By Suzanne Gordon
BeyondChron
January 20th, 2026
Most VA doctors and nurses don’t spend their lunch hours attending rallies in front of their hospital or clinic. They’re too busy charting, catching up on research, or reaching out to patients. On Wednesday January 15th, however, about 50 nurses, physicians, and other employees at a protest in front of the San Francisco VA Medical Center on Clement Street. They were there because, they argue, cuts in staff implemented by the Trump administration are crippling their ability to care for patients.
“It’s like we’re caring for patients with two hands tied behind our backs,” an internal medicine physician told me. “They have implemented a hiring freeze here. We can’t fill positions that were vacant because they’re frozen. We lost a Whole Health Coach position; we’ve lost people who do scheduling of patient appointments.” These appointment schedulers are critical positions, the doctor explains. They’re the ones who make needed appointments and remind vets to actually show up for them.
The whole health coach that has been lost plays an important role in helping veterans make needed behavioral changes. The doctor gives me an example. Joe is a veteran whose sole desire in life is to play with his grandchildren. But he suffers from pain and depression and has trouble motivating himself to move. Since immobility will worsen his pain, and many other health conditions, the whole health coach would help him to slowly move first five, then ten, and then fifteen or more minutes a day. But this position has been eliminated by policies that have been implemented by Donald Trump’s VA Secretary, former Georgia Congressman, Doug Collins.
Ever since Collins took the helm of the nation’s second largest federal agency, the Department of Veterans Affairs (VA), he and his staff (with the support of Republicans in Congress) have been relentlessly dismantling the Veterans Health Administration (VHA) –the nation’s largest, and most successful healthcare system. Studies consistently confirm that the VHA delivers care that is equal or superior to the private sector.
Collins spent the first days on the job firing probationary employees, cutting researchers who were on contract with the Veterans Health Administration, and announcing that he wanted to cut 83,000 – out of almost 400,000 employees – who’d dedicated their careers to fulfilling Abraham Lincoln’s promise to care for those who had borne the battle.
After a storm of protest, Collins back tracked and said he wouldn’t outright fire employees. He’d accomplishing his DOGE like goal by refusing to fill 30,000 positions left vacant when someone died, retired, or left for another job. These kind of vacancies are routine in any healthcare facility or practice. Those committed to providing high quality patient care fill needed positions immediately.
As if leaving positions unfilled wasn’t a significant enough blow, just before Thanksgiving, Collins announced that he would cap positions at every VA facility in the country. In August the VA Office of the Inspector General (OIG) documented a 50 percent increase in “severe shortages” between fiscal years 2024 and 2025. Ignoring this entirely, Collins gave directors of medical centers and clinics a month to decide which vacant positions to eliminate, and which job offers to rescind. Even though many of these positions – clerks, doctors, nurses, radiology techs – were desperately needed, they would be permanently erased from the organizational charts and thus would be impossible to fill in the future. At the San Francisco VA, about 60% of needed positions would be vaporized.
VA spokesman Peter Kasperowicz has claimed that positions being eliminated are no longer necessary. “Care won’t be affected because no VA employees are being removed. Most (of these positions) have not been filled for more than a year, underscoring how they are no longer needed.”
Military Times recently reported that Collins insists that these cuts will not impact care because “The issue is not how many people we have; it’s how well we are using those people,” This laughable assertion is belied by the facts and maps like this detailing the extent of the cuts nationwide.
Zero into what’s happening in California and you discover that the situation is truly is alarming. California is home to about 1.5 million veterans, of whom about half are eligible for VHA healthcare (complex requirements determine who does, and does not, have access to the free healthcare services the DoD promised recruits when they enlisted). Before Collins’ took his wrecking ball to VA healthcare, the San Francisco system had about 3800 employees who served about 100,000 veterans at the SF VA Medical Center and/or at Community Based Outpatient Clinics (CBOCs) located in Santa Rosa, San Bruno, Downtown San Francisco, Eureka, and Ukiah.
In his speech at the rally, Mark R. Smith, a VA occupational therapist and President of Local One of the National Federation of Federal Employees (NFFE) (who was careful to note that he was speaking in his personal capcity not on behalf of the VA or federal government) outlined the shock and awe assault that Trump and Collins have unleashed over the last year. The administration has abrogated all contracts with the unions, like NFFE and AFGE (The American Federation of Government Employees) that represent VA workers. For decades, these unions had offices in VA facilities. In an attempt to deny federal workers a voice and decent working conditions, Trump did away with all the entire union contract and NFFE was unceremoniously ejected from its office at the San Francisco VA hospital. This has made it increasingly difficult for unions like NFFE to assure that staff have any voice in designing or implementing policies that keep patients – and VA workers –safe.
At the SF VA, Smith says, staffing cuts and caps have targeted more than 150 clinical staff positions. Things have gotten so bad that the University of California just failed to renew its decades long radiology contract with the facility and UCSF radiologists will be at the SF VA only one day a week.
I also spoke at the rally, challenging Doug Collins’ insistence that staff cuts at the VA won’t impact veteran care because they will have many choices in the private sector. As the Veterans Healthcare Policy Institute documented in a 50 state analysis of private sector capacity to care for a huge influx of veterans, the nation is grappling with an epidemic of healthcare professional shortages. Across the United States, more than 79 million (that’s 23% of the US population and 30% of the adult population) live in areas with shortages of primary care providers; 123 million people live in areas with severe shortages of mental health providers. As a result of cuts to Medicaid, the ACA, and funding for academic health centers, the nation is about to lose 768 rural hospitals, including many in California and urban hospitals are also instituting hiring freezes and staffing cuts.
Another rally speaker was Army veteran, Katie Weber, who has been treated at the SF VA Medical Center and Santa Rosa Community Based Outpatient Clinic for decades. Weber, like too many women service members, was raped while on active duty and continues to cope with Military Sexual Trauma (MST). Weber told me that she has long depended on the VA for mental healthcare as well as for cancer treatment for cancer. “We’ve lost a lot of groups in Santa Rosa,” Weber told me, “My therapy at the Vet Center was weekly and I was healing so well, and then they cut it back to bi-weekly. They’re sending us to a call center to refill our meds instead of being able to request it from a provider. Why,” Weber asks, “for what reason?”
The answer is crystal clear. Trump is determined to cut back on government services – even to those who have sacrificed to serve their country – to fund tax cuts for billionaires. But, Weber says, “We won’t let them. We won’t stop. “
Weber attends weekly rallies in front of the Santa Rosa VA and drives down whenever she’s needed in front of the SF VA. “We not only have to fight this but also help with the morale of the staff.”
Suzanne Gordon, Author, Veterans, Wounds of War
Senior Policy Analyst, Veterans Healthcare Policy Institute
