This is not surprising considering what the VA does on a local level. At the Reno VA Hospital for example in 2002-(first half of) 2003 they had 1 doctor in the Reno Eye Clinic. She had a list of over 3,000 vets that needed appointments for a regular eye exam or other services that as the only doctor she couldn't handle, and for some reason couldn't refer out. About 2 months before she left to go into private practice the staff in the eye clinic was reassigned to a nurse for supervision. For over 3 months no one at the eye clinic was responsible for answering the phone. The nurse that was put in charge of the eye clinic was given a bonus for "streamlineing" the VA Eye Clinic...and getting rid of the list of vets that needed eye treatment. She got rid of it by throwing it in the trash. No vet on that list was seen as a reference to the list. About 30 days before the only doctor in the clinic lefte they hired an optometrist (not at DOCTOR) to run the facility. The optometrist was making not only management decisions but MEDICAL decisions. Probably in violation of the law. I lost almost 80% of my vision in one eye because of her bad judgement, and lack of medical qualifications.