Veterans Affairs committee  It's one of the larger VA medical centres. I believe it services—my numbers may not be exactly correct—over 100,000 veterans a year.

Veterans Affairs committee  Size can make the culture that much more difficult to change, because the larger an organization, the more difficult it is going to be to change a culture that's been there for a while.

Veterans Affairs committee  It's pretty much the same thing to investigate. When I was in the private practice of law, I looked at lots of industries, including the health care industry, and you become an expert on whatever the various topic is. I did have to learn about VA in particular, but that learning

Veterans Affairs committee  I couldn't agree with you more. Our staff, our folks, are very dedicated and committed to our work, because we realize that the better the job we do, the better the services veterans will receive, and they so richly deserve them.

Veterans Affairs committee  That's very fair to say, yes.

Veterans Affairs committee  There are hundreds of investigations at any one time.

Veterans Affairs committee  It was my pleasure.

Veterans Affairs committee  I don't believe we have any open projects in this area at the time. We're certainly well aware of the issue. We look at issues on a regular basis to see if we should expend resources there, but as of this time, I don't believe we have any open projects.

Veterans Affairs committee  We are just finishing up a national review of pain management practices that includes recommendations. Typically our recommendations are going to be focused on what the VA policy or practice is in a particular area and whether they are following that policy or practice. If we thi

Veterans Affairs committee  We'll listen to why they don't agree with it. If we still think it's a valid recommendation that we think is appropriate under the circumstance, we will keep it in the report, and we will note that the department does not concur with that recommendation, but it's an open recommen

Veterans Affairs committee  Yes.

Veterans Affairs committee  I think it really starts and stops at the top. The saying is that you're a reflection of your leadership. What I think we're going to find when we finish our work in D.C. is that the tone at the top is still critical, and if you don't have the leadership at the very top of the

Veterans Affairs committee  Well, we hope they don't get worried. It's that we're here and we're going to do our work. It's a combination of both. For the medical centres, we have an inspection program. We now show up unannounced. We try to inspect every medical centre at least every three years or so. It c

Veterans Affairs committee  Yes. We treat with respect everybody who provides us information. We try to listen to what they have to say. Unfortunately, some of what is told to us is not always accurate, and at some point we have to identify that, and given our limited resources, we're not able to go further

Veterans Affairs committee  For something like that to change a policy of the VA, it would be to go through the VA. If we see something that we think could be something that would make the VA more effective for veterans, we might write a report on it after doing an audit or review, or just some kind of asse