Shinseki in a CNN interview.

Coming from a distinguished veteran and senior soldier, that statement is remarkable. Shinseki went on to add that “Leadership and integrity problems can and must be fixed”, but what could go so wrong in the VA that it leaves one of our nation’s most distinguished soldiers baffled and angry?

VA bureaucrats have responded with a list of 17 systemic fixes, and these may all be good ideas, but they will never fix the “lack of integrity” that Shinseki correctly identified as the cause. Systemic fixes for inappropriate scheduling practices will not work on their own because the problem is deeply cultural. In the short term, the new Secretary will see a lot of vocal compliance, hiding and lip-service. In the medium to long term, people will continue to behave according to their own view of “how it really is around here”, rather than anything they see written down from management.

The new Secretary will be besieged by subordinates and consultants offering systemic fixes, because systemic fixes are well within the cultural comfort zone, require no commitment beyond passive compliance and the intellect, and typically justify large budgets. None of these will have the slightest long-term effect on integrity problems at the VA.

The only remedy that will persist six months and more from today is to do the hard work of cultural change. This cannot be done in the intellect alone, because the intellect does not motivate real action or real integrity – good or bad. Actions come from the heart and are motivated by values and personal strategies, and imposed courses, lectures and systems have very little effect on the real behaviors. Moreover, as a veteran intelligence officer, this blogger can say with some authority that there is no system or procedure, however well-designed, that cannot be gamed if the culture permits it.

The VA has an opportunity here to ignore the usual solutions and instead to do something that works. People are whole humans, not disembodied intellects, and only a practical approach to values-based leadership on the part of the new Secretary can result in successful, lasting change As well, the VA will want to avoid almost all the conventional approaches which lack originality, credibility, results and measurement.

Our veterans deserve it.

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