Veterans: If you are facing a medical emergency, be prepared for long delays if you need care after hours, on weekends or on holidays.
In the cable TV drama “The Pitt,” a cyberattack crashes the electronic systems in the emergency department. Doctors race against dangerously long radiology wait times placing lives at risk; fortunately, the crisis quickly resolves.
A similar crisis has developed nationwide in the ERs of Veterans Affairs facilities. But it’s not a fictional cyberattack. Instead, it is a direct result of changes implemented by President Donald Trump. The budget and staffing cuts made under Trump and Elon Musk — when he was head of the Department of Government Efficiency — are the reasons why veterans are waiting hours in VA emergency rooms while doctors are calling, pleading for radiology results.
Radiology is a specialty in which doctors interpret X-rays, CT scans and other imaging. When a doctor orders urgent scans in the ER, results should arrive within an hour. However, on the night of my final ER shift before retiring this spring, ERs in the VA system were warned that radiology results were delayed by over five hours.
Just a week before that, a veteran arrived in the ER with severe abdominal pain and alarming vital signs. The ER staff began lifesaving treatment and ordered a CT scan to identify the cause. In these moments, quick diagnosis is essential.
The CT scan was performed quickly, but definitively reviewing the images requires a radiologist. Seattle VA staff transmitted the images to the National Teleradiology Program, the VA’s centralized off-site radiology service. During weekday office hours, VA hospitals have on-site radiologists. For nights, weekends and holidays, the NTP, in California, steps in.
During this wait, the patient’s fate hinged on that radiology report. The ER doctor, observing clear abnormalities, called NTP, asking for urgent review. Whether the patient went to the operating room or was to be treated non-surgically in the ICU depended on that radiologist’s report.
As hours passed, responsibility passed to the next ER doctor. The veteran’s pain persisted despite IV opioids. Again, the ER doctor called NTP. But, too few radiologists on duty meant hundreds of urgent scans across the nation were waiting in the queue.
After a 10-hour delay, the CT report confirmed a perforated intestine and life-threatening peritonitis: a surgical emergency. The long delay reduced the patient’s chances of survival.
These lengthy radiology delays are now common and disrupt the entire VA healthcare system. Frontline ER doctors face the hardest decisions, while veterans in emergency situations bear the greatest risk. When radiology reports are delayed, ER doctors must choose between reading scans themselves and risking error, or transferring veterans to hospitals with functioning radiology programs. Or, simply waiting hour after hour.
The Office of Inspector General investigated NTP delays before the second Trump Administration. From our experience, the delays that started in 2025 have worsened significantly and, as with the abdominal pain patient, are risking lives. On some nights, only a handful of radiologists cover VA medical centers nationwide.
Unfortunately, what’s happening is not a made-for-TV cyberattack that could be satisfyingly wrapped up in an episode of “The Pitt.” President Trump set out to cut the federal civil service, and he succeeded: His Inauguration Day executive order terminating remote work arrangements included VA radiologists.
The American College of Radiologists warned against this change, which indeed has broken the NTP system.
What is easy to break may not be so easy to fix. The 2025 OIG report documented recruitment difficulties due to a national radiologist shortage. Based on our experience with this damage to NTP, VA is no longer an employer of choice for radiologists.
The nation is facing a crisis in providing emergency care for our veterans. Americans need to contact their elected members of Congress and ask them to repair the damage done to the VA.
After 41 years caring for thousands of veterans, these were my parting words to my last veteran patient: “I’m sorry. You’ll be waiting for several hours for this CT scan report to come back.” That night, the average wait for emergent radiology reports was five hours and 21 minutes.
