Senior VA leaders have been trying to change the culture of the VA for decades. You have a Central Office that is totally disconnected from the field. Regulations are vague at best open to many interpretations. And, each facility has become a fiefdom (Marcher Baron is what comes to mind) unto themselves. It will take way more than 2 years to see any change. A friend of mine put it best: “The VA has been living in perception for so long, that when reality is forced on them, they don’t know how to act and try with all their might to go right back to the safety of perception.” But, historically, about every 40 years or so, the VA has a huge scandal, goes through a complete re-organization, and then the process starts all over again.