on the totem pole, the better they were in trying to help do something for you. The nurses have always been outstanding. The doctors are a mixed group, ranging from outstanding to, well you know, doctors think they are God. Once they get higher than that, my experience is that there is a steep downfall and those that run the hospitals are just politicians and mid-level managers caring more about looking good on reports and moving up than helping the vets.
I remember seeing on the wall at my local VA Medical Center multiple sheets of paper showing how they were one of the top ones but their numbers were mostly in the 80% percentile but better than the rest. They were proud of being in the top tier but all I saw in the numbers was that they showed that the best was pleasing only 4 out of 5 veterans - nothing to be proud of IMHO.
I can just see in my mind the big shots sitting around the table wondering why their claims processing numbers were not good and then deciding that the beatings would continue until the morale improved among the processors.